如何在模拟中少做更多的事情

In 2015, more than 300,000 women died during pregnancy and immediately following childbirth.¹这些死亡中有99％发生在发展中国家。²由Laerdal Medical资助的非营利组织Laerdal Global Health（LGH）制定了降低低资产社国家的母亲和婴儿死亡188体育直播比分率的计划。我们认为，可以从LGH的经验中学到很多东西，这些经验可以转移到高级课程的环境中。

LGH was founded in 2010. Working in partnership with Jhiepego, the American Academy of Pediatrics, and the Church of Latter-Day Saints, LGH has helped make tremendous improvements in the health of new mothers and newborns in developing countries. A study in Tanzania, for example, measured the success of the Helping Babies Breathe Program with a sustained 47% reduction in early neonatal mortality within 24 hours and a 24% reduction in fresh stillbirths after 2 years.³these same solutions that have made a difference in Tanzania can do the same in the United States and elsewhere.

尽管在美国，医疗设施和专业培训更加先进，但总有改进的余地。每年在美国，由于怀孕或分娩并发症，每年约有700名妇女死亡。⁴世界卫生组织（WHO）计算出大约一半是可以预防的。⁵幸运的是，training using simulation is a proven way to identify and reduce preventable error.

在本文中，我们分享了如何将Laerdal Global Health及其合作伙伴的经验转移到您的培训环境中，以改善孕产妇和新生儿护理。

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,without purposeful learning goals, there is no desired outcome to unify you as the educator with your learners.

many experts recommend that you start with what your desired outcome is. Then, use thesm一个rtframework to craft your learning goals accordingly. Ask yourself if your learning goals are…

specific

measurable

一个可见

r真实

time绑定

LGH的目标是通过提供支持卫生工作者的工具和培训来帮助到2020年每年挽救40万人的生命。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.

当您开始计划单个模拟时，请记住学习者的经验水平以及学习的设置。您可能没有专门的模拟实​​验室的资金 - 没关系！Consider the setting of LGH’s trainings in Tanzania and use that as inspiration to get creative with the existing resources, faculty, and equipment you have.

One study compared two simulations – one using a standardized patient at a local hospital and one using a high-fidelity simulator in a simulation lab. In both settings, there were equal improvements among the learners.⁷这证明了这一点模拟而不是模拟器的类型是开发学习者的关键。

Worldwide each year, 140 million women give birth.⁸to improve the survival of new mothers and infants, healthcare professionals need to be given engaging and fulfilling training. Simulations that adhere to the best practices in adult learning can provide this. Not every situation requires high-fidelity to gain a high return on learning. Experts recommend matching the level of your simulation with the experience you need to create for effective learning to occur.

高保真模拟训练会导致表“发抖”endous improvements in learner’s skills acquisition. For this reason, many educators adopt a form of tunnel-vision towardonly高保真模拟和可以忽略ir desired outcome in the process. Those new to simulation may find funding such high-fidelity simulators challenging and those experienced in simulation may be blind to other, complimentary methods of teaching.

LGH的经验证明了低保真任务培训师和模拟器可以极大地提高学习者的技术技能和人际交往能力。没有电气要求或复杂的设置。通过与JHPIEGO合作开发的帮助母亲生存计划，我们看到产后出血降低了17％，保留胎盘降低了47％，降低了34％的胎盘静止病。⁹因此，您不应忽略低保真模拟作为选项。

there are many simulation methods from which to choose...The key is selecting the technology or method that provides for active engagement with the learner.*

In the United States, the cost of maternity care exceeds 60 billion dollars, yet women are still dying during pregnancy or childbirth.¹⁰一个nd, an estimated 60,000 women suffer complications that are near-fatal.¹¹In response, some hospitals are beginning to implement more hands-on training to manage obstetric emergencies – and they are using simulation to accomplish this.

Low-fidelity simulation is also a great supplement to your program if you做具有一个完全发出的分娩模拟器。全身模拟器的技术可能会淹没母亲劳动母亲的护理程序的学习者。在这种情况下，在向他们介绍更身临其境的培训经验之前，使用低保真分娩模拟器或任务培训师可以确保您的学习者对自己的技能充满信心。

LGH’s experience training midwives and other healthcare professionals in rural areas shows the impact low-fidelity solutions can have. Whether your simulation experience level is high or low – or your facility is large or small – low-fidelity simulation is something to consider.