Tıp Eğitiminde Simülasyonun Önemi ve Simülasyon Eğitimi ile Acil Tıp Ekibinin Kardiyopulmoner Resüsitasyon Uygulamasında Takım Performansının Artırılması
Abstract
Amaç: Bu çalışmada tıp eğitiminde simülasyonun önemini, simülasyonla eğitimin kardiyo-pulmoner resüsitasyonda takım performansını artırıp artırmadığını ve tıp eğitiminin kalitesini artırmak için yapılması gerekenleri araştırdık.
Gereç ve Yöntemler: Çalışma, Gaziantep Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı tarafından yürütüldü. Tıp fakültesi 3. Sınıf öğrencilerinden 120 kişi 4 gruba ayrılarak Temel Yaşam Desteği eğitimi verildi. Eğitim yöntemleri olarak; geleneksel yolla eğitim, basit manken üzerinde simülasyon yöntemi ile eğitim, yüksek teknoloji içeren manken üzerinde simülasyon yöntemi ile eğitim ve kendi kendine eğitim yöntemleri uygulandı. Takım performansı değerlendirmesi için kontrol listeleri kullanıldı.
Bulgular: Tüm grupların cinsiyet ve yaş ortalamalarına göre dağılımları arasında anlamlı fark yoktu (sırasıyla; p=0,311, p=0,217). Tüm grupların teorik bilgi düzeylerinin eğitimler sonrası arttığı test edildi (p<0,001). Bu artışta gruplar arasında anlamlı bir farklılık yoktu (p=0,067). Ancak teorik bilgi düzeylerindeki bu artış takım performansı düzeylerindeki artışla uyumlu değildi. Takım performansı ve beceri yeterliliğinde simülasyonla eğitilen 2 grup diğer gruplara göre anlamlı ölçüde daha başarılı bulundu (p<0,001). Simülasyonla eğitilen bu iki grubun arasında performans değerlendirmelerinde anlamlı bir fark yoktu (p=1,000). Geleneksel yöntem ile eğitilen grupla kendi kendine eğitim alan grup arasında takım performansı açısından anlamlı bir fark yoktu (p=1,000) ancak beceri değerlendirmesinde kendi kendine eğitim alan grup daha başarılı oldu (p=0,018). Uygulanan anket sonuçlarına göre öğrencilerin kendine olan güveni genel olarak artmıştı (p<0,001). Performans değerlendirmeleri için kullanılan kontrol listeleri kendi aralarında mükemmel düzeyde korelasyon göstermekteydi (p<0,001).
Sonuç: Simülasyonla eğitim tekniği resüsitasyon gibi karmaşık olayların yönetilmesinde takım performansını, beceri düzeyini ve öğrencilerin kendilerine olan güvenlerini artırmaktadır. Bu nedenle tıp eğitimine entegre edilmesi gerekmektedir.
References
- Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13 Suppl 1(Suppl 1):i2-10.
- McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010;44(1):50-63.
- López-Messa JB, Martín-Hernández H, Pérez-Vela JL, Molina-Latorre R, Herrero-Ansola P. Novedades en métodos formativos en resucitación [Novelities in resuscitation training methods]. Med Intensiva. 2011;35(7):433-441.
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):640-656.
- Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, et al. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation. 2010;81(4):446-452.
- Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580-588.
- King HB, Battles J, Baker DP, Alonso A, Salas E, Webster J, et al. TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug.
- Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al. Part 5: Adult Basic Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):685-705.
- McEvoy MD, Smalley JC, Nietert PJ, Field LC, Furse CM, Blenko JW, et al. Validation of a detailed scoring checklist for use during advanced cardiac life support certification. Simul Healthc. 2012;7(4):222-235.
- Rodgers DL, Bhanji F, McKee BR. Written evaluation is not a predictor for skills performance in an Advanced Cardiovascular Life Support course. Resuscitation. 2010;81(4):453-456.
- Siassakos D, Fox R, Crofts JF, Hunt LP, Winter C, Draycott TJ. The management of a simulated emergency: better teamwork, better performance. Resuscitation. 2011;82(2):203-206.
- Kory PD, Eisen LA, Adachi M, Ribaudo VA, Rosenthal ME, Mayo PH. Initial airway management skills of senior residents: simulation training compared with traditional training. Chest. 2007;132(6):1927-1931.
- Hunziker S, Johansson AC, Tschan F, Semmer NK, Rock L, Howell MD, et al. Teamwork and leadership in cardiopulmonary resuscitation. J Am Coll Cardiol. 2011;57(24):2381-2388.
- Hoadley TA. Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation. Nurs Educ Perspect. 2009;30(2):91-95.
- Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ. 2012;46(7):636-647.
- Owen H, Mugford B, Follows V, Plummer JL. Comparison of three simulation-based training methods for management of medical emergencies. Resuscitation. 2006;71(2):204-211.
- Moule P, Albarran JW, Bessant E, Brownfield C, Pollock J. A non-randomized comparison of e-learning and classroom delivery of basic life support with automated external defibrillator use: a pilot study. Int J Nurs Pract. 2008;14(6):427-434.
The Importance of Simulation in Medical Education and Improving the Emergency Team Performance on Cardiopulmonary Resuscitation by Using Simulation-Based Education
Abstract
Objective: This study investigated the importance of simulation in medical education, whether simulation training enhances team performance in cardiopulmonary resuscitation, and what measures are necessary to improve the quality of medical education.
Materials and Methods: The study was conducted by the Department of Emergency Medicine, Faculty of Medicine, Gaziantep University. 120 third-year medical students were divided into 4 groups and given Basic Life Support training. The training methods employed were traditional training, training using a simple mannequin simulation method, training with a high-tech mannequin simulation method, and self-training. Checklists were used for team performance assessment.
Results: There was no significant difference between the distributions of all groups according to gender and age averages (p=0.311, p=0.217, respectively). It was tested that the theoretical knowledge levels of all groups increased after the training (p<0.001, for all). There was no significant difference between the groups in this increase (p=0.067). However, this increase in theoretical knowledge levels was not compatible with the increase in team performance levels. The two groups trained with simulation were found to be significantly more successful than the other groups in team performance and skill competence (p<0.001). There was no significant difference in performance assessments between these two groups trained with simulation (p=1.000). There was no significant difference in team performance between the group trained with the traditional method and the self-trained group (p=1.000), but the self-trained group was more successful in skill assessment (p=0.018). According to the applied survey results, the students' self-confidence generally increased (p<0.001). The checklists used for performance assessments showed excellent correlation among themselves (p<0.001).
Conclusion: Simulation training technique increases team performance, skill level and students' self-confidence in managing complex events such as resuscitation. Therefore, it should be integrated into medical education.
Ethical Statement
Ethics committee approval was obtained for this study from the Gaziantep University Faculty of Medicine Medical Ethics Committee (Ethics committee decision no: 19.06.2012/277 Date: 19.06.2012). The Declaration of Helsinki was complied with.
Thanks
We thank to Prof. Dr. Yeşim Şenol and ATUDER.
References
- Gaba DM. The future vision of simulation in health care. Qual Saf Health Care. 2004;13 Suppl 1(Suppl 1):i2-10.
- McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010;44(1):50-63.
- López-Messa JB, Martín-Hernández H, Pérez-Vela JL, Molina-Latorre R, Herrero-Ansola P. Novedades en métodos formativos en resucitación [Novelities in resuscitation training methods]. Med Intensiva. 2011;35(7):433-441.
- Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):640-656.
- Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, et al. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation. 2010;81(4):446-452.
- Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580-588.
- King HB, Battles J, Baker DP, Alonso A, Salas E, Webster J, et al. TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug.
- Berg RA, Hemphill R, Abella BS, Aufderheide TP, Cave DM, Hazinski MF, et al. Part 5: Adult Basic Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(18 Suppl 3):685-705.
- McEvoy MD, Smalley JC, Nietert PJ, Field LC, Furse CM, Blenko JW, et al. Validation of a detailed scoring checklist for use during advanced cardiac life support certification. Simul Healthc. 2012;7(4):222-235.
- Rodgers DL, Bhanji F, McKee BR. Written evaluation is not a predictor for skills performance in an Advanced Cardiovascular Life Support course. Resuscitation. 2010;81(4):453-456.
- Siassakos D, Fox R, Crofts JF, Hunt LP, Winter C, Draycott TJ. The management of a simulated emergency: better teamwork, better performance. Resuscitation. 2011;82(2):203-206.
- Kory PD, Eisen LA, Adachi M, Ribaudo VA, Rosenthal ME, Mayo PH. Initial airway management skills of senior residents: simulation training compared with traditional training. Chest. 2007;132(6):1927-1931.
- Hunziker S, Johansson AC, Tschan F, Semmer NK, Rock L, Howell MD, et al. Teamwork and leadership in cardiopulmonary resuscitation. J Am Coll Cardiol. 2011;57(24):2381-2388.
- Hoadley TA. Learning advanced cardiac life support: a comparison study of the effects of low- and high-fidelity simulation. Nurs Educ Perspect. 2009;30(2):91-95.
- Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ. 2012;46(7):636-647.
- Owen H, Mugford B, Follows V, Plummer JL. Comparison of three simulation-based training methods for management of medical emergencies. Resuscitation. 2006;71(2):204-211.
- Moule P, Albarran JW, Bessant E, Brownfield C, Pollock J. A non-randomized comparison of e-learning and classroom delivery of basic life support with automated external defibrillator use: a pilot study. Int J Nurs Pract. 2008;14(6):427-434.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Early Pub Date | July 21, 2025 |
| Publication Date | July 21, 2025 |
| Submission Date | September 23, 2024 |
| Acceptance Date | December 3, 2024 |
| Published in Issue | Year 2025 Volume: 20 Issue: 2 |
