Zirkle Molly, Blum Richard, Raemer Daniel B, Healy Gerald, Roberson David W
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA.
Laryngoscope. 2005 Mar;115(3):495-500. doi: 10.1097/01.mlg.0000157834.69121.b1.
Simulation is a tool that has been used successfully in many high performance fields to permit training in rare and hazardous events. Our goal was to develop and evaluate a program to teach airway crisis management to otolaryngology trainees using medical simulation.
A full-day curriculum in the management of airway emergencies was developed. The program consists of three airway emergency scenarios, developed in collaboration between attending otolaryngologists and faculty from the Center for Medical Simulation. Following each scenario, the participants are led in a structured, video-assisted debriefing by a trained debriefer. Didactic material on team leadership and crisis management is built into the debriefings. Pediatric otolaryngology fellows, residents, and medical students have participated in the four courses that have been held to date. Participants evaluated the program on a five-point Likert scale.
A total of 17 trainees participated in four pilot training courses. The survey data are as follows: overall program, 5.0 (SD, 0.00); course goals, 4.79 (SD, 0.43); realism, 4.36 (SD, 0.63); value of lecture, 4.71 (SD, 0.47); and quality of debriefings, 4.92 (SD, 0.28). Sample comments include: "This is a valuable tool for students and residents since true emergencies in ORL are often life-threatening and infrequent," and "This is a great course-really all physicians should experience it." Overall evaluation was extremely positive and both residents and fellows described the course as filling an important void in their education.
Medical simulation can be an extremely effective method for teaching airway crisis management and teamwork skills to otolaryngology trainees at all levels.
模拟是一种已在许多高性能领域成功应用的工具，可用于罕见和危险事件的培训。我们的目标是开发并评估一个使用医学模拟向耳鼻咽喉科住院医师传授气道危机管理的项目。
制定了一个关于气道紧急情况管理的全天课程。该项目包括三个气道紧急情况场景，由耳鼻咽喉科主治医生与医学模拟中心的教员合作开发。每个场景结束后，由一名经过培训的汇报员带领参与者进行结构化的、视频辅助的汇报。汇报中融入了关于团队领导和危机管理的教学材料。儿科耳鼻咽喉科住院医师、实习医生和医学生参加了迄今为止举办的四门课程。参与者以五点李克特量表对该项目进行评估。
共有17名学员参加了四门试点培训课程。调查数据如下：整体项目，5.0（标准差，0.00）；课程目标，4.79（标准差，0.43）；真实感，4.36（标准差，0.63）；讲座价值，4.71（标准差，0.47）；汇报质量，4.92（标准差，0.28）。示例评论包括：“这对学生和住院医师来说是一个有价值的工具，因为耳鼻咽喉科的真正紧急情况往往危及生命且不常见”，以及“这是一门很棒的课程——实际上所有医生都应该体验一下”。总体评价非常积极，住院医师和住院实习医生都表示该课程填补了他们教育中的一个重要空白。
医学模拟可以成为向各级耳鼻咽喉科住院医师传授气道危机管理和团队协作技能的极其有效的方法。
