一项新的包含模拟训练的外科住院医师关键技能课程可提高其对急性住院患者治疗的准备水平。

A novel critical skills curriculum for surgical interns incorporating simulation training improves readiness for acute inpatient care.

机构信息

Department of Surgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.

出版信息

J Surg Educ. 2009 Sep-Oct;66(5):248-54. doi: 10.1016/j.jsurg.2009.09.002.

DOI:10.1016/j.jsurg.2009.09.002

PMID:20005496

Abstract

INTRODUCTION

Surgical interns encounter complex, acute care situations often managed with limited supervision. Furthermore, medical school training does not adequately prepare students for special surgical considerations. Using simulation training, we implemented a course aimed at improving surgical intern readiness for responding to unique, life-threatening issues encountered in daily surgical care.

METHODS

Twenty University of Minnesota surgical interns participated in the 3-week course. The first session consisted of interactive didactics and simulation covering hypoxia, shock, and metabolic disturbances; the second session addressed cardiopulmonary emergencies, including ventricular assist device and pacemaker use. Electronic simulation scenarios comprised the third session, allowing learners to demonstrate learned/practiced skills. The outcomes were assessed objectively (pretest and posttest) and subjectively (standardized feedback evaluations).

RESULTS

Fifteen learners completed the pretest and posttest. The mean absolute score increase was 14% with average relative score improvement of 43%. Twenty learners completed feedback evaluations using a standard 5-point Likert scale. Respondents scored the first 2 sessions on topic importance (5 = very important), giving the first session 4.90 (+/- 0.31) and the second session 4.45 (+/- 0.89). Respondents ranked their confidence in executing practiced skills on actual patients (5 = very confident) as 4.24 (+/- 0.71). There was uniform support for the value of the electronic simulation scenarios as enhanced learning tools.

CONCLUSIONS

We developed a course for surgical interns incorporating didactics and simulation. Learners demonstrated objective improvement in testing and reported that the course topics were highly important. After course completion, learners provided feedback indicating a high level of confidence in executing practiced skills, suggesting improved preparation for acute surgical care.

摘要

简介

外科实习医生经常在有限的监督下处理复杂的急性护理情况。此外，医学院的培训并没有让学生充分做好应对特殊外科考虑因素的准备。我们通过模拟培训，实施了一门课程，旨在提高外科实习医生应对日常外科护理中遇到的独特、危及生命问题的准备能力。

方法

20 名明尼苏达大学的外科实习医生参加了为期 3 周的课程。第一节课包括互动式教学和模拟课程，涵盖了缺氧、休克和代谢紊乱；第二节课介绍了心肺紧急情况，包括心室辅助设备和起搏器的使用。电子模拟情景构成了第三节课的内容，让学习者能够展示所学/练习的技能。结果通过客观（前测和后测）和主观（标准化反馈评估）进行评估。

结果

15 名学习者完成了前测和后测。平均绝对分数提高了 14%，平均相对分数提高了 43%。20 名学习者使用标准的 5 分李克特量表完成了反馈评估。受访者对前两个课程的主题重要性进行评分（5 分表示非常重要），第一个课程得分为 4.90（+/-0.31），第二个课程得分为 4.45（+/-0.89）。受访者对在实际患者身上执行练习技能的信心程度（5 分表示非常有信心）评为 4.24（+/-0.71）。受访者一致认为电子模拟情景作为增强学习工具具有价值。