Approche neurocomportementale de la gestion anesthésique de l’hémorragie du post partum : étude expérimentale en simulation médicale haute-fidélité

Abstract : Background: the postpartum hemorrhage is the leading cause of maternal mortality in the world. Human factors and especially situation awareness have primarily responsibility to explain suboptimal cares. Based on eye tracking and analysis of behavior in high fidelity simulation of postpartum hemorrhage management, the goal of this study is to identify perceptual and cognitive key parameters of the expertise associated with good performance. Methods: two groups of fifteen anesthetists (Novices and Expert) watched the beginning of a severe simulated postpartum hemorrhage management. During this first experimental phase, situation awareness was assessed using SAGAT questionnaire and visual behavior was analyzed with eye tracking. In the continuity of the video sequence, they have to step in the PPH situation and to provide care to the patient. Performance was evaluated and self-assessed as well as cognitive load. Results: no statistical difference between the Experts and Novices groups was observed on performance of simulated PPH management, situation awareness, cognitive load or theoretical knowledge of PPH. Only results of self-assessed performance and eye tracking data revealed that Experts tended to get accurate evaluation of their performance and to monitor more the bloodloss of the patient. Conclusions: this study has clearly shown the limits of classical assessment of performance and also human factors based on questionnaires to identify expertise in simulated PPH care. A neuroscientific approach with new technology like eye tracking could provide new objective and more sensitive insights on human factors.
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Master Thesis
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Submitted on : Friday, January 18, 2019 - 4:04:49 PM
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Arnaud Desvergez. Approche neurocomportementale de la gestion anesthésique de l’hémorragie du post partum : étude expérimentale en simulation médicale haute-fidélité. Santé publique et épidémiologie. 2018. ⟨dumas-01986252⟩

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