Department of Surgery, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
J Surg Educ. 2009 Sep-Oct;66(5):248-54. doi: 10.1016/j.jsurg.2009.09.002.
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.
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).
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.
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.
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。
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。
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。
我们为外科实习医生开发了一门课程，其中包括教学法和模拟。学习者在测试中表现出客观的进步，并报告说课程主题非常重要。课程结束后，学习者提供的反馈表明他们对执行练习技能的信心很高，这表明他们对急性外科护理的准备有所提高。
