Simulation-based training for determination of brain death by pediatric healthcare providers.
Simulation-based training for determination of brain death by pediatric healthcare providers.
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DOI：
10.1186/s40064-015-1211-4
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Nishiyama K
中科院分区：
文献类型：
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作者：
Araki T;Yokota H;Ichikawa K;Osamura T;Satomi A;Tsuru T;Umehara M;Niitsu T;Yamamoto T;Nishiyama K
在以往的全国性研究中，儿科医生确定脑死亡（BD）的能力较低，对日本BD（JBD）标准不熟悉。由于2010年修订了JBD标准，允许儿科脑死亡供体捐献器官，因此我们创建了为期2天的培训课程，以评估儿科BD确定和诊断方面的知识并提高技能。该课程包括两个单元：多站圆桌会议和小组讨论会，并以20个问题的前后测试作为结束。在多站轮会议上，与会者在由专家教员组成的工作站之间轮换。对于实践技能开发，我们使用Sim Junior 3G™模拟人体模型（美国纽约州沃平格斯福尔斯的挪度医疗公司）进行结构化模拟。在小组讨论环节中，我们实施了基于模拟的角色扮演，以在复杂的临床情况下练习决策。通过自我评分和问卷调查的方式调查了学员对课程的印象。来自多个专业的147名儿科医疗保健提供者参加了这门课程，145人完成了整个过程。采用自我评分法和问卷调查法，从价值（4.58 ± 0.64，范围1-5）、时间安排（2.40 ± 0.61，范围1-3）和难度（2.89 ± 0.43，范围1-5）三个方面对课程进行评价。最后，参与者对整个课程计划进行评分（9.64 ± 1.69;范围1-11）。从93名参与者那里获得了各种积极的反馈。后测成绩（83.6%）显著高于前测成绩（62.9%）。这种基于模拟的课程是一种有效的方法，以培训儿科医疗保健提供者在确定BD在日本，并可能提高基线知识的BD参与者。
Low competency for determination of brain death (BD) and unfamiliarity with Japanese BD (JBD) criteria among pediatricians were highlighted in previous nationwide studies. Because the JBD criteria were amended in 2010 to allow organ donation from pediatric brain-dead donors, we created a 2-day training course to assess knowledge and improve skill in the determination and diagnosis of pediatric BD. The course consisted of two modules: a multistation round session and a group discussion session, and was bookended by a before and after 20-question test. In the multistation round session, participants rotated between stations staffed by expert faculty members. For hands-on skill development, we used the Sim Junior 3G™ simulation mannequin (Laerdal Medical, Wappingers Falls, NY, USA) for structured simulations. In the group discussion session, we implemented simulation-based role playing to practice decision making in prepared scenarios of complicated clinical situations. We investigated the participants’ impressions of the course by self-scoring and questionnaires. Of 147 pediatric healthcare providers from multiple specialties who participated in this course, 145 completed the entire process. The course was evaluated in three aspects with self-scoring and questionnaires: (1) value (4.58 ± 0.64; range 1–5); (2) time schedule (2.40 ± 0.61; range 1–3); and (3) difficulty (2.89 ± 0.43; range 1–5). Finally, participants scored the entire course program (9.64 ± 1.69; range 1–11). Various positive feedbacks were obtained from a total of 93 participants. Post-test scores (83.6 %) were significantly higher than pre-test scores (62.9 %). This simulation-based course represents an effective method to train pediatric healthcare providers in determining BD in Japan and may improve baseline knowledge of BD among participants.