设置急救联络员分类情景模拟培训提高护士心肺复苏技能

目的提高全院护士急救技能。方法将心脏骤停设计为3类模拟情景,设置病区急救联络员并培训,由急救联络员负责培训各病区护士。结果设立病区急救联络员并运用不同情境模拟培训后,抽考护士CPR技能考核成绩显著提高(P0.01);护士对此培训模式持肯定态度。结论将心脏骤停情景案例进行归类,并设立病区急救联络员实施以点带面的培训,能有效提高全院护士的急救技能。     

密室逃脱教学法在口腔门诊护士急救技能培训中的应用

目的 探讨密室逃脱教学法在口腔医院门诊护士急救技能培训中的应用效果。方法 将口腔医院工作1~3年的108名门诊护士按随机数字表法分为试验组和对照组各54人。对照组按培训大纲进行急救培训,理论及技能培训共12 h;试验组在对照组基础上,增加密室逃脱教学法进行培训,共4次。结果 培训后,试验组急救理论知识和急救技能操作考核成绩、批判性思维能力、团队协作能力评分显著高于对照组（均P<0.05）。结论 密室逃脱教学法能有效提高口腔门诊护士临床急救知识和技能操作,有助于培养护士的批判性思维能力和团队协作能力。     

情景模拟演练在急救技能教学中的应用

目的探讨情景模拟演练教学法在急救技能教学中的应用效果,以提高临床护理教学质量。方法将进入急诊科实习的72名护生随机分成实验组和对照组各36例,对照组采用传统单项技能三段式教学;实验组采用情景模拟演练法教学,根据教学内容模拟急诊科常见的急重症急救情景,进行演示训练,包括情景设置、角色安排、技能练习、角色互换、考核答疑等步骤。最后由考核小组对两组护生急救理论知识、急救技能和操作综合能力进行考核。结果实验组急救理论知识、急救技能及综合能力成绩均显著优于对照组（P〈0．05,P〈0．01）。结论情景模拟演练教学可提高护生急救理论知识、急救技能和操作综合能力的成绩;提高临床护理教学质量。     

情景模拟教学在外科住院医师腹腔镜技能培训中的应用

目的:评估情景模拟教学在外科住院医师腹腔镜技能培训中的作用。方法:选取2018～2020年进行住院医师规范化培训的43名学员,随机分为实验组(n=22)与对照组(n=21)。实验组采用情景模拟教学法进行腹腔镜技能培训,对照组采用传统腹腔镜技能培训方法。采用医学模拟情景引导性反馈评分量表评估情景模拟教学的实施效果;采用短时压力状态问卷量表评估培训学员在完成技能培训时的心理应激情况。结果:医学模拟情景引导性反馈评分显示,实验组在"建立引人入胜的学习环境""保持引人入胜的学习环境""唤起高参与度的讨论""识别实际表现与期望的差异""帮助学员达到或维持良好表现"方面的得分高于对照组。短时压力状态问卷评分显示,实验组学员的投入度、焦虑度高于对照组,但两组在完成训练任务时的苦恼度方面差异无统计学意义。结论:情景模拟教学法可在外科住院医师腹腔镜技能培训中的应用成功构建良好的仿真环境,学员能感受到更接近真实临床工作时所产生的心理情绪变化。     

遗忘曲线在护士单项急救技能培训中的应用

目的:根据遗忘曲线制定多种形式循序渐进的培训复训方案,快速有效提高应急网络及新护士单项急救技能并持久巩固培训效果.方法:将51例单项急救护理技能培训护士随机分成两组,实验组(26例)采用多种形式循序渐进的培训复训方案,对照组(25例)采用每月一次的常规复训方法,1年后比较两组培训效果.结果:两组护理人员急救技能考核成绩均较培训前显著提高(P<0.01),其中实验组培训成绩显著高于对照组(P<0.01),而完成单项操作时间与达到熟练掌握所需复训次数均低于对照组,差异有显著性(P<0.01).结论:应用遗忘曲线规律制定针对遗忘时间点的培训复训方案占用护士时间较少,但能快速提高护士单项急救技能并持续维持技能水平.     

医护团队情景教学法在急诊临床教学中的应用

目的探讨医护团队情景教学法在急诊临床教学中的应用及效果。方法将急诊科实习的67名本科医学生、89名护生随机分为观察组和对照组,每组78名。对照组采用传统教学法教学,观察组采用医护团队情景教学法教学。培训4周后,比较两组综合考核评分。采用中文版评判性思维能力量表(CTDI-CV)对学生培训前、后进行评定并对两组的教学满意度进行评价。结果培训后,观察组综合考核评分、评判性思维总分及5个因子分显著高于对照组(均P<0.05)。观察组对教学模式满意度的评分显著高于对照组(P<0.01)。结论医护团队情景教学法能够有效提升学生的临床操作和思维能力,提高临床教学质量。     

预案情景模拟教学在新护士培训中的应用

目的探讨预案情景模拟教学在新护士培训中的应用效果。方法在分析和总结上年度新护士发生的不良事件基础上,制定基础疾病护理预案、专科护理预案、监护室抢救预案、非专科常见病及难见病护理预案22项,并采用预案情景模拟教学法对22名新护士进行培训、考核和评价。结果实施预案情景模拟教学后,新护士不良事件发生率由2.4%下降至0.4%,教学前后比较,差异有统计学意义(P0.01)。结论预案情景模拟教学可快速提升新护士病情观察和临床适应能力,降低不良事件发生风险,保障患者安全。     

思维导图结合情景模拟用于急诊护士创伤急救规范化培训

目的探讨思维导图结合情景模拟在急诊护士创伤急救规范化培训中的应用效果。方法根据培训时间将急诊科规培护士分为两组,将2017年1～12月的30名护士设为对照组,按传统培训方式进行创伤急救规范化培训;2018年1～12月的32名护士为观察组,采用思维导图结合情景模拟方法进行创伤急救规范化培训。结果培训后观察组理论成绩、操作成绩显著高于对照组,评判性思维能力总分和7个维度得分显著高于对照组(P0.05,P0.01)。结论思维导图结合情景模拟的培训方式有助于提高急诊科规培护士的评判性思维能力,增强培训效果,从而使护士能更好地配合创伤急救,提高创伤急救护理工作质量。     

BOPPPS联合情景模拟法在内科护理学教学中的应用

目的 探讨BOPPPS联合情景模拟法在内科护理学教学中的应用效果.方法 选取2017级护理本科生311人,按照班级随机分为实验组153人与对照组158人;实验组实施BOPPPS联合情景模拟法,对照组采用传统教学法,两组均采用批判性思维倾向和学习积极主动性量表进行教学主观评价;采用综合实训成绩与期末理论考试成绩进行客观评价.结果 实验组综合实训与期末理论考试成绩显著高于对照组(均P<0.01);教学后实验组除系统化能力外,批判性思维总分及其余6个维度评分显著优于对照组(均P<0.01);实验组学习积极主动性总分及各维度得分显著高于对照组(均P<0.01).结论 BOPPPS联合情景模拟法的应用,有助于提高护生的批判性思维能力、调动护生的学习积极主动性,提升内科护理的教学效果.     

仿真人模拟教学在急救护理技能教学中的应用

目的探讨仿真人模拟教学在急救护理技能教学中的应用效果。方法采用方便取样的方法选取某校105名护理本科生为研究对象．将其随机分为实验组（53人）和对照组（52人）,实验组采用仿真人模拟教学,对照组采用传统的示教法教学。结果实验组护生急救护理技能成绩、理论成绩显著高于对照组（P〈0．05．P〈0．01）;实验组94．34％护生认为仿真人模拟教学有利于不同学科知识的综合应用,75．47％护生认为有利于急救技能的熟练掌握,69．81％护生认为加深了急救知识与急救技能之间的联系。结论在急救护理技能教学中运用仿真人模拟教学有利于护生急救护理技能的掌握和综合能力的培养。     

三模块实习教案在海姆立克操作教学的应用

目的探讨三模块实习教案在精神病专科医院以海姆立克操作为主导的噎食急救处置中的教学效果。方法选取实习本科护生90人为研究对象,分为研究组46人和对照组44人。对照组采用传统教学方法实施带教,研究组采用三模块实习教案方法实施带教,均实习2周。结果研究组操作技能考核得分及教学总体满意率显著高于对照组(均P0.01)。结论三模块实习教案教学可提升海姆立克急救技能及急救处置带教效果,提升教学满意率。     

Framework for incorporating simulation into urology training

Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Simulation‐based training can provide urology trainees with the opportunity to develop their technical and non‐technical skills in a safe and structured environment. Despite its promised benefits, incorporation of simulation into current curricula remains minimal. This paper provides a comprehensive review of the current status of simulation for both technical and non‐technical skills training as it pertains to urology. It provides a novel framework with contextualised examples of how simulation could be incorporated into a stage‐specific curriculum for trainees through to experienced urologists, thus aiding its integration into current training programmes.

OBJECTIVES

? Changes to working hours, new technologies and increased accountability have rendered the need for alternative training environments for urologists. ? Simulation offers a promising arena for learning to take place in a safe, realistic setting. ? Despite its benefits, the incorporation of simulation into urological training programmes remains minimal. ? The current status and future directions of simulation for training in technical and non‐technical skills are reviewed as they pertain to urology. ? A framework is presented for how simulation‐based training could be incorporated into the entire urological curriculum.

MATERIALS AND METHODS

? The literature on simulation in technical and non‐technical skills training is reviewed, with a specific focus upon urology.

RESULTS

? To fully integrate simulation into a training curriculum, its possibilities for addressing all the competencies required by a urologist must be realized. ? At an early stage of training, simulation has been used to develop basic technical skills and cognitive skills, such as decision‐making and communication. ? At an intermediate stage, the studies focus upon more advanced technical skills learnt with virtual reality simulators. ? Non‐technical skills training would include leadership and could be delivered with in situ models. ? At the final stage, experienced trainees can practise technical and non‐technical skills in full crisis simulations situated within a fully‐simulated operating rooms.

CONCLUSIONS

? Simulation can provide training in the technical and non‐technical skills required to be a competent urologist. ? The framework presented may guide how best to incorporate simulation into training curricula. ? Future work should determine whether acquired skills transfer to clinical practice and improve patient care.     

Team planning discussion and clinical performance: a prospective,randomised, controlled simulation trial

Planning held before emergency management of a critical situation might be an invaluable asset for optimising team preparation. The purpose of this study was to investigate whether a brief planning discussion improved team performance in a simulated critical care situation. Forty-four pairs of trainees in anaesthesia and intensive care were randomly allocated to either an intervention or control group before participating in a standardised simulated scenario. Twelve different scenarios were utilised. Groups were stratified by postgraduate year and simulated scenario, and a facilitator was embedded in the scenario. In the intervention group, the pairs had an oral briefing followed by a 4-min planning discussion before starting the simulation. The primary end-point was clinical performance, as rated by two independent blinded assessors on a score of 0–100 using video records and pre-established scenario-specific checklists. Crisis resource management and stress response (cognitive appraisal ratio) were also assessed. Two pairs were excluded for technical reasons. Clinical performance scores were higher in the intervention group; mean (SD) 51 (9) points vs. 46 (9) in the control group, p = 0.039. The planning discussion was also associated with higher crisis resource management scores and lower cognitive appraisal ratios, reflecting a positive response. A 4-min planning discussion before a simulated critical care situation improved clinical team performance and cognitive appraisal ratios. Team planning should be integrated into medical education and clinical practice.