聚类与间隔模拟在产钳辅助阴道分娩中的随机试验。

IF 3.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2025-08-19 DOI:10.1016/j.ajogmf.2025.101755

Andrew T. Greene DO , Matthew James Zuber MD , Joshua Nitsche MD, PhD , Mark Newman MD , Brian Brost MD

引用次数: 0

摘要

背景：产钳辅助阴道分娩（FAVD）在第二产程管理中的比例正在下降。这种下降反映在产科住院实习生学习机会的减少上。先前的研究已经证明，练习者在模拟中执行FAVD的技能和信心有所提高。目前还不清楚模拟课程的最佳时间和频率，以提高技能的留存率。目的：我们测试了聚类训练和间隔训练对受训者的影响，并假设间隔训练会导致更好的技能保留。我们使用市售骨盆训练器（Lucy's Mum, MODEL-med®），并在干预后1个月测量客观结构化技术技能评估（OSATS）分数。研究设计：这是一项随机对照试验，分组与间隔的FAVD模拟会话。35名（n=35）参与者给了我们80%的能力来检测OSATS分数6的差异。不能独立执行FAVD的受训人员和产科服务提供者被随机分组到一个单独的学习课程（分组/30分钟的模型实践教学；n=17）或三个单独的学习课程（间隔/每x3分钟10分钟；n=18），间隔一周。参与者完成了一个在线模块，介绍了FAVD，并完成了模拟前后的技能问卷。我们使用了一个安装在胸前的GoPro™相机来捕捉第一人称视角技术，以便让专家评审对参与者的身份视而不见，并使用这种盲法镜头来评定OSATS的平均分数。结果：聚类和间隔模拟训练均可改善干预后的FAVD OSATS评分（与基线相比+4.8 vs +5.9），但随机分组之间的中位数变化无差异（p = 0.78,Wilcoxon Rank Sum）。两个模拟组在应用镊子、进行安全检查和独立/安全执行FAVD方面都有更高的置信度（p < 0.05， t检验）。结论：我们描述了一种新颖的使用点护理视频和模拟器应用来改进FAVD模拟训练。无论聚类还是间隔模拟课程，OSATS分数和培训提供者自我评估都有所提高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

A randomized trial of clustered vs spaced simulation in forceps-assisted vaginal deliveries

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

期刊介绍： The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including: Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women. Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health. Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child. Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby. Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.