Does Repeated Exposure to Critical Situations in a Screen-Based Simulation Improve the Self-Assessment of Non-Technical Skills in Postpartum Hemorrhage Management?
Does Repeated Exposure to Critical Situations in a Screen-Based Simulation Improve the Self-Assessment of Non-Technical Skills in Postpartum Hemorrhage Management?
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DOI：
10.1177/1046878119827324
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发表时间：
2019-04-01
影响因子：
2
通讯作者：
Tesniere, Antoine
中科院分区：
文献类型：
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作者：
Barre, Jessy;Michelet, Daphne;Tesniere, Antoine
背景。产后出血（PPH）是全世界孕产妇死亡的主要原因。非技术技能（如沟通）现在被认为是促进医疗安全的一个因素。在仿真领域，基于屏幕的仿真是当前计算机技术发展的热点。本研究评估了一种基于屏幕的模拟设备PerinatSims，该设备用于提高PPH情况下的技术和非技术技能。本实验假设接触和重复使用PerinatSims训练可以提高非技术技能的自我评估，从而提高管理PPH的能力。方法。主要终点是在数字模拟器上模拟PPH期间对非技术技能的自我评估。20名法国助产士进行了9次25分钟的PPH屏幕模拟中的3次。在每个模拟环节结束时进行四份自我评估问卷：领导力/团队工作问卷（BAT）、负面情绪/情绪问卷（das -21）、心流问卷（Flow）和心理负荷问卷（NASA-TLX）。使用重复测量方差分析和Bonferroni事后检验比较两次治疗之间的结果。结果。研究发现，在三个基于屏幕的模拟过程中，参与者的领导能力和团队工作自我评估有所提高，心流感有所提高，负面情绪（DASS-21得分中的焦虑和抑郁）有所减少。压力的显著减少只在第二和第三阶段之间被发现，而NASA-TLX的显著差异只在两个维度上被观察到，表现和挫折。结论。使用基于屏幕的模拟工具反复暴露在PPH情境中，可以提高助产士的自我评估，特别是在领导力、团队合作、情绪管理和心流感方面。此外，助产士对该设备的反馈非常积极。他们强调希望更多地使用PerinatSims来接受PPH管理方面的培训，包括技术和非技术技能。
Background. Postpartum hemorrhage (PPH) is the leading cause of maternal death in the world. Non-technical skills (e.g. communication) are now recognized as a contributing factor to medical safety. In the field of simulation, screen-based simulations are currently very popular with computer/technological development. This study evaluates a screen-based simulation device, PerinatSims, developed to improve technical and non-technical skills in PPH situation. This experiment hypothesized that exposure and repetition of training with PerinatSims would improve the self-assessment of non-technical skills, and therefore increase the ability to manage PPH. Methods. The primary endpoint was a self-assessment of non-technical skills during simulation session of PPH on a digital simulator. Twenty French midwives performed three of nine 25 minutes sessions of PPH screen-based simulation. Four self-assessment questionnaires were administered at the end of each simulation session: a leadership/team working questionnaire (BAT), a negative feelings/emotional questionnaire (DASS-21), a Flow questionnaire and a mental load questionnaire (NASA-TLX). Results between sessions were compared using a repeated measures ANOVA followed by a Bonferroni post hoc test. Results. The study showed a positive evolution during the three screen-based simulation sessions: an increase of leadership and team working self-assessment, an increase of Flow sense, and a decrease of negative emotions (anxiety and depression in the DASS-21 score). Significant decrease of stress was found only between the second and the third sessions, and significant differences in the NASA-TLX were observed only in two dimensions, Performance and Frustration. Conclusion. A repeated exposure to PPH situations with a screen-based simulation tool improved the midwives' self-assessment, especially for leadership, team working, emotion management and Flow sense. Furthermore, midwives had a very positive feedback on the device. They highlighted the desire to use PerinatSims more often to be trained to PPH management, for technical as well as non-technical skills.