How to Do More with Less in Simulation

2015年，怀孕期间和分娩后立即死亡30万妇女死亡。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.

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.

大多数教育者会认为学习目标是任何班级中最重要的要素。提醒一句，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。

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.⁷This proves thatsimulation, rather than the type of simulator, is the key to developing your learners.

Worldwide each 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.

有许多仿真方法可以选择...关键是选择提供与学习者积极参与的技术或方法。

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。¹⁰And, an estimated 60,000 women suffer complications that are near-fatal.¹¹作为回应,一些医院开始及其ment 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 youdohave 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’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.