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如何通过产科模拟培训到达农村社区
圣安东尼奥的大学医院是一家领先的教学医院。围产期外展计划通过多学科模拟培训为南德克萨斯州周边地区的社区医院提供支持。
In 2015, more than 300,000 women died during pregnancy and immediately following childbirth.199% of these deaths occurred in developing countries.2Laerdal Global Health (LGH), a not-for-profit organization funded by Laerdal Medical, develops programs to reduce maternal and infant mortality rates in low-resource countries. We believe a lot can be learned from LGH’s experience that can be transferred to high-resourse environments.
LGH成立于2010年。与Jhiepego,美国儿科学会和后期圣徒教会合作,LGH帮助了发展中国家的新母亲和新生儿的健康。例如,在坦桑尼亚进行的一项研究测量了帮助婴儿呼吸计划的成功,在24小时内,新生儿死亡率持续降低了47%,两年后新生的死亡人数降低了24%。3These same solutions that have made a difference in Tanzania can do the same in the United States and elsewhere.
reduction in early neonatal mortality
减少新生
Though medical facilities and professional training are more advanced in the U.S., there is always room for improvement. Each year in the U.S., approximately 700 women die each year as a result of pregnancy or delivery complications.4The World Health Organization (WHO) calculates that about half of these are preventable.5Fortunately,使用仿真训练是识别和减少可预防错误的验证方法。
In this article, we share how you can transfer Laerdal Global Health’s and its partners experience into your training setting to improve maternal and newborn care.
In low-resource areas, educators have no choice but to do more with less. The experience of teaching with less in this case, though, has inspired educators to return to the basics of curricular design and the fundamentals of simulation.
Most educators would argue that learning goals are the most important element in any class. As a reminder,没有有目的的学习目标,就没有理定的结果将您与学习者统一为教育者。
Many experts recommend that you start with what your desired outcome is. Then, use theSMARTframework to craft your learning goals accordingly. Ask yourself if your learning goals are…
| S特定 | M可靠 | Attainable | Realistic | Time-bound |
LGH’s goal is to help save 400,000 more lives annually by 2020 by providing the tools and training to support health workers.6By clearly defining what the organization aims to achieve, LGH can create solutions and programs to help get you there. You, too, can set yourself up for success by using the SMART method to create strong learning goals and, subsequently, strong learning objectives.
As you begin to plan individual simulations, keep in mind the experience level of your learners as well as the setting where your learning will take place. You might not have the funding for a dedicated simulation lab – and that’s okay!考虑一下LGH在坦桑尼亚的培训的设置,并以此为灵感来获得创造性的创造力,以利用您拥有的现有资源,教师和设备。
一项研究比较了两个模拟 - 一项模拟 - 一项在当地医院使用标准化患者,另一个在模拟实验室中使用高保真模拟器。在这两种情况下,学习者之间都有平等的进步。7This proves thatsimulation, rather than the type of simulator, is the key to developing your learners.
全世界的每一个year, 140 million women give birth.8为了改善新母亲和婴儿的生存,需要给予医疗保健专业人员参与和实现培训。遵守成人学习中最佳实践的模拟可以提供这一点。并非每种情况都需要高保真才能获得很高的学习回报。专家建议将模拟的水平与您创建的有效学习的经验相匹配。
High-fidelity simulation training can lead to tremendous improvements in learner’s skills acquisition. For this reason, many educators adopt a form of tunnel-vision toward只要高保真模拟,可能会在此过程中忽略其预期的结果。那些新手模拟的人可能会发现这种高保真模拟器具有挑战性的资金,而在模拟中经历的人可能对其他免费的教学方法视而不见。
LGH’s experience is proof that low-fidelity task trainers and simulators can vastly improve a learner’s technical skills and interpersonal skills.Without electrical requirements or complicated set-up. Through the Helping Mothers Survive program, developed in collaboration with Jhpiego,we have seen a 17% reduction in postpartum hemorrhage, 47% reduction in retained placenta, 34% reduction in intrapartum stillbirth.9For this reason, you should not ignore low-fidelity simulation as an option.
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有许多仿真方法可以选择...关键是选择为与学习者积极参与的技术或方法。 |
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在美国,产假费用超过600亿美元,但妇女在怀孕或分娩时仍在死亡。10而且,估计有60,000名妇女遭受近乎致命的并发症。11作为回应,一些医院开始实施更多的动手培训来管理产科紧急情况 - 他们正在使用模拟来实现这一目标。
If your simulation program does not have access to a full-body birthing simulator, low-fidelity simulation might be the answer. Birthing simulators and task trainers that can be used with a standardized patient offer an opportunity for learners to engage in real patient interactions. Learners can also practice essential skills for normal and complicated deliveries so that they are prepared to act in an emergency.
一项研究发现,只有43%的学习者能够成功解决肩膀障碍的紧急情况。12Following a simulated shoulder dystocia scenario, learners improved in the use of basic maneuvers, good patient communication, and higher successful delivery rate.13
如果您dohave a fully-articulating birthing simulator. Learners that are new to the care procedures for a mother in labor may be overwhelmed by the technology of a full-body simulator. In this case,using a low-fidelity birthing simulator or task trainer can ensure that your learners are confident in their skills before introducing them to a more immersive training experience.
LGH在农村地区培训助产士和其他医疗保健专业人员的经验表明,低保真解决方案可能产生的影响。无论您的仿真体验水平高还是低 - 还是大小的设施,低保真模拟都是值得考虑的。
Creating a realistic training environment is always a challenge. Add to that the complexities of low funding, scarce teaching resources, and limited time for training and it can become quite a puzzle. LGH and its partners have witnessed these challenges first-hand around the world – and helped healthcare professionals overcome them.
对于许多人来说,模拟培训解决方案是一项投资 - 不仅在改善学习成果方面,而且在不可避免的成本节省和对机构的责任下降。重要的是要记住,这些节省成本将以减少与伤害相关的伤害和成本的形式,而不是直接利润。
Our aim is to train healthcare professionals to provide the highest quality care, and there are examples where this can reduce costs…We’re teaching healthcare professionals to pick up on things before they escalate.
低保真模拟在学习周期中占有一席之地。如果您的计划没有很多资金选择,则可以是一种有用的培训方法。高保真模拟可能是昂贵的,并且需要更大的初始投资,但是低保真模拟可以提供类似的资源的经验。14And,low-fidelity simulation can help to mitigate implementation barriers such as low faculty expertise and availability.
在美国,规划社区外展的低预算诊所和组织可以从相同的成本意识心态中受益。由于众多的医院设施在低收入社区关闭,诊所正在接受高危患者的涌入。15为了更好地准备城市和农村诊所的医疗保健专业人员,在制定任何培训计划时,应考虑在低资源国家使用的相同任务培训师和分娩模拟器。
In addition to the affordability of low-fidelity simulators and task trainers, they are simple and easy to use. Educators with little to no simulation experience can quickly learn how to set up a scenario and are able to make the most of their teaching time. This type of training efficiency allows many students to train in a single learning session and reduces a care team’s time off the floor. For organizations struggling to find time for training, we suggest low-fidelity solutions as a start.
Choosing to invest in low-fidelity products that are within financial reach can still lead to significant reductions in patient harm. The ease of use and productivity are simply an added bonus for educators and trainees alike.
In the United States, women are more likely to die from childbirth or pregnancy-related causes than other women in the developed world.16许多医院没有进行模拟,很有可能他们认为模拟是一项需要主要设施的昂贵努力。我们在LGH的经验表明,它不一定是。
While Laerdal Global Health’s not-for-profit efforts are focused on low-resource countries, their insight and experience can be used to positively influence training within the U.S. Most importantly, their experience in various communities around the world verifies that simulation can be effective in any learning setting – as long as educators have clear objectives and the tools to match.

* Aebersold,M。(2018)。基于模拟的学习:不再是本科教育的新颖性。The Online Journal of Issues in Nursing, 23(2). Retrieved from:http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No2-May-2018/Articles-Previous-Topics/Simulation-Based-Learning-Undergraduate-Education.html
** New Jersey Health Care Quality Institute. (2018).Take five with james Spaulding, bsn, rn, ccrn, sim lab coordinator at st. peter’s university hospital.从...获得:http://www.njhcqi.org/take-five-with-with-james-spaulding-bsn-rn-ccrn-ccrn-sim-lab-coordinator-at-s-peters-peters-university--university-hospital/