Автор(ы): Talkimbayeva N.A., Kolbayev M.T., Anuar A., Latkina K.S., Iglikova A.E.
Город: Алматы, Казахстан
Учреждение: NPJSC "S. D. Asfendiyarov Kazakh National Medical University" Almaty, Kazakhstan
The global trend towards continuous improvement in the quality of training of future specialists, the lack of opportunities for each internist to fully practice new practical skills on patients (especially children), the focus on compliance with safe, highly qualified medical care for patients, as well as compliance with all ethical standards of behavior have led to an innovative model of medical education — the use of simulation training methods. The simulation training method is aimed at teaching new practical skills and improving existing knowledge by repeatedly practicing the skill in simulated possible situations in an environment as close to reality as possible. This method of training is especially important for both future specialists and practitioners, for mastering and practicing the skills of emergency and emergency care. Working out skills, ranging from primitive simulators to robotic dummies, depending on the level of training, allows you to safely and repeatedly work out almost any skill that will be used in the future practice of a young specialist, and minimize the risk of medical errors.
According to the international recommendations of the American Heart Association (AHA), simulators with the ability to reproduce quantitatively large and accurate functions, with the presence of feedback and the ability to adjust actions when performing the skill show a great effect for the sustainable formation of action skills in critical situations, such as performing cardiopulmonary resuscitation (CPR), etc. Simulation training allows interns to urgently diagnose conditions such as: respiratory failure, shock, cardiac arrest, as well as CPR and emergency care. This is extremely important, since only 13% of children survive out — of-hospital cardiac arrest and 27% of children survive in hospital conditions .
One of the important issues in the training of future doctors is the choice of existing recommendations for the provision of medical care. To ensure a qualified approach in the provision of medical care, guidelines (clinical protocols of the Ministry of Health of the Republic of Kazakhstan) adopted by leading associations of specialists in developed countries and the World Health Organization are used.
Improve the practical skills of intern students to provide highly qualified professional care to pediatric patients using simulation training methods.
Материалы и методы
The article presents the experience of the simulation Center of the NPJSC "Kazakh National Medical University named after S. D. Asfendiyarov". Introduction of innovative methods in the educational process using simulation methods of training on dummy simulators and multi-purpose paediatric simulators manufactured by Gaumard.
On the basis of the simulation center of the Kazakh National Medical University, a pediatric unit was created, equipped with modern highly realistic simulation dummies and multi-purpose pediatric simulators of the manufacturer Gaumard, designed to teach intern students the skills of providing emergency and emergency care in critical conditions in children.
During the lesson, the skills of diagnosing children with critical or life-threatening conditions and stabilizing the condition of such children are formed, as well as, if necessary, providing resuscitation assistance to children with cardiac or respiratory disorders.
Training in the assessment, recognition and stabilization of life-threatening conditions in pediatric patients with the development of practical skills using simulation methods. Using a computer in the developed clinical scenarios, various states and physiological parameters are programmed on a dummy (heart rate, respiratory rate, respiratory noises, convulsions, skin color, pupil reactions to light, blood pressure, saturation, electrocardiogram, etc.), this process requires interns to assess the patient's condition as intently as possible and provide emergency highly qualified assistance in conditions simulated by the trainer, as close as possible to the real one. The results of the medical measures performed during the training on the simulation dummy are modeled depending on the correctness or erroneous management of the patient, so there is an adequate assessment of the actions or inactions of the intern doctor, which does not require additional interpretations and comments from the coach. During the practical training on the diagnosis and stabilization of life-threatening conditions in pediatric patients, the emphasis is on effective teamwork in critical situations, where each team member performs his role, and the skills of role distribution and communication in the team are also practiced. These classes allow the coach to adequately assess both the team work and the work of each participant individually.
When training interns, all the acquired skills are followed by an analysis of the interns skills (debriefing), where the performed or not performed medical manipulations are considered in detail at all stages of care.
The advantages and disadvantages of mastering the skills of assessment, recognition and stabilization of emergency conditions in children in the simulation Center were discussed with the interns who were trained in the simulation Center. All interns noted the high level of realism and the importance of simulation training, and the high efficiency of using theoretical knowledge in the formation of practical skills. Interns expressed a desire to increase the number of training hours with the use of simulation dummies in the pre-graduate training program.
Methods of diagnosis and stabilization of life-threatening conditions in children using simulation training methods can significantly improve the effectiveness of diagnosis and treatment of children, and will form in future specialists not only the reflection of knowledge, but also increase the level of clinical thinking in emergency conditions in patients, as well as increase the level of teamwork of future specialists.