Evaluation of the effectiveness of the formation and improvement of the competence of carrying out resuscitation measures for pregnant women and women in labor in the system of continuous professional development of medical practitioners using simulation

Abstract

Annotation. The Ministry of Health of Ukraine has implemented a system of continuous professional development (CPD) for doctors. One of the possible measures of CPD, which ensures a continuous process of training and improvement of professional competences of medical workers, is simulation training. The purpose of our work is to evaluate the effectiveness of the use of simulation technologies as a CPD tool for the formation and improvement of the competence of medical workers in carrying out basic and advanced resuscitation measures for pregnant women and women in labor. During 2019-2021, 28 simulation trainings on the topic “Basic and advanced life support of pregnant women and women in labor” were held for medical workers of the city of Vinnytsia and Vinnytsia region, which were attended by 246 medical workers at an age from 20 to 63 years (the mean age – 43.1±8.6 years) and medical experience from 1 to 43 years (the mean medical experience – 19.04±10.89 years). Among the training participants, 38.9% were obstetrician-gynecologists, 17.6% anesthesiologists, 20.1% midwives, 13.4% nurse anesthetists, and 10% nurses. To evaluate the theoretical knowledge of the training participants, we used test control: the initial assessment of knowledge (pre-test), which was compared with the results of the final test (post- test). In addition, at the end of the training, an anonymous questionnaire was conducted regarding the self-assessment of the acquired skills and the attitude of the trainees to the conducted simulation training. Statistical processing of the obtained data was carried out using the SPSS 21 statistical information processing package (©SPSS Inc.). The results of our research show that training using simulation technologies contributes to a 1.7 increase (on average – from 5.76±2.67 to 9.62±1.63 points; p<0.001) in the level of theoretical knowledge by the formation and improving the competence of carrying out resuscitation measures and algorithms for providing medical assistance in case of circulatory arrest. A comparative analysis of the results of the self-assessment of the basic techniques of cardiopulmonary resuscitation before and after the training shows an improvement in skills with a 2 times increase in the average score for the restoration of airway patency, ventilation with an Ambu bag – by 27.7%, indirect heart massage – by 32,9%, dosing and administration of epinephrine – by 24.7%, dosing and administration of amiodarone – by 37.2%, rhythm assessment and defibrillation – 2 times (p<0.001). The assessment of the attitude of medical workers to simulation training in general demonstrated the satisfaction of the trainees with the training, simulation scenarios, educational presentations, qualifications and attitude of the trainers. According to 95.5% of respondents, the goals and objectives of the training were fully achieved and they will be able to effectively use the acquired skills in their practical activities. Thus, the method of simulation training is an effective tool of CPD.