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模拟训练提高应对医疗紧急情况的能力。

Simulation training improves ability to manage medical emergencies.

机构信息

Department of Trauma Surgery, J.W. Goethe University Hospital, Theodor-Stern-Kai 7, Frankfurt 60590, Germany.

出版信息

Emerg Med J. 2010 Oct;27(10):734-8. doi: 10.1136/emj.2009.074518.

Abstract

OBJECTIVE

In the case of an emergency, fast and structured patient management is crucial for a patient's outcome. Every physician and graduate medical student should possess basic knowledge of emergency care and the skills to manage common emergencies. This study determines the effect of a simulation-based curriculum in emergency medicine on students' abilities to manage emergency situations.

METHODS

A controlled, blinded educational trial of 44 final-year medical students was carried out at Frankfurt Medical School; 22 students completed the former curriculum as the control group and 22 the new curriculum as the intervention group. The intervention consists of simulation-based training with theoretical and simulation-based training sessions in realistic encounters based on the Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and adapted Advanced Trauma Life Support (ATLS) training. Further common emergencies were integrated corresponding to the course objectives. All students faced a performance-based assessment in a 10 station Objective Structured Clinical Examination (OSCE) using checklist rating within a maximum of 4 months after completion of the intervention.

RESULTS

The intervention group performed significantly better at all of the 10 OSCE stations in the checklist rating (p<0.0001 to p=0.016).

CONCLUSIONS

The simulation-based intervention offers a positively evaluated possibility to enhance students' skills in recognising and handling emergencies. Additional studies are required to measure the long-term retention of the acquired skills, as well as the effect of training in healthcare professionals.

摘要

目的

在紧急情况下,快速而结构化的患者管理对患者的预后至关重要。每位医师和住院医师都应具备基本的急救知识和处理常见紧急情况的技能。本研究旨在确定基于模拟的急诊医学课程对学生处理紧急情况能力的影响。

方法

在法兰克福医学院进行了一项针对 44 名应届医学专业学生的对照、盲法教育试验;其中 22 名学生完成了原课程,作为对照组,22 名学生完成了新的课程,作为干预组。干预措施包括基于模拟的培训,以及基于基础生命支持(BLS)、高级心脏生命支持(ACLS)和改编的高级创伤生命支持(ATLS)培训的现实遭遇中的理论和模拟培训课程。根据课程目标,还整合了其他常见的紧急情况。所有学生都在完成干预后最多 4 个月内参加了基于 10 站客观结构化临床考试(OSCE)的基于表现的评估,使用检查表评分。

结果

干预组在 OSCE 的所有 10 个站的检查表评分中表现明显更好(p<0.0001 至 p=0.016)。

结论

基于模拟的干预提供了一种经过评估的可能性,可以提高学生识别和处理紧急情况的技能。需要进一步的研究来衡量所获得技能的长期保留情况,以及培训对医疗保健专业人员的影响。

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