Cone Stephen W, Rafiq Azhar, Merrell Ronald C
Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Simul Healthc. 2008 Summer;3(2):111-5. doi: 10.1097/SIH.0b013e31815c96f7.
Resuscitation science is a dynamic part of healthcare training, with an expanding role for simulation. Historically, performance measurement and documentation relied upon the presence of an instructor, an expensive and potentially inaccurate assessment tradition that tied performance testing to a fixed facility. We hypothesize that an automated system might be developed and validated to document performance in airway management for self assessment in the absence of a human trainer. The system would also store and transmit data to a central registry to document skill acquisition and maintenance.
Multiple video and pressure inputs captured and documented resuscitation task performance on a readily available standard practice manikin. Bag-valve-mask ventilation (BVM), endotracheal intubation, and ventilation via endotracheal tube (ETT) were studied for accuracy, adequacy, and time. The 12 participants performed each task for 5 repetitions, resulting in 60 total attempts for each skill.
Twelve untrained participants performed 3 critical tasks in airway management. Review with the system informed the participant of his/her performance and desired outcome. The system also documented skill performance objectively relative to a standard, recording both successes and failures. Compressed and abstracted performance records populated an average 14-megabyte file size (excluding full motion video).
This system was successfully used to document student performance of BVM, orotracheal intubation, and ventilation via ETT. The system easily integrates documentation, including text reports, airway pressure readings, still images and videos of task performance. Such digital documentation could guide skill acquisition and quantitatively certify performance with minimal reliance upon an instructor and evaluator.
复苏科学是医疗培训中一个充满活力的部分，模拟的作用在不断扩大。从历史上看，性能测量和记录依赖于有一名教员在场，这是一种昂贵且可能不准确的评估传统，将性能测试与固定设施联系在一起。我们假设可以开发并验证一种自动化系统，用于在没有人工培训师的情况下记录气道管理中的性能以供自我评估。该系统还将存储数据并将其传输到中央登记处，以记录技能的获得和维持情况。
多个视频和压力输入捕捉并记录了在一种现成的标准练习人体模型上的复苏任务表现。研究了袋阀面罩通气（BVM）、气管插管和通过气管内导管（ETT）通气的准确性、充分性和时间。12名参与者对每项任务进行5次重复操作，每项技能总共尝试60次。
12名未经培训的参与者进行了气道管理中的3项关键任务。通过该系统进行的回顾向参与者告知了其表现和期望结果。该系统还相对于一个标准客观地记录了技能表现，记录了成功和失败情况。压缩和摘要后的性能记录形成了一个平均大小为14兆字节的文件（不包括全动态视频）。
该系统成功用于记录学生在BVM、口气管插管和通过ETT通气方面的表现。该系统轻松整合了文档，包括文本报告、气道压力读数、任务表现的静态图像和视频。这种数字文档可以指导技能的获得，并在对教员和评估人员依赖最小的情况下对性能进行定量认证。
