PDF(Pubmed)
Abstract：
This study analyzed the adherence to the modified Advanced Life Support in Obstetrics (ALSO) algorithm (HELP-RER) for handling shoulder dystocia (SD) using a virtual reality (VR) training modality. Secondary outcomes were improvements in the post-training diagnosis-to-delivery time, human skills factors (HuFSHI), and perceived task-load index (TLX). Prospective, case-control, single-blind, 1:1 randomized crossover study. Participants were shown a 360° VR video of SD management. The control group was briefed theoretically. Both groups underwent HuFSHI and HELP-RER score assessments at baseline and after the manikin-based training. The TLX questionnaire was then administered. After a washout phase of 12 weeks, we performed a crossover, and groups were switched. There were similar outcomes between groups during the first training session. However, after crossover, the control group yielded significantly higher HELP-RER scores [7 vs. 6.5; (p = 0.01)], with lower diagnosis-to-delivery-time [85.5 vs. 99 s; (p = 0.02)], and TLX scores [57 vs. 68; (p = 0.04)]. In the multivariable linear regression analysis, VR training was independently associated with improved HELP-RER scores (p = 0.003). The HuFSHI scores were comparable between groups. Our data demonstrated the feasibility of a VR simulation training of SD management for caregivers. Considering the drawbacks of common high-fidelity trainings, VR-based simulations offer new perspectives.
摘要：
这项研究分析了使用虚拟现实（VR）训练方式处理肩难产（SD）的改良产科高级生命支持（ALSO）算法（HELP-RER）的依从性。次要结果是培训后诊断至分娩时间的改善，人类技能因素(HuFSHI)，和感知任务负载指数(TLX)。前瞻性,病例控制，单盲,1:1随机交叉研究。向参与者显示了SD管理的360°VR视频。对照组从理论上进行了简要介绍。两组在基线和基于人体模型的训练后都进行了HuFSHI和HELP-RER评分评估。然后施用TLX问卷。经过12周的冲洗阶段，我们进行了交叉，和小组交换。在第一次培训期间，两组之间的结果相似。然而,交叉后，对照组的HELP-RER评分明显较高[7vs.6.5；（p=0.01）]，诊断至分娩时间较短[85.5vs.99s；(p=0.02)]，和TLX得分[57vs.68；（p=0.04）]。在多元线性回归分析中，VR训练与HELP-RER评分的提高独立相关(p=0.003)。两组之间的HuFSHI评分相当。我们的数据证明了对护理人员进行SD管理的VR模拟训练的可行性。考虑到常见高保真训练的缺点，基于VR的模拟提供了新的视角。
