背景:新生儿远程复苏使用实时,在先进的新生儿复苏期间,将新生儿学家与社区医院护理团队联系起来的音频-视频远程医疗。虽然远程医疗继续发展,培训远程复苏研究员的最佳做法尚不清楚。
目的:我们的目的是使用基于模拟的掌握学习模型开发新生儿远程复苏课程,该模型为新生儿围产期医学(NPM)研究员提供知识,技能,以及导致远程复苏所需的行为。
方法:使用技术增强的模拟教育和精通学习模型,我们开发了一个纵向飞行员远程复苏课程。从07/2018到03/2021,NPM研究员参加了课程,其中包括个性化的远程医疗学习,观察和引导模拟远程复苏,最后,进行临床(非模拟)远程复苏。开发了一种绩效评估工具,通过映射到研究生医学教育认证委员会(ACGME)核心能力的八个问题来评估能力,以1到5的比例回答(1=严重缺陷;5=专家的能力)。
结果:四名NPM研究员参加了课程,以个性化的速度推进课程。三个学习模块的中位数得分为96-100%。研究员根据掌握时间参加了不同数量的模拟远程复苏(每个研究员2-3次监督模拟,每个人1-4次无监督模拟)。总的来说,18次模拟远程复苏(8次无监督,10次监督)和1次临床远程复苏。完成了25次业绩评估。ACGME能力的评估分数一直很高,平均分数在4.2-4.6之间,其中4等于“准备进行无监督实践”,5等于“专家能力”。
结论:随着远程医疗使用的不断扩大,提高学习者对远程复苏的舒适度和熟练程度的课程至关重要。基于模拟的掌握学习模型可能是一种使学习者逐渐接触和掌握复杂的远程复苏技能和行为的方法。
BACKGROUND: Neonatal tele-resuscitation uses real-time, audio-video telemedicine to connect neonatologists with community hospital care teams during advanced neonatal resuscitations. While telemedicine continues to expand, best practices for training fellows in tele-resuscitation are not known.
OBJECTIVE: We aimed to develop a neonatal tele-resuscitation curriculum using a simulation-based mastery learning model that provides neonatal-perinatal medicine (NPM) fellows with the knowledge, skills, and behaviors needed to lead tele-resuscitations.
METHODS: Using technology-enhanced simulation education and a mastery learning model, we developed a longitudinal pilot tele-resuscitation curriculum. From 07/2018 to 03/2021, NPM fellows participated in the curriculum, which included individualized telemedicine learning, observing and leading simulated tele-resuscitations, and finally, performing clinical (non-simulated) tele-resuscitations. A performance assessment tool was developed to assess competency through eight questions mapped to the Accreditation Council for Graduate Medical Education (ACGME) core competencies, with responses on a 1 to 5 scale (1 = critical deficiencies; 5 = competence of an expert).
RESULTS: Four NPM fellows participated in the curriculum, progressing through the curriculum at an individualized pace. Median scores on the three learning modules were 96-100%. Fellows participated in variable number of simulated tele-resuscitations based on when mastery was achieved (2-3 supervised simulations per fellow, 1-4 unsupervised simulations per fellow). In total, eighteen simulated tele-resuscitations (eight unsupervised, 10 supervised) and one clinical tele-resuscitation were conducted. Twenty-five performance assessments were completed. Assessment scores across the ACGME competencies were consistently high, with mean scores ranging from 4.2-4.6, with 4 equating to \'ready for unsupervised practice\' and 5 equating to \'competence of an expert\'.
CONCLUSIONS: As telemedicine use continues to expand, curricula that improve learners\' comfort with and proficiency in tele-resuscitation are essential. A simulation-based mastery learning model may be one approach that affords learners gradual exposure to and mastery of complex tele-resuscitation skills and behaviors.