Nikolay Pavlov, Marc von Gernler, Sabina A Guler, Sebastian Haubitz, Hans-Joachim Kabitz
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引用次数: 0
Abstract
Background: Thoracentesis is a common bedside procedure. Complication rates are, among other factors, associated with the clinicians' skills. Simulation-based training (SBT) for teaching procedural skills is widely recommended in medical education. However, the current evidence on the effectiveness of SBT for thoracentesis and the impact of different instructional features has not yet been comprehensively reviewed.
Objective: To summarize and critically appraise the current evidence on the effectiveness of SBT for thoracentesis in improving educational and patient outcomes, and to examine the instructional characteristics of effective training programs.
Methods: A systematic review of the published literature on effectiveness of SBT for thoracentesis was performed and is reported according to PRISMA guidelines. Methodological quality was assessed using the MERSQI and the risk of bias of the included studies was evaluated. Extracted data were analyzed descriptively and random-effects meta-analyses were used to calculate the pooled correlation for self-confidence and performance scores.
Results: Of the 17 studies included in the review, 14 used a pretest-posttest design and 15 investigated the effectiveness of high-fidelity simulation. Instructional features and outcome measures varied considerably across studies and no association was recognized. The majority of the reported outcomes were positive. The pooled correlation for self-confidence was 1.59 (95% confidence interval [CI] 0.94-2.24; n = 5 studies), and for performance scores 23.94 (95% CI 8.83-39.05, n = 5).
Conclusion: SBT for thoracentesis using high-fidelity simulators is effective in improving procedural skills and self-confidence. More evidence is needed to demonstrate a potential positive impact on behavioral and patient-related outcomes.
背景：胸穿刺是一种常见的床边手术。除其他因素外，并发症发生率与临床医生的技能有关。以模拟训练为基础的程序技能教学在医学教育中被广泛推荐。然而，目前关于SBT对胸穿刺的有效性和不同教学特点的影响的证据尚未得到全面的审查。目的：总结和批判性评价目前关于SBT胸穿刺在改善教学和患者预后方面的有效性的证据，并探讨有效培训方案的教学特点。方法：系统回顾已发表的关于SBT胸腔穿刺有效性的文献，并根据PRISMA指南进行报道。采用MERSQI评估方法学质量，并评估纳入研究的偏倚风险。对提取的数据进行描述性分析，并采用随机效应荟萃分析计算自信与表现得分的综合相关性。结果：在纳入的17项研究中，14项采用了前测后测设计，15项研究了高保真模拟的有效性。教学特征和结果测量在不同的研究中差异很大，没有发现关联。大多数报告的结果都是积极的。自信心的合并相关系数为1.59（95%可信区间[CI] 0.94-2.24, n = 5项研究），表现得分的合并相关系数为23.94 （95% CI 8.83-39.05, n = 5）。结论：采用高保真模拟器进行SBT胸腔穿刺可有效提高手术技巧和自信心。需要更多的证据来证明对行为和患者相关结果的潜在积极影响。协议注册：PROSPERO；否。: CRD420251064566;URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251064566。
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