PDF(Pubmed)
Abstract：
Background Multidisciplinary simulation training in the management of acute obstetric emergencies has the potential to reduce both maternal and perinatal morbidity. It is a valuable tool that can be adapted for targeted audiences of different specialities at all experience levels from medical students to senior consultants. Methods In this study, pre- and post-course questionnaires of learners with varying levels of clinical experience from Obstetrics and Gynaecology (O&G), Anaesthesia, Neonatology, Emergency Medicine, midwifery, and nursing who undertook two simulation courses (namely the Combined Obstetrics Resuscitation Training course, CORE, and the CORE Lite), which comprised lectures and simulation drills with manikins and standardized patients, between 2015 and 2023 were compared. This also included a period when training was affected by the coronavirus disease 2019 (COVID-19) pandemic. Results The results showed that both simulation courses increased confidence levels among all learners in the management of obstetric emergencies. Pre-course, participants were most confident in the management of neonatal resuscitation and severe pre-eclampsia, followed by postpartum haemorrhage. They were least confident in the management of vaginal breech delivery, uterine inversion, and twin delivery. Post-course, participants were most confident in the management of neonatal resuscitation and shoulder dystocia, followed by postpartum haemorrhage. They were least confident in the management of uterine inversion and maternal sepsis, followed by vaginal breech delivery and twin delivery. Whilst we saw a huge improvement in confidence levels for all obstetric emergencies, the greatest improvement in confidence levels was noted in vaginal breech delivery, twin delivery, and uterine inversion. Conclusion The simulation courses were effective in improving the confidence in the management of obstetric emergencies. While it may be difficult to measure the improvement in clinical outcomes as a result of simulation courses alone, the increase in confidence levels of clinicians can be used as a surrogate in measuring their preparedness in facing these emergency scenarios.
摘要：
背景多学科模拟训练在急性产科紧急情况的管理有可能降低孕产妇和围产期发病率。这是一个有价值的工具，可以适应从医学生到高级顾问的所有经验水平的不同专业的目标受众。方法在本研究中,来自妇产科（O＆G）的具有不同临床经验水平的学习者的课程前和课程后问卷，麻醉,新生儿科,急诊医学,助产,和护理，他们接受了两个模拟课程(即产科联合复苏培训课程，CORE,和CORELite），其中包括与人体模型和标准化患者的讲座和模拟演练，2015年至2023年进行了比较。这也包括培训受到2019年冠状病毒病(COVID-19)大流行影响的时期。结果结果表明，两个模拟课程都提高了所有学习者在产科紧急情况管理中的信心水平。课程前,参与者对新生儿复苏和严重先兆子痫的管理最有信心，其次是产后出血。他们对阴道臀位分娩的管理最不自信，子宫内翻,和双胞胎分娩。课程后，参与者对新生儿复苏和肩难产的管理最有信心，其次是产后出血。他们对子宫内翻和产妇败血症的治疗最不自信，其次是阴道臀位分娩和双胎分娩。虽然我们看到所有产科紧急情况的信心水平都有了巨大的改善，在阴道臀位分娩中，信心水平改善最大，双胞胎分娩，和子宫内翻.结论模拟课程可有效提高产科急诊管理的信心。虽然仅靠模拟课程可能难以衡量临床结果的改善，临床医生信心水平的提高可以作为衡量他们面对这些紧急情况的准备情况的替代指标.
