How to Do More with Less in Simulation

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 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.³这些在坦桑尼亚产生的相同解决方案在美国和其他地方也可以做到这一点。

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,training using simulation is a proven way to identify and reduce preventable error.

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.

在低资源领域，教育工作者别无选择，只能做更多的事情。但是，在这种情况下，教学经验较少，激发了教育工作者返回课程设计和模拟的基础知识。

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.

许多专家建议您从期望的结果开始。然后，使用聪明的相应地制定学习目标的框架。问问自己的学习目标是否是…

Specific

Measurable

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.⁶通过明确定义组织的目标，LGH可以创建解决方案和计划以帮助您到达那里。您也可以通过使用智能方法来创建强大的学习目标以及随后实现强大的学习目标来为成功做好准备。

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!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.

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。⁷这证明了这一点simulation, rather than the type of simulator, is the key to developing your learners.

每年在全球范围内，有1.4亿妇女分娩。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，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.

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。

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。