PDF(Pubmed)
Abstract：
Every day approximately 810 women die from complications related to pregnancy and childbirth worldwide. Around two thirds of these deaths happen in sub-Saharan Africa. One of the strategies to decrease these numbers is improving the quality of care by emergency obstetric simulation-based training. The effectiveness of such training programs depends on the program\'s instructional design.
This review gives an overview of studies about emergency obstetric simulation-based training and examines the applied instructional design of the training programs in sub-Saharan and Central Africa.
We searched Medline, Embase and Cochrane Library from inception to May 2021. Peer-reviewed articles on emergency obstetric, postgraduate, simulation-based training in sub-Saharan and Central Africa were included. Outcome measures were categorized based on Kirkpatrick\'s levels of training evaluation. The instructional design was evaluated by using the ID-SIM questionnaire.
In total, 47 studies met the inclusion criteria. Evaluation on Kirkpatrick level 1 showed positive reactions in 18 studies. Challenges and recommendations were considered. Results on knowledge, skills, and predictors for these results (Kirkpatrick level 2) were described in 29 studies. Retention as well as decay of knowledge and skills over time were presented. Results at Kirkpatrick level 3 were measured in 12 studies of which seven studies demonstrated improvements of skills on-the-job. Improvements of maternal and neonatal outcomes were described in fifteen studies and three studies reported on cost-estimations for training rollout (Kirkpatrick level 4). Instructional design items were heterogeneously applied and described.
Results of 47 studies indicate evidence that simulation-based training in sub-Saharan and Central Africa can have a positive impact across all four levels of Kirkpatrick\'s training evaluation model. However, results were not consistent across all studies and the effects vary over time. A detailed description of instructional design features in future publications on simulation-based training will contribute to a deeper understanding of the underlying mechanisms that determine why certain training programs are more effective in improving maternal and neonatal healthcare outcomes than other.
This review gives an overview of studies about emergency obstetric simulation-based training and examines the applied instructional design of the training programs in sub-Saharan and Central Africa.
We searched Medline, Embase and Cochrane Library from inception to May 2021. Peer-reviewed articles on emergency obstetric, postgraduate, simulation-based training in sub-Saharan and Central Africa were included. Outcome measures were categorized based on Kirkpatrick\'s levels of training evaluation. The instructional design was evaluated by using the ID-SIM questionnaire.
In total, 47 studies met the inclusion criteria. Evaluation on Kirkpatrick level 1 showed positive reactions in 18 studies. Challenges and recommendations were considered. Results on knowledge, skills, and predictors for these results (Kirkpatrick level 2) were described in 29 studies. Retention as well as decay of knowledge and skills over time were presented. Results at Kirkpatrick level 3 were measured in 12 studies of which seven studies demonstrated improvements of skills on-the-job. Improvements of maternal and neonatal outcomes were described in fifteen studies and three studies reported on cost-estimations for training rollout (Kirkpatrick level 4). Instructional design items were heterogeneously applied and described.
Results of 47 studies indicate evidence that simulation-based training in sub-Saharan and Central Africa can have a positive impact across all four levels of Kirkpatrick\'s training evaluation model. However, results were not consistent across all studies and the effects vary over time. A detailed description of instructional design features in future publications on simulation-based training will contribute to a deeper understanding of the underlying mechanisms that determine why certain training programs are more effective in improving maternal and neonatal healthcare outcomes than other.
摘要：
全世界每天约有810名妇女死于与妊娠和分娩有关的并发症。这些死亡中约有三分之二发生在撒哈拉以南非洲。减少这些数字的策略之一是通过基于产科模拟的急诊培训来提高护理质量。此类培训计划的有效性取决于计划的教学设计。
■这篇综述概述了有关基于产科模拟的急诊培训的研究，并探讨了撒哈拉以南非洲和中非培训计划的应用教学设计。
■我们搜索了Medline，Embase和Cochrane图书馆从成立到2021年5月。同行评议的关于急诊产科的文章，研究生,包括撒哈拉以南非洲和中非的基于模拟的培训。根据柯克帕特里克的培训评估水平对结果指标进行分类。通过使用ID-SIM问卷对教学设计进行评估。
■总共，47项研究符合纳入标准。对Kirkpatrick1级的评估在18项研究中显示阳性反应。审议了挑战和建议。关于知识的结果，技能,29项研究描述了这些结果的预测因子(柯克帕特里克2级)。介绍了知识和技能随时间的保留以及衰减。在12项研究中测量了Kirkpatrick3级的结果，其中7项研究证明了在职技能的提高。在15项研究中描述了产妇和新生儿结局的改善，三项研究报告了培训推广的成本估算（Kirkpatrick4级）。教学设计项目被不同地应用和描述。
■47项研究的结果表明，撒哈拉以南非洲和中部非洲的基于模拟的培训可以对柯克帕特里克培训评估模型的所有四个层面产生积极影响。然而,所有研究的结果均不一致,影响随时间变化.在未来的出版物中对基于模拟的培训的教学设计功能的详细描述将有助于更深入地了解潜在的机制，这些机制决定了为什么某些培训计划比其他培训计划更有效地改善孕产妇和新生儿的医疗保健结果。
■这篇综述概述了有关基于产科模拟的急诊培训的研究，并探讨了撒哈拉以南非洲和中非培训计划的应用教学设计。
■我们搜索了Medline，Embase和Cochrane图书馆从成立到2021年5月。同行评议的关于急诊产科的文章，研究生,包括撒哈拉以南非洲和中非的基于模拟的培训。根据柯克帕特里克的培训评估水平对结果指标进行分类。通过使用ID-SIM问卷对教学设计进行评估。
■总共，47项研究符合纳入标准。对Kirkpatrick1级的评估在18项研究中显示阳性反应。审议了挑战和建议。关于知识的结果，技能,29项研究描述了这些结果的预测因子(柯克帕特里克2级)。介绍了知识和技能随时间的保留以及衰减。在12项研究中测量了Kirkpatrick3级的结果，其中7项研究证明了在职技能的提高。在15项研究中描述了产妇和新生儿结局的改善，三项研究报告了培训推广的成本估算（Kirkpatrick4级）。教学设计项目被不同地应用和描述。
■47项研究的结果表明，撒哈拉以南非洲和中部非洲的基于模拟的培训可以对柯克帕特里克培训评估模型的所有四个层面产生积极影响。然而,所有研究的结果均不一致,影响随时间变化.在未来的出版物中对基于模拟的培训的教学设计功能的详细描述将有助于更深入地了解潜在的机制，这些机制决定了为什么某些培训计划比其他培训计划更有效地改善孕产妇和新生儿的医疗保健结果。
