Mastering Sedation and Associated Respiratory Events through Simulation-Based Training: A Randomised Controlled Trial Involving Non-Anaesthesiology Residents.

Jean-Noël Evain, Tran Do, Hakim Harkouk, Pierre Drolet, Roger Perron, Mihai Georgescu, Arnaud Robitaille, Issam Tanoubi
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Abstract

Non-anaesthetists commonly administer procedural sedation worldwide, posing the risk of respiratory events that can lead to severe complications. This study aimed to evaluate whether simulation-based learning could lead to enhancements in the clinical proficiency of non-anaesthesiology residents in managing sedation and related respiratory complications. Following the evaluation of baseline clinical performance through a pre-test simulation, 34 residents were randomly allocated to either participate in an innovative simulation-based learning module (intervention group) or view a brief self-learning video (control group). After a one-month period, their clinical performance was assessed again in a post-test simulation involving respiratory arrest during procedural sedation. Two independent assessors rated each resident's performance using video recordings and a scoring tool with scores ranging from 0 to 19/19. The two assessments were averaged for each performance, and the pre- to post-test change was calculated for each resident. While baseline clinical performance was similar, mean (SD) increase in clinical performance was significantly greater in the intervention group than in the control group (+2.4 (1.6) points versus +0.8 (1.3) points, respectively; p = 0.002). Our simulation-based learning sedation module resulted in the enhanced management of sedation-related complications compared to baseline and minimal self-learning. Simulation-based medical education may offer an effective approach for equipping non-anaesthesiology residents with essential skills to mitigate risks associated with sedation. (ClinicalTrials.gov identifier: NCT02722226).

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通过模拟训练掌握镇静和相关呼吸事件:非麻醉科住院医师参与的随机对照试验。
在全球范围内,非麻醉科医生通常会实施手术镇静,这就带来了呼吸系统事件的风险,可能导致严重的并发症。本研究旨在评估模拟学习是否能提高非麻醉科住院医师在处理镇静和相关呼吸系统并发症方面的临床能力。在通过考前模拟评估基线临床表现后,34 名住院医师被随机分配参加创新的模拟学习模块(干预组)或观看简短的自学视频(对照组)。一个月后,在涉及手术镇静过程中呼吸骤停的模拟测试中再次评估他们的临床表现。两名独立评估员使用视频记录和评分工具对每位住院医师的表现进行评分,评分范围为 0 到 19/19。每项表现的两次评估结果取平均值,并计算每位住院医师测试前与测试后的变化。虽然基线临床表现相似,但干预组临床表现的平均(标清)增幅明显高于对照组(分别为 +2.4 (1.6) 分和 +0.8 (1.3) 分;P = 0.002)。与基线和最低限度的自学相比,我们基于模拟学习的镇静模块加强了对镇静相关并发症的管理。基于模拟的医学教育可为非麻醉科住院医师提供一种有效的方法,使其掌握降低镇静相关风险的基本技能。(ClinicalTrials.gov 标识符:NCT02722226)。
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来源期刊
CiteScore
4.40
自引率
12.50%
发文量
111
审稿时长
8 weeks
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