The application of scenario simulation exercise based on case learning in the first aid training for malignant hyperthermia

doi:10.3760/cma.j.cn115259-20230331-00350

Abstract

Abstract: Objective To explore the application effect of case-based learning(CBL) combined with scenario simulation exercise in emergency training for malignant hyperthermia(MH) during anesthesia crisis events. Methods A total of 45 anesthesiologists from Peking University Third Hospital from September 2018 to May 2023 were selected as the study subjects. They were randomly divided into an experimental group and a control group using a mixed block randomization method. The experimental group of 15 physicians used CBL combined with scenario simulation exercise, while the control group of 30 physicians used traditional teaching methods. After training, the teaching effectiveness will be evaluated by the proportion of correct answers in two groups of MH related theoretical exams, using t-tests or χ² tests for comparison between two group; and evaluate the necessity and effectiveness of CBL combined withscenario simulation exercise by conducting a questionnaire survey among the experimental group physicians. Results The proportion of physicians in the experimental group who answered correctly in the aspects of rapid diagnosis of MH and standardized application of the specific drug dantrolene sodium was higher than that of physicians in the control group, with [11/15 to 12(40.0%)] and [10/15 to 9(30.0%)], respectively, and the differences were statistically significant (all P<0.05); The proportion of people who answered correctly in the other four aspects were [7/15 to 15(50.0%)], [6/15 to 10(33.3%)], [11/15 to 15(50.0%)], and [13/15 to 26(86.7)], and the differences were not statistically significant (all P>0.05). Among the 15 physicians in the experimental group, all 15 physicians believed that it was necessary to conduct CBL combined withscenario simulation exercise in MH emergency training; 13 physicians believed that the training was very effective. Conclusions CBL combined with scenario simulation exercise in MH emergency training is helpful for anesthesiologists to quickly diagnose MH and standardize the application of the specific drug dantrolene sodium, and has been unanimously recognized by physicians.

Key words: Anesthesia crisis event, Malignant hyperthermia, Case-based learning, Scenario simulation exercise

CLC Number:

Lin Xiaona, Zhang Jing, Zheng Hongcai, Zhou Yang, Guo Xiangyang, Li Zhengqian. The application of scenario simulation exercise based on case learning in the first aid training for malignant hyperthermia[J]. Chinese Journal of Medical Education, 2024, 44(2): 105-108.

References

[1] 中国防治恶性高热专家共识工作组. 中国防治恶性高热专家共识(2020版)[J].中华麻醉学杂志,2021,41(1):20-25. DOI: 10.3760/cma.j.cn131073.20210102.00107.
[2] Li Z, Liu K, Guo X: Dantrolene available in China for malignant hyperthermia treatment[J]. Anesthesiology, 2022,136(3):515-516.
[3] 韩永正, 郭向阳. 国产注射用丹曲林钠用于恶性高热抢救规范化管理的个人建议[J].中华麻醉学杂志,2021,41(1):16-19. DOI: 10.3760/cma.j.cn131073.20201207.00106.
[4] Cain CL, Riess ML, Gettrust L, et al. Malignant hyperthermia crisis: optimizing patient outcomes through simulation and interdisciplinary collaboration[J]. AORN J, 2014,99(2):301-308; quiz 309-311. DOI: 10.1016/j.aorn.2013.06.012.
[5] Mejía V, Gonzalez C, Delfino AE, et al. Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study[J]. Braz J Anesthesiol, 2018,68(3):292-298. DOI: 10.1016/j.bjan.2018.01.005.
[6] 曹锡梅, 崔慧林, 蔡玉瑾, 等. 基于情景教学法的线上教学方式在留学生组织学与胚胎学教学中的应用[J].中华医学教育杂志,2021,41(10):896-899. DOI: 10.3760/cma.j.cn115259-20210202-00156.
[7] Ebbitt L, Johnson E, Herndon B, et al. Suspected Malignant Hyperthermia and the Application of a Multidisciplinary Response[J]. Healthcare (Basel), 2020,8(3):328.DOI: 10.3390/healthcare8030328.
[8] Sousa CS, Bispo DM, Cunha AL, et al. Educational intervention on malignant hyperthermia with nursing professionals of the operating room[J]. Rev Esc Enferm USP, 2015,49(2):292-297. DOI: 10.1590/S0080-623420150000200015.
[9] Quick J, Murthy R, Goyal N, et al. Malignant hyperthermia: an anesthesiology simulation case for early anesthesia providers[J]. MedEdPORTAL, 2017,13:10550. DOI: 10.15766/mep_2374-8265.10550.
[10] Ho PT, Carvalho B, Sun EC, et al. Cost-benefit analysis of maintaining a fully stocked malignant hyperthermia cart versus an initial dantrolene treatment dose for maternity units[J]. Anesthesiology, 2018,129(2):249-259. DOI: 10.1097/ALN.0000000000002231..
[11] 李春玲, 黄长盛, 郭曲练, 等. 临床麻醉学课程思政的设计与实施效果[J].中华医学教育杂志,2023,43(9):659-662. DOI: 10.3760/cma.j.cn115259-20221008-01275.
[12] 何征宇, 徐侨翌, 李尹娇枝, 等. 案例教学法联合情景模拟教学法在住院医师规范化培训中的应用[J].临床麻醉学杂志,2020,36(8):813-814. DOI: 10.12089/jca.2020.08.020.

[1]	Liu Xiangyang, Zhou Jie, Shi Min, Zhou Yingni, Liu Tao, Li Xiaomiao. Application of case-based learning combined with KWL method for clinical internship teaching in endocrinology and metabolism department [J]. Chinese Journal of Medical Education, 2023, 43(9): 675-678.
[2]	Wu Yue, Shen Bingzheng, Tan Yi, He Jingsheng, Zhou Benhong. Application of problem-based learning combined with case-based learning in the teaching of pharmaceutical management [J]. Chinese Journal of Medical Education, 2023, 43(4): 272-275.
[3]	Wang Qiuning, Liu Xiaojian, Yang Jingming. The exploration and application of presentation-assimilation-discussion combined with case-based learning in pharmacology theory teaching [J]. Chinese Journal of Medical Education, 2023, 43(3): 195-198.
[4]	Zhang Wenbo, Zhang Jianyun, Xie Xiaoyan, Liu Denggao, Zhang Jie, Li Tiejun, Guo Chuanbin, Peng Xin. Application of blended teaching mode based on standard clinical cases in oral and maxillofacial oncology course [J]. Chinese Journal of Medical Education, 2023, 43(11): 837-841.
[5]	Deng Weiwei, Gao Yu, Jin Mengdie, Song Yanping, Chen Nan. Application of case-based learning in the teaching pediatric physical therapy for postgraduates in rehabilitation [J]. Chinese Journal of Medical Education, 2023, 43(1): 23-26.
[6]	Yang Hongxia, Jiang Min. Exploration of case-based learning incorporated by KWL form in probation teaching for pediatric undergraduates [J]. Chinese Journal of Medical Education, 2022, 42(12): 1106-1109.
[7]	Yang Yin, Guan Yuanzhi. Application of case-based learning in the teaching of medical microbiology [J]. Chinese Journal of Medical Education, 2021, 41(9): 807-809.
[8]	Wang Changming, Yang Guangxin, Li Xuan. Application of case-based learning in the teaching of ultrasound diagnostics and operation skills during the training of vascular surgeons [J]. Chinese Journal of Medical Education, 2021, 41(7): 592-596.
[9]	He Ji, Zhang Yixuan, Li Gang, Fan Dongsheng. Application of an online case-based learning platform in standardized training of neurology residents [J]. Chinese Journal of Medical Education, 2021, 41(3): 226-229.
[10]	Wang Yang, Cao Yu, Zhao Zhigang, Zhang Yan, Qiu Huimin, Liu Jintong. Application of case-based learning method in psychological health education [J]. Chinese Journal of Medical Education, 2020, 40(6): 439-442.
[11]	Zou Huiru, Wang Ya'nan, Lin Xin, Dai Yanmei. The application of case-based learning in stomatological teaching [J]. Chinese Journal of Medical Education, 2020, 40(3): 192-195.
[12]	Liu Jianzhang, Cao Zhanqiang, Liu Yunsong, Zhou Yongsheng. Application of an online case-based learning system for prosthodontics [J]. Chinese Journal of Medical Education, 2020, 40(2): 107-110.
[13]	Han Xue, Yao Maolin, Wang Qi, Ma Lu, Wang Dapeng, Chen Xiong, Zou Zhonglan, Wang Qingling, Hu Ting, Qin Zixiu, Pan Xueli, Hong Feng, Zhang Aihua. Application and effect of case-based inquiry teaching method in toxicology experiment teaching [J]. Chinese Journal of Medical Education, 2020, 40(10): 766-769.
[14]	Dong Dan, Hou Jun, Wang Xiaofang, Chen Xueling. Application of case-based learning in experiment course of medical microbiology [J]. Chinese Journal of Medical Education, 2020, 40(10): 770-773.
[15]	Min Li, Fang Xiang, Zhou Yong, Luo Yi, Zhang Wenli, Duan Hong, Li Jian, Zeng Jing, Qing Ping, Tu Chongqi. Application of 3D-multimodality image reconstruction in orthopedics clinical probation teaching [J]. Chinese Journal of Medical Education, 2020, 40(1): 47-50.