高级创伤生命支持培训后外科住院医师管理技能的创伤模拟人评估

Trauma mannequin assessment of management skills of surgical residents after advanced trauma life support training.

作者信息

Ali J, Gana T J, Howard M

机构信息

Department of Surgery, University of Toronto at St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.

出版信息

J Surg Res. 2000 Sep;93(1):197-200. doi: 10.1006/jsre.2000.5968.

DOI:10.1006/jsre.2000.5968

PMID:10945963

Abstract

BACKGROUND

We tested the effectiveness of Advanced Trauma Life Support (ATLS) training among surgical residents using a specially designed mannequin.

MATERIALS AND METHODS

Thirty-two Postgraduate Year I surgical residents were randomly assigned to two groups of 16 each. By use of a trauma mannequin, the 32 residents' performances were scored using four trauma scenarios before 16 residents (ATLS group) completed a standard ATLS course. Performances were also scored after the ATLS course on another four trauma scenarios. The scores were standardized to a maximum of 20 for each scenario. Organized Approach scores with a range of 1 to 5, Priority scores ranging from 1 to 7, and global ratings of Honors, Pass, Borderline, or Fail were assigned for each clinical scenario.

RESULTS

The pre-ATLS assessment scores were similar for both groups ranging between 9.4 +/- 3.5 and 11.4 +/- 2.9 for the ATLS group and between 10.2 +/- 3.8 and 11.4 +/- 3.9 for the non-ATLS group. The ATLS group scores ranged from 16.0 +/- 1.3 to 17.4 +/- 3.1 after the course and the non-ATLS group scores ranged from 11.4 +/- 4.2 to 12.9 +/- 4.0 (P < 0.05). Pre-ATLS Organized Approach scores were 2.9 +/- 1.0 and 2.7 +/- 1.1 (NS) for the ATLS and non-ATLS groups, respectively, with post-ATLS scores being significantly higher in the ATLS group (4.9 +/- 1.2 compared with 2.8 +/- 1.2 for the non-ATLS group, P < 0. 05). Initial Priority scores were also similar for both groups (3.2 +/- 1.4 for the ATLS group and 3.3 +/- 2.0 for the non-ATLS group). Post-ATLS Priority scores were significantly higher (6.4 +/- 1.4) in the ATLS group compared with 4.2 +/- 1.9 for the non-ATLS group (P < 0.05). The pre-ATLS global ratings were similar for both groups and post-ATLS there were 10 Honors ratings in the ATLS group and none for the control group.

CONCLUSIONS

Using a trauma mannequin, for assessment, surgical residents completing the ATLS course demonstrated superior resuscitation skills compared with a non-ATLS group.

摘要

背景

我们使用专门设计的人体模型测试了高级创伤生命支持（ATLS）培训对外科住院医师的有效性。

材料与方法

32名一年级外科住院医师被随机分为两组，每组16人。在16名住院医师（ATLS组）完成标准ATLS课程之前，通过使用创伤人体模型，根据四种创伤场景对这32名住院医师的表现进行评分。在ATLS课程结束后，同样根据另外四种创伤场景进行评分。每个场景的分数标准化后最高为20分。为每个临床场景分配1至5分的有序处理分数、1至7分的优先级分数以及荣誉、通过、边缘或不及格的整体评级。

结果

两组ATLS前评估分数相似，ATLS组为9.4±3.5至11.4±2.9，非ATLS组为10.2±3.8至11.4±3.9。课程结束后，ATLS组分数范围为16.0±1.3至17.4±3.1，非ATLS组分数范围为11.4±4.2至12.9±4.0（P<0.05）。ATLS组和非ATLS组ATLS前的有序处理分数分别为2.9±1.0和2.7±1.1（无显著性差异），ATLS组ATLS后的分数显著更高（4.9±1.2，而非ATLS组为2.8±1.2，P<0.05）。两组初始优先级分数也相似（ATLS组为3.2±1.4，非ATLS组为3.3±2.0）。ATLS组ATLS后的优先级分数显著高于非ATLS组（6.4±1.4，而非ATLS组为4.2±1.9，P<0.05）。两组ATLS前的整体评级相似，ATLS后，ATLS组有10个荣誉评级，而对照组没有。