Kaczorowski J, Levitt C, Hammond M, Outerbridge E, Grad R, Rothman A, Graves L
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Fam Med. 1998 Nov-Dec;30(10):705-11.
This study compared the effectiveness of two booster strategies designed to improve retention of skills and knowledge in neonatal resuscitation by family practice residents.
Residents were randomly allocated to one of three groups: video, hands on, or control. Residents in the two experimental groups received a "booster" 3-5 months after the Neonatal Resuscitation Program (NRP) course. All participants completed the follow-up test 6-8 months after taking the course. The main outcome measures consisted of the NRP written examination and the performance checklists.
A total of 44 residents completed the study (video, n = 13; hands-on, n = 14; control, n = 17). Overall, participants had significantly lower scores at follow-up than at baseline, indicating deterioration in both neonatal skills and knowledge. Residents in the hands-on booster group made significantly fewer errors across all five checklists in life-supporting but not in lifesaving scores than those allocated to the control and video groups.
The beneficial effect of mannequin practice or video boosters on skills and knowledge retention was less than what had been anticipated, and no benefit could be demonstrated in comparison to the control group. Deteriorating knowledge and skills remain a major concern, since boostering by hands-on or video at 3-5 months do not seem to have an impact on the retention of knowledge or lifesaving skills.
本研究比较了两种强化策略对家庭医学住院医师新生儿复苏技能和知识保持效果的影响。
将住院医师随机分为三组:视频组、实践组或对照组。两个实验组的住院医师在新生儿复苏项目(NRP)课程结束3 - 5个月后接受一次“强化培训”。所有参与者在课程结束6 - 8个月后完成后续测试。主要观察指标包括NRP笔试和操作检查表。
共有44名住院医师完成了研究(视频组,n = 13;实践组,n = 14;对照组,n = 17)。总体而言,参与者在随访时的得分显著低于基线,表明新生儿技能和知识均有所下降。在所有五项生命支持检查表中,实践强化组的住院医师犯错明显少于对照组和视频组,但在救生得分方面无差异。
模拟练习或视频强化对技能和知识保持的有益效果低于预期,与对照组相比未显示出益处。知识和技能的下降仍是一个主要问题,因为在3 - 5个月时进行实践或视频强化似乎对知识或救生技能的保持没有影响。