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The Role of Low-Fidelity Simulation in Labor and Delivery

改善孕产妇和新生儿护理

Simulating birth scenarios can help healthcare professionals recognize and potentially mitigate adverse events for new mothers and newborns.1然而，为这些情景选择的现实程度或“富达”并不总是必须极端。通常，当教育工作者开始计划劳动和交付周围的情景时，他们的战略迅速跳跃高保真，全身的分娩模拟器。但，根据学习目标，计划和建立高保真仿真所需的努力可能是不必要的和劳动密集型的。

Low-fidelity simulation can provide learners with a wealth of training experience –以最少的费用。Below, we sum up three ways that you can use low-fidelity simulation training to reduce preventable harm to maternal and newborn patients.

Task Trainers – How Your Learners Can Improve Skills Performance

Situations that require repeated practice are best suited for use of a task trainer. For example, a great opportunity to use a task trainer is in the training of birthing assessments and different delivery protocols. Learners can practice hands-on, psychomotor skills independently and at their own pace without the complexity of a high-fidelity simulation.

In a study evaluating the training of shoulder dystocia using a birthing simulator, learners saw a 44% improvement in the following.2

  1. 评估
  2. 寻求帮助
  3. Positioning
  4. Suprapubic pressure
  5. Episiotomy assessment
  6. Internal rotation
  7. Delivery of posterior arm

使用任务培训师，学生可以专注于建立他们对执行特定技能和教育工作者可以衡量并确认学习者掌握这些技能的基本面。从这里，学习者可以推进高保真仿真或治疗真正的患者，知道他们有必要的基础经验。

If your learners are in need of repetitive, isolated skills practice, a task trainer may be what you need to integrate into your training.

Standardized Patient – Improving Skills Performance for New Learners

The use of standardized patients (SP) can be beneficial to develop a practitioner’s interpersonal communication skills. Because SPs can verbalize symptoms that they are experiencing, they are particularly useful in gathering patient history and diagnosing symptoms. By using a SP’s body language to convey certain information, healthcare professionals are required to be more observant of their patient.

华盛顿大学医学中心劳动和交付单位开发的一种情况证明了在出生情景中使用SP的益处。制定产科出血的紧急情况，SP为医疗保健团队提供了危急触发。随着患者的病情恶化，SP变得焦虑而且有关。3通过使用这种类型的实践，学习者提高了他们的观察和专业技能。

By incorporating a SP into your scenario, you can introduce a real, human element to your simulation training. Learners can converse with a "real" patient, observing physical cues and considering their overall demeanor to form a more complete diagnosis.

结合双混合模拟提供了最好的两个世界

Task trainers and SPs share one key benefit: they both can be included in your simulations in creative ways. You are free to be as imaginative as you'd like – especially if you consider hybrid simulation as an option. Hybrid simulation is when two or more simulation modalities are used in the same simulation session (i.e. attaching a task trainer to a SP).使用这种形式的仿真可以允许技术和沟通技能的综合实践.4

研究表明，学习者更有吸引力的患者与SP互动，但很可能与Manikins更频繁地使用逼真的程序触摸。4Hybrid simulation is one means to improve both clinical treatment和a learner’s patient interaction skills.

通过在一个场景中结合两种形式的模拟，您可以有效地教导与出生相关的复杂性，同时帮助学习者与患者培养他们的沟通和融洽关系。

模拟从来都不是一个放之四海而皆准的解决方案

考虑到计划的规模，预算和学习目标，每个模拟应该是不同的。对于不需要高保真，丰富的仿真设备的情况，还有其他可用的选项。

Whether they are used together or alone, task trainers and standardized patients both have their unique role. They can enforce foundational clinical assessment and procedural skills and help to develop a learner’s interpersonal and communication skills, respectively. What is even more exciting is that, when used appropriately together, they can help you achieve both skill sets in your learners.

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参考
  1. Le Morvan, P. & Stock, B. (2005). Medical learning curves and the Kantian ideal.Journal of Medical Ethics,31（9）;513-518。
  2. Fialkow，M.F.，Adams，C.R.，Carranza，L.，Golden，S.J.，Benedetti，T.J.，＆Fernandez，R。（2014）。基于原位标准化患者的模拟，用于培训劳动和交付单位的产后出血和团队技能。医疗保健中的模拟：医疗保健社会学报，9（1）：65-71。DOI：10.1097 / SIH.0000000000000007
  3. Flynn, K. (2012).The use of standardized patients to minimize anxiety in undergraduate nursing students in the clinical setting.Retrieved fromhttp://sophia.stkate.edu/cgi/viewContent.cgi？article=1057&context= ma_nursing.
  4. Lopreiato, J.O. (2016). Healthcare simulation: Dictionary. Rockville, MD: Agency for Healthcare Research and Quality
  5. Coffey，F. Tsuchiya，K。，Timmons，S.，Baxendale，B.，Adolph，S.，＆Atkins，S。（2016）。模拟患者与急性护理情景中的Manikins。Clin教授，13（4）：257-61。DOI：10.1111 / TCT.12425
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