幼儿园教师和临床医生在幼儿园保教学员儿童急救培训中的效果比较

The effects of the peer-led tuition and physician tuition model on the pediatric first aid training for caregivers and teachers

目的探讨幼儿园教师和临床医生对幼儿园保教学员儿童急救培训的效果。方法两次抽取上海市19个区县的保教人员作为学员,第1次抽取的保教学员分配在以临床医生为师资的培训模式中,第2次抽取的保教学员分配在以幼儿园教师为师资的同伴培训模式中,两种不同师资模式的学员统一接受美国儿科学会培训托幼机构保教学员儿童急救知识和技能的标准模式进行培训。学员培训前、后进行理论知识评估,并在培训后进行操作技能评估,比较培训前、后两种模式学员的理论成绩和培训后的技能操作成绩。结果2次共抽取148名学员,第1次83名,第2次65名。幼儿园教师及临床医生教员各3名。两种不同师资模式的学员在来自地区、年龄、学历、工作年限、职业、是否学习过儿童意外伤害知识及有无接受过正规的急救培训等差异均无统计学意义(P>0.05)。培训后两种模式的理论成绩(t=1.676,P=0.096)和技能操作总成绩差异均无统计学意义(t=0.849,P=0.397),同时以幼儿园教师为师资的培训模式能够更好地增强保教学员儿童急症救助的信心(χ2=13.565,P<0.01)。年龄≤40岁、～45岁和≥46岁的学员理论考试通过率分别为98.1%、89.5%和81.8%,技能操作考试通过率分别为97.2%、94.7%和77.3%,理论及技能操作考试通过率在年龄上的差异均有统计学意义。而不同培训模式、地区、幼儿园性质、学历、工作年限和是否接受过正规急救培训等因素对理论及操作考试通过率均无显著影响。结论在幼儿园保教学员儿童急救培训中,幼儿园教师作为师资不仅可达到临床医生的培训效果,并且在增强学员实施儿童急救信心方面更具有优势。

Objective To compare the training efficacy of the peer-led tuition model and physician tuition model on the pediatric first aid training for caregivers and teachers （PedFACTs）. Methods Teachers working in the kindergarten in Shanghai were recruited in two times. The number of teachers in eacb district or county was selected on the basis of the proportion of teachers of the district or county possessing in Shanghai. The first recruited teachers received first aid tuition from experienced clinical staff, and the second recruited teachers received first aid tuition from teachers instructors. The teachers in both of two models received American pediatric first aid for caregivers and teachers courses translated and modified into Chinese. The courses included small group activity, video presentation, PedFACTs challenge and first aid kit. The first aid knowledge in the two models was evaluated before and after the training. The theoretical assessment consisted of 37 multiple-choice questions addressing the treatment and prevention of common emergencies, which were developed from the American examination papers for the teachers, Instructor＇s Resource Manual for Pediatric First Aid for Caregivers and Teachers and the text book Pediatric First Aid Training for Caregivers and Teachers. A score of 80% of the assessment or greater was required to pass in accordance with American Academy of Pediatrics examination guidelines. Trainees practical skills were also tested at the end of the course, including cardiopulmonary resuscitation, management of a blocked airway on a child, management of a blocked airway on an infant. All analyses were done using SPSS. Results 148 teachers were recruited at two times, 83 at the first time and 65 at the second time. The demographics of the two models were not significant different in terms of district, age, education background, occupation, whether received first aid training or not, length of teaching experience and so on （P 〉 0.05 ）. There was no statistical significance in theoretical score before （ t = 1.631, P =0.105） or after（ t = 0.849, P = 0. 397） the training between the peer-led tuition model and physician tuition model. There was also no statistical significance in practical total score（ t = 1. 676 ,P =0. 096）, the score of cardiopulmonary resuscitation （ t = 1. 747, P = 0. 062 ） , the score of management of a blocked airway on a child （ t = 1. 762, P = 0.080 ）, the score of management of a blocked airway on an infant （t = 1. 149, P = 0. 252 ） between the two models. Before the training, 89. 2% of trainees considering their first aid knowledge common or poor in the model of peer-led tuition was similar to that （92.8%） in the model of physician tuition （X2 = 0. 570, P = 0. 450） ; 73.8% of trainees in the model of peer-led tuition had litttle or no confidence in providing first aid for the injured children, it was similar to that（70.7% ） in the model of physician tuition （X2 = 0. 179,P = 0.676）. But after training, 86.2% of trainees considering their first aid knowledge good or very good in the model of peer-led tuition was significantly higher than that （44.6%） in the model of physician tuition （X2 =26. 983 ,P 〈0.01 ） ; 95.4% of trainees were confident or very confident to provide first aid for the injured children in the model of peer-led tuition was significantly higher than that（68.7% ） in the model of physician tuition （X2 = 13. 565,P 〈 0.01 ）. The passing rate of theoretical assessment in trainees aged ≤40 years was 98.1% ; 89.5% in trainees aged past 40 and just under 46 years; 81.8% in trainees aged ≥46 years. The passing rate of practical assessment in trainees aged ≤40 years was 97.2% ; 94.7% in trainees aged past 40 and just under 46 years; 77.3% in trainees aged t〉46 years. The differences of theoretical or practical passing rate between ages were statistically significant, while not significant between models, district, kind of kinder-garten, educational background, occupation, length of teaching experience, whether received first aid training or not, whether studied the knowledge of injury or not. Conclusions The model of peer-led tuition in PedFACTs is not only proved to have the same efficacy as the model of physician tuition, but also shows the advantages in strengthening trainees＇ confidence in PedFACTs.