Advanced neonatal procedural skills: a simulation-based workshop: impact and skill decay.
Advanced neonatal procedural skills: a simulation-based workshop: impact and skill decay.
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DOI：
10.1186/s12909-023-04000-1
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发表时间：
2023-01-13
影响因子：
3.6
通讯作者：
Amin, Harish
中科院分区：
文献类型：
--
作者：
Stritzke, Amelie;Murthy, Prashanth;Fiedrich, Elsa;Assaad, Michael-Andrew;Howlett, Alexandra;Cheng, Adam;Vickers, David;Amin, Harish
新生儿围产期医学（NPM）专业的受训人员必须能够根据加拿大皇家学院的要求掌握广泛的程序技能。虽然常见的新生儿程序在日常临床实践中很常见，有机会获得能力，但在获得高级新生儿程序技能方面存在很大差距。随着设计能力进入NPM培训，模拟提供了一个独特的机会，以获得，实践和教授潜在的救生程序技能。关于模拟训练对不同能力领域和技能衰减的影响知之甚少。我们设计了一个独特的基于模拟的4小时研讨会，涵盖了6个先进的程序，因为它们的稀有性，但挽救生命的效果选择：胸管插入，除颤，交换输血，骨内（IO）访问，超声引导穿刺和心包穿刺术。在一组NPM和高级普通儿科志愿者中，测量了手术技能（DOPS）的直接观察（1），自我感知能力，舒适度和认知知识（2），9-12个月后（技能衰减，3），以及第二次研讨会后（4）。23名参与者的所有6项手术的DOPS从3.83增加到4.59。除颤和胸管插入在第一次研讨会前后DOPS增加最快。所有手术的技能下降都很明显，其中交换输血的下降幅度最大，其次是心包穿刺术、除颤和胸管。自我感知能力，舒适度和认知知识增加所有六个程序在四个时间点。交换输血在没有DOPS增加的情况下脱颖而出，最大的技能衰减和对自我评估能力和舒适度的影响最小。与自我评估相比，所有的技能都被导师认为更好。基于模拟的干预高级程序技能日增加了导师评估的直接观察程序技能的所有技能检查，除了交换输血。技能衰退会在9-12个月后影响这些技能。胸管插入和除颤可能受益于提醒会议，心包穿刺术可能足以教学一次。受训者的观察技能优于他们自己的评估。助推器会议的效果小于第一次干预，但最终得分高于干预前。不适用，不是医疗保健干预。在线版本包含补充材料，可通过10.1186/s12909-023-04000-1获得。
Trainees aiming to specialize in Neonatal Perinatal Medicine (NPM), must be competent in a wide range of procedural skills as per the Royal College of Canada. While common neonatal procedures are frequent in daily clinical practice with opportunity to acquire competence, there are substantial gaps in the acquisition of advanced neonatal procedural skills. With the advent of competency by design into NPM training, simulation offers a unique opportunity to acquire, practice and teach potentially life-saving procedural skills. Little is known on the effect of simulation training on different areas of competence, and on skill decay. We designed a unique simulation-based 4-h workshop covering 6 advanced procedures chosen because of their rarity yet life-saving effect: chest tube insertion, defibrillation, exchange transfusion, intra-osseus (IO) access, ultrasound-guided paracentesis and pericardiocentesis. Direct observation of procedural skills (DOPS), self-perceived competence, comfort level and cognitive knowledge were measured before (1), directly after (2), for the same participants after 9–12 months (skill decay, 3), and directly after a second workshop (4) in a group of NPM and senior general pediatric volunteers. The DOPS for all six procedures combined for 23 participants increased from 3.83 to 4.59. Steepest DOPS increase pre versus post first workshop were seen for Defibrillation and chest tube insertion. Skill decay was evident for all procedures with largest decrease for Exchange Transfusion, followed by Pericardiocentesis, Defibrillation and Chest Tube. Self-perceived competence, comfort and cognitive knowledge increased for all six procedures over the four time points. Exchange Transfusion stood out without DOPS increase, largest skill decay and minimal impact on self-assessed competence and comfort. All skills were judged as better by the preceptor, compared to self-assessments. The simulation-based intervention advanced procedural skills day increased preceptor-assessed directly observed procedural skills for all skills examined, except exchange transfusion. Skill decay affected these skills after 9–12 months. Chest tube insertions and Defibrillations may benefit from reminder sessions, Pericardiocentesis may suffice by teaching once. Trainees’ observed skills were better than their own assessment. The effect of a booster session was less than the first intervention, but the final scores were higher than pre-intervention. Not applicable, not a health care intervention. The online version contains supplementary material available at 10.1186/s12909-023-04000-1.
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影响因子：
2.9
作者：
Bismilla, Z.;Finan, E.;Whyte, H.
通讯作者：
Whyte, H.
DOI：
10.1097/acm.0b013e318217e119
发表时间：
2011-06
期刊：
Academic medicine : journal of the Association of American Medical Colleges
影响因子：
--
作者：
McGaghie WC;Issenberg SB;Cohen ER;Barsuk JH;Wayne DB
通讯作者：
Wayne DB
影响因子：
8.8
作者：
Barsuk, Jeffrey H.;McGaghie, William C.;Wayne, Diane B.
通讯作者：
Wayne, Diane B.
影响因子：
9.5
作者：
Chen, G;Gully, SM;Eden, D
通讯作者：
Eden, D
影响因子：
2.9
作者：
Finan, E.;Bismilla, Z.;Whyte, H. E.
通讯作者：
Whyte, H. E.