YENİ NESİL BİLGİSAYAR DESTEKLİ SİMÜLASYON MAKETİNDE KARDİYOPULMONER RESÜSİTASYON EĞİTİMİNİN ASİSTAN EĞİTİMİNDEKİ ETKİNLİĞİ

Yıl 2024, Cilt: 31 Sayı: 1, 63 - 70, 18.03.2024

Eyyüp Sabri Özden Mustafa Soner Özcan Pınar Karabacak Burcu Kaplan Filiz Alkaya Pakize Kırdemir

https://doi.org/10.17343/sdutfd.1387913

Öz

Amaç
Kardiyopulmoner resüsitasyon (KPR) uygulamalarında,
lisans ve lisansüstü tıp eğitiminde simülasyon
teknolojisi kullanımı giderek artmaktadır. Sürekli eğitimin
bir parçası olan resüsitasyon eğitiminde yeni nesil
bilgisayar destekli simülasyon maketi (YNBDSM)
kullanımı ile asistanların bilgi düzeylerinin gelişimi
araştırıldı.
Gereç ve Yöntem
Eğitime 21 klinikten 192 asistan çağrıldı. Toplam 125
asistan eğitime katıldı. 10 kişilik gruplar halinde toplam
3 makette 3 eğitimci ile 2 saat süre ile KPR eğitimi
verildi. Eğitim öncesi katılımcılara 50 soruluk doğru/
yanlış testi yapıldı. 100 puan üzerinden değerlendirildi.
2 saatlik uygulamada asistanlar birebir YNBDSM
üzerinde havayolu açma manevraları, solunum, kompresyon
ve defibrilasyon gibi resüsitasyon aşamalarını
uyguladı. Tüm asistanlar YNBDSM tabletinde
uygun kompresyon derinliğini gösteren gösterge ile
hastaya etkin kompresyon yapıldığı anlaşılarak resüsitasyonu
uyguladı. Maketin monitöründe şoklanabilir
ve şoklanamaz tüm ritimler gösterilerek, senaryolar
oluşturularak ileri yaşam desteği algoritması uygulandı.
Eğitim sonrası katılımcılara aynı doğru/yanlış testi
verildi. İlk ve son test karşılaştırması cinsiyet, klinik ve
asistan eğitim yıllarına göre yapıldı.
Bulgular
Resüsitasyon öncesi test (RÖT) ve resüsitasyon sonrası
test (RST) puanlarının karşılaştırılmasında anlamlı
farklılık gözlenmiştir. 0-1 yıl, 2-3 yıl ve 3 yıldan
fazla çalışanlarda RÖT ve RST puanları arasında istatistik
olarak anlamlı farklılık gözlendi. RÖT ile RST
puanları ve RST ile RÖT-RST farkı arasında istatistik
olarak anlamlı pozitif bir korelasyon, RÖT ile RÖTRST
farkı arasında istatistik olarak anlamlı negatif korelasyon
tespit edilmiştir.
Sonuç
Çalışmalarda resüsitasyon eğitiminde simülasyonun
kullanılması eğitim sonuçlarını iyileştirdiği, resüsitasyon
yönergelerine daha iyi uyum sağlandığı gösterilmiştir.
Yeni nesil bilgisayar destekli simülasyon maketinde
asistanların görerek ve uygulayarak yaptığı KPR
eğitiminin bilgi düzeylerini geliştirmede etkin olduğu
kanısındayız.

Anahtar Kelimeler

Yeni Nesil Bilgisayar Destekli Simülasyon Maketi, Kardiyopulmoner Resüsitasyon, Eğitim

EFFECTİVENESS OF CARDIOPULMONARY RESUSCITATION TRAINING IN NEW GENERATION COMPUTER ASSISTED SIMULATION MODEL IN THE ASSISTANT DOCTORS EDUCATION

Öz

Objective
The use of simulation technology in cardiopulmonary
resuscitation (CPR) applications and undergraduate
and postgraduate medical education is increasing.
We investigated the development of assistant doctors
knowledge levels by using the new generation
computer assisted simulation model (NGCASM) in
resuscitation training, which is a part of continuing
education.
Material and Method
The training was attended by 192 assistant doctors
from 21 departments. A total of 125 assistant doctors
participated in the training. In groups of 10, CPR
training was given for 2 hours with 3 trainers on 3
models in total. A 50-question true/false test was
given to the participants before the training. It was
evaluated over 100 points. In the 2-hour practice,
assistant doctors performed resuscitation steps
such as airway opening maneuvers, breathing,
compression and defibrillation on the NGCASM.
All assistant doctors performed resuscitation with
the indicator showing the appropriate compression
depth on the NGCASM tablet, indicating that
effective compression was performed on the patient.
All shockable and non-shockable rhythms were
displayed on the monitor of the model and advanced
life support algorithm was applied by creating
scenarios. After the training, the same true/false
test was given to the participants. Initial and posttest
comparisons were made according to gender,
department and assistant doctors educastion year.
Results
A significant difference was observed in the
comparison of pre-resuscitation test (PreRT) and
post-resuscitation test (PRT) scores. A statistically
significant difference was observed between the
PreRT and PRT scores of those who worked 0-1
year, 2-3 years, and more than 3 years. A statistically
significant positive correlation was found between the
PreRT and PRT scores and between the PRT and
PreRT-PRT difference, and a statistically significant
negative correlation was found between the PreRT
and PreRT-PRT difference.
Conclusion
Studies have shown that the use of simulation in
resuscitation training improves training outcomes
and better compliance with resuscitation guidelines.
We believe that the CPR training performed by
seeing and practicing by the assistant doctors in the
new generation computer assisted simulation model
is effective in improving their level of knowledge.

Anahtar Kelimeler

New generation computer assisted simulation model, cardiopulmonary resuscitation, education

Kaynakça

• 1. Chalkias A, Antoniou P, Xanthos T. Education in resuscitation: The need for a new teaching method. Am J Emerg Med 2017;35(2):370-371. doi: 10.1016/j.ajem.2016.11.028.
• 2. Okuda Y, Bryson EO, DeMaria S, Jacobson L, Quinones J, Shen B, Levine AI. The utility of simulation in medical education: What is the evidence? Mount Sınaı Journal of Medicine 2009;76: 330-343.
• 3. Cheng A, Magid DJ, Auerbach M, et al. Part 6: Resuscitation Education Science: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020;142:551–579.
• 4. Taş D, Akyol A. Kardiyopulmoner resüsitasyon eğitiminde yeni eğilim: Yüksek güvenirlikli simulasyon. Journal of Cardiovascular Nursing 2017;8(17):100-108.
• 5. Conlon LW, Rodgers DL, Shofer FS, Lipschik GY. Impact of levels of simulation fidelity on training of interns in ACLS. Hospital Practice 2014; 42(4): 135-141.
• 6. Monsieurs KG, Nolan JP, Bossaert LL, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 1. Executive summary. Resuscitation 2015;93: 1-80.
• 7. Hamilton R. Nurses' knowledge and skill retention following cardiopulmonary resuscitation training: a review of the literature. J Adv Nurs 2005;51(3):288-97. doi: 10.1111/j.1365-2648.2005.03491.x.
• 8. Sok SR, Kim JA, Lee Y, Cho Y. Effects of a simulation-based cpr training program on knowledge, performance, and stress in clinical nurses. J Contin Educ Nurs 2020;51(5):225-232. doi: 10.3928/00220124-20200415-07.
• 9. Onan A, Simsek N, Elcin M, Turan S, Erbil B, Deniz KZ. A review of simulation-enhanced, team-based cardiopulmonary resuscitation training for undergraduate students. Nurse Education in Practice 2017;27:134-143.
• 10. Soar J, Monsieurs KG, Ballance JH, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 9. Principles of education in resuscitation. Resuscitation. 2010;81(10):1434-44. doi: 10.1016/j.resuscitation.2010.08.014.
• 11. Soar J. European Resuscitation Council Guidelines 2021: Adult advanced life support [Internet]. www.cprguidelines.eu. 2021. [cited April 2021]. Available from: https://www.cprguidelines.eu/ assets/guidelines/RESUS-8903-ALS.pdf
• 12. Greif R, Bhanji F, Bigham BL, et al. Education, implementation, and teams: 2020 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2020;142(16):222-283.
• 13. Bray J, Nehme Z, Nguyen A, et al. Education implementation teams task force of the international liaison committee on resuscitation. A systematic review of the impact of emergency medical service practitioner experience and exposure to out of hospital cardiac arrest on patient outcomes. Resuscitation 2020;155:134-142. doi: 10.1016/j.resuscitation.2020.07.025.
• 14. 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: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 2013;23:128(4):417-35. doi: 10.1161/CIR.0b013e31829d8654.
• 15. Langdorf MI, Strom SL, Yang L, et al. High fidelity simulation enhances ACLS training. Teaching an Learning in Medicine 2014;26(3):266-273.
• 16. Smereka J, Szarpak L, Czekajlo M, et al. The TrueCPR device in the process of teaching cardiopulmonary resuscitation: A randomized simulation trial. Medicine (Baltimore) 2019;98(27):e15995. doi: 10.1097/MD.0000000000015995.
• 17. Abelairas-Gómez C, Barcala-Furelos R, Szarpak Ł, et al. The effect of strength training on quality of prolonged basic cardiopulmonary resuscitation. Kardiol Pol 2017;75(1):21-27. doi: 10.5603/KP.a2016.0165.
• 18. Huang J, Tang Y, Tang J, et al. Educational efficacy of high-fidelity simulation in neonatal resuscitation training: a systematic review and meta-analysis. BMC Med Educ 2019;29;19(1):323. doi: 10.1186/s12909-019-1763-z.
• 19. Finan E, Bismilla Z, Whyte HE, et al. High-fidelity simulator technology may not be superior to traditional low-fidelity equipment for neonatal resuscitation training. J Perinatol 2012;32(4):287- 92. doi: 10.1038/jp.2011.96. 70