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Acil Servis Stajı Sırasında İntörn Doktorların Temel ve İleri Yaşam Desteği Becerilerinin Değerlendirilmesi

Yıl 2019, Cilt: 2 Sayı: 4, 6 - 10, 31.12.2019

Öz

Amaç

Tıp fakültesi eğitiminde öğrencilerin CPR eğitimi sırasında, kardiyak arresti etkili bir şekilde tedavi etmeye hazırlamak için CPR öğrenme deneyimini optimize etmek önemlidir. Çalışmamızın amacı intörn doktorlarda CPR eğitimimizinetkinliğini değerlendirmek ve kalitesini arttırmaktır.

Gereç ve Yöntem

Prospektif olarak 2017 - 2018 tarihleri arasında Acil Servis Stajında CPR eğitimi alan, Pre-Post testi cevaplayan intörn doktorların test skorları karşılaştırıldı. İntörn doktorlara Acil stajına başladıkları ilk gün bilgilendirme toplantısı sırasında önceden hazırlanmış sorularla pre-test ve eğitim sonrası aynı sorularla post-test yapılarak, eğitim kalitesi ve CPR bilgi düzeyleri ve değişimi değerlendirildi.

Bulgular

Çalışma süresince 185 intörn pre-test, 128 intörn post-test ile değerlendirildi. 57 intörn doktor derse katılmadıkları ya da post testi cevaplamadıkları için değerlendirilmeye alınmadı. Eğitim sonrası başarı oranı temel-ileri yaşam desteği, taşikardi-bradikardi ve toplam değerlendirmede belirgin olarak arttı. Bu bölümler içinde en fazla başarı değişimi ileri yaşam desteği sorularında en az başarı değişimi taşikardi-bradikardi sorularında idi.

Sonuç

İntörn doktorlarda temel ve ileri yaşam desteği konusunda 3 saat didaktik ve 1 saat simüle senaryo manken eşliğinde eğitimimiz etkindir.

Kaynakça

  • 1. Johnson NJ, Salhi RA, Abella BS, et al. Emergency department factors associated with survival after sudden cardiac arrest. Resuscitation 2013;84:292–7.
  • 2. Ali B, Zafari AM. Narrative review: cardiopulmonary resuscitation and emergency cardiovascular care: review of the current guidelines. Ann Intern Med 2007;147:171–9.
  • 3. Casey W. Cardiopulmonary resuscitation: a survey of standards among junior hospital doctors. J R Soc Med 1984;77:921–4.
  • 4. Skinner D, Camm A, MilesW. Cardiopulmonary resuscitation skills of preregistration house officers. Br Med J (Clin Res Ed) 1985;290: 1549–50.
  • 5. Smith GB, Hill SL. Resuscitation training for medical students in the UK—a comparison with the US. Intensive Care Med 1987;13: 260–5.
  • 6. Morris F, Tordoff S, Wallis D, Skinner D. Cardiopulmonary resuscitation skills of preregistration house officers: five years on. BMJ 1991;302:626–7.
  • 7. Goodwin A. Cardiopulmonary resuscitation training revisited. J R Soc Med 1992;85:452–3.
  • 8. Gillard J, Dent T, Jolly B,Wallis D, Hicks B. CPR and the RCP (2). Training of students and doctors in UK medical schools. J R Coll Physicians Lond 1993;27:412–7.
  • 9. Graham C, Guest K, Scollon D. Cardiopulmonary resuscitation. Paper 2: A survey of basic life support training for medical students. J Accid Emerg Med 1994;11:165–7.
  • 10. Leah V, Whitbread M, Coats TJ. Resuscitation training for medicalstudents. Resuscitation 1998;39:87–90.
  • 11. Jordan T, Bradley P. A survey of basic life support training in various undergraduate healthcare professions. Resuscitation 2000;47:321–3.
  • 12. Price C, Bell S, Janes S, Ardagh M. Cardiopulmonary resuscitation training, knowledge and attitudes of newly-qualified doctors in New Zealand in 2003. Resuscitation 2006;68:295–9.
  • 13. Meaney PA, Bobrow BJ, Mancini ME, et al. CPR Quality Summit Investigators, the American Heart Association Emergency Cardiovascular Care Committee, and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 2013;128:417–35.
  • 14. TalikowskaM, Tohira H, Finn J. Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis. Resuscitation 2015;96:66–77.
  • 15. Yannopoulos D, Aufderheide TP, Abella BS, et al. Quality of CPR: an important effect modifier in cardiac arrest clinical outcomes and intervention effectiveness trials. Resuscitation 2015;94:106–13.
  • 16. Abella BS, Alvarado JP,Myklebust H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305–10.
  • 17. Mcevoy MD, Field LC, Moore HE, et al. The effect of adherence to ACLS protocols on survival of event in the setting of in-hospital cardiac arrest. Resuscitation 2014;85:82–7.
  • 18. Crowe C, Bobrow BJ, Vadeboncoeur TF, et al. Measuring and improving cardiopulmonary resuscitation quality inside the emergency department. Resuscitation 2015;93:8–13.
  • 19. Lunenfeld E, Weinreb B, Lavi Y, Amiel GE, Friedman M. Assessment of emergency medicine: a comparison of an experimental objective structured clinical examination with a practical examination. Med Educ 1991;25(1):38-44.
  • 20. Berden HJ, Bierens JJ, Willems FF, Hendrick JM, Pijls NH, Knape JT. Resuscitation skills of lay public after recent training. Ann Emerg Med 1994; 23: 1003–1008.
  • 21. Lighthall GK, Barr J, Howard SK, Gellar E, Sowb Y, Bertacini E, et al. Use of a fully simulated intensive care unit environment for critical event management training for internal medicine residents. Critical Care Medicine 2003;31:2437–43.
  • 22. Promes SB, Chudgar SM, O’Connor Grochowski C, Shayne P, Isenhour J, Glickman SW, et al. Gaps in procedural experience and competency in medical school graduates. AcademicEmergency Medicine 2009;16:S58–62.
  • 23. Wu EH, Elnicki DM, Alper EJ, Bost JE, Corbett EC Jr, Fagan MJ, et al. Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students. Academic Medicine 2008;83:S63–7.
  • 24. Kim JH, Kim WO, Min KT, Yang JY, Nam YT. Learning by computer simulation does not lead to better test performance than textbook study in the diagnosis and treatment of dysrhythmias. J Clin Anesth 2002;14(5):395- 400.
  • 25. Perkins GD. Simulation in resuscitation training. Resuscitation 2007;73(2):202-11.
  • 26. Eng AJ, Namba JM, Box KW, Lane JR, Kim DY, Davis DP, et al. Highfidelity simulation training in advanced resuscitation for pharmacy residents. Am J Pharm Educ 2014;78(3):59.
  • 27. Yoo HB, Park JH, Ko JK. An effective method of teaching advanced cardiac life support (ACLS) skills in simulation-based training. Korean J Med Educ 2012;24(1):7-14.

Evaluation of Basic and Advanced Life Support Skills of 6th-Year Medical Students During Emergency Medicine Clerkship

Yıl 2019, Cilt: 2 Sayı: 4, 6 - 10, 31.12.2019

Öz

Aim

It is important to optimize CPR training so that medical students become capable of treating cardiac arrest effectively. CPR training program and to improve the quality of CPR training among 6th-year medical students.

Material and Methods

In this study, the pre-and post-test scores of 6th-year medical students who received CPR training during emergency medicine clerkship between the years 2017 and 2018 were compared prospectively. The students completed the pre-test during the information meeting held on the first day of the clerkship. At the end of the training course, the students took the post-test which was identical to the pre-test. The pre-test and post-test results were compared to evaluate the improvement in the CPR skills of the students and the quality of the CPR training

Results

During the study, 185 participants took the pre-test and 128 participants took the post-test. Fifty-seven participants who failed to attend the course or the post-test were excluded. After the course, the success rates increased significantly in the Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and arrhythmia management sections and in the overall evaluation. Among these, the most significant increase in success was in the ACLS section and the least significant increase was in the arrhythmia management section.

Conclusion

The BLS-ACLS course we provided to 6th-year medical students, which consisted of 3-hours of didactic training and 1- hour of scenario-based simulation training, was shown to be effective.

Kaynakça

  • 1. Johnson NJ, Salhi RA, Abella BS, et al. Emergency department factors associated with survival after sudden cardiac arrest. Resuscitation 2013;84:292–7.
  • 2. Ali B, Zafari AM. Narrative review: cardiopulmonary resuscitation and emergency cardiovascular care: review of the current guidelines. Ann Intern Med 2007;147:171–9.
  • 3. Casey W. Cardiopulmonary resuscitation: a survey of standards among junior hospital doctors. J R Soc Med 1984;77:921–4.
  • 4. Skinner D, Camm A, MilesW. Cardiopulmonary resuscitation skills of preregistration house officers. Br Med J (Clin Res Ed) 1985;290: 1549–50.
  • 5. Smith GB, Hill SL. Resuscitation training for medical students in the UK—a comparison with the US. Intensive Care Med 1987;13: 260–5.
  • 6. Morris F, Tordoff S, Wallis D, Skinner D. Cardiopulmonary resuscitation skills of preregistration house officers: five years on. BMJ 1991;302:626–7.
  • 7. Goodwin A. Cardiopulmonary resuscitation training revisited. J R Soc Med 1992;85:452–3.
  • 8. Gillard J, Dent T, Jolly B,Wallis D, Hicks B. CPR and the RCP (2). Training of students and doctors in UK medical schools. J R Coll Physicians Lond 1993;27:412–7.
  • 9. Graham C, Guest K, Scollon D. Cardiopulmonary resuscitation. Paper 2: A survey of basic life support training for medical students. J Accid Emerg Med 1994;11:165–7.
  • 10. Leah V, Whitbread M, Coats TJ. Resuscitation training for medicalstudents. Resuscitation 1998;39:87–90.
  • 11. Jordan T, Bradley P. A survey of basic life support training in various undergraduate healthcare professions. Resuscitation 2000;47:321–3.
  • 12. Price C, Bell S, Janes S, Ardagh M. Cardiopulmonary resuscitation training, knowledge and attitudes of newly-qualified doctors in New Zealand in 2003. Resuscitation 2006;68:295–9.
  • 13. Meaney PA, Bobrow BJ, Mancini ME, et al. CPR Quality Summit Investigators, the American Heart Association Emergency Cardiovascular Care Committee, and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation. Cardiopulmonary resuscitation quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 2013;128:417–35.
  • 14. TalikowskaM, Tohira H, Finn J. Cardiopulmonary resuscitation quality and patient survival outcome in cardiac arrest: A systematic review and meta-analysis. Resuscitation 2015;96:66–77.
  • 15. Yannopoulos D, Aufderheide TP, Abella BS, et al. Quality of CPR: an important effect modifier in cardiac arrest clinical outcomes and intervention effectiveness trials. Resuscitation 2015;94:106–13.
  • 16. Abella BS, Alvarado JP,Myklebust H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305–10.
  • 17. Mcevoy MD, Field LC, Moore HE, et al. The effect of adherence to ACLS protocols on survival of event in the setting of in-hospital cardiac arrest. Resuscitation 2014;85:82–7.
  • 18. Crowe C, Bobrow BJ, Vadeboncoeur TF, et al. Measuring and improving cardiopulmonary resuscitation quality inside the emergency department. Resuscitation 2015;93:8–13.
  • 19. Lunenfeld E, Weinreb B, Lavi Y, Amiel GE, Friedman M. Assessment of emergency medicine: a comparison of an experimental objective structured clinical examination with a practical examination. Med Educ 1991;25(1):38-44.
  • 20. Berden HJ, Bierens JJ, Willems FF, Hendrick JM, Pijls NH, Knape JT. Resuscitation skills of lay public after recent training. Ann Emerg Med 1994; 23: 1003–1008.
  • 21. Lighthall GK, Barr J, Howard SK, Gellar E, Sowb Y, Bertacini E, et al. Use of a fully simulated intensive care unit environment for critical event management training for internal medicine residents. Critical Care Medicine 2003;31:2437–43.
  • 22. Promes SB, Chudgar SM, O’Connor Grochowski C, Shayne P, Isenhour J, Glickman SW, et al. Gaps in procedural experience and competency in medical school graduates. AcademicEmergency Medicine 2009;16:S58–62.
  • 23. Wu EH, Elnicki DM, Alper EJ, Bost JE, Corbett EC Jr, Fagan MJ, et al. Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students. Academic Medicine 2008;83:S63–7.
  • 24. Kim JH, Kim WO, Min KT, Yang JY, Nam YT. Learning by computer simulation does not lead to better test performance than textbook study in the diagnosis and treatment of dysrhythmias. J Clin Anesth 2002;14(5):395- 400.
  • 25. Perkins GD. Simulation in resuscitation training. Resuscitation 2007;73(2):202-11.
  • 26. Eng AJ, Namba JM, Box KW, Lane JR, Kim DY, Davis DP, et al. Highfidelity simulation training in advanced resuscitation for pharmacy residents. Am J Pharm Educ 2014;78(3):59.
  • 27. Yoo HB, Park JH, Ko JK. An effective method of teaching advanced cardiac life support (ACLS) skills in simulation-based training. Korean J Med Educ 2012;24(1):7-14.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Orijinal Çalışma
Yazarlar

Enver Özçete

İlhan Uz

Funda Karbek Akarca

Yayımlanma Tarihi 31 Aralık 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 2 Sayı: 4

Kaynak Göster

AMA Özçete E, Uz İ, Karbek Akarca F. Evaluation of Basic and Advanced Life Support Skills of 6th-Year Medical Students During Emergency Medicine Clerkship. Anatolian J Emerg Med. Aralık 2019;2(4):6-10.