Department of Surgery, Division of Surgery Education, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Simul Healthc. 2011 Apr;6(2):65-70. doi: 10.1097/SIH.0b013e318206953a.
Medical student procedural training has become increasingly limited amid concerns for patient safety. Because simulation education has been shown to be effective for early skills training, we used germ simulation for teaching hand hygiene principles and aseptic technique in urinary catheterization (UC). We hypothesized that posttraining, students would demonstrate proficiency comparable to surgery residents.
Seventy-five clinical clerks, second-year medical students, underwent the simulation training. Sixty-four volunteered to have their asepsis scores compared with 21 residents who were credentialed for UC placement. We used simulated germs to objectively quantify effectiveness of hand washing and maintenance of aseptic technique during UC. A task-specific check list was also used for assessing UC skills. Students completed a posttraining feedback survey.
Compared with residents, students after simulation training washed their hands with equal effectiveness at baseline (P = 0.2), maintained better sterility (P = 0.05), and had a higher technical proficiency score during UC (P < 0.001). Students believed that it was a great idea to use simulated germs to highlight effectiveness of hand washing (100%) and they indicated that they would pay extra attention when washing hands (97%).
We describe a novel approach to germ simulation and a training approach to teach aseptic technique in UC. Students reported a heightened awareness of the importance of hand hygiene and aseptic precautions during UC. Further studies are needed to see if this could lead to a reduction in hospital-acquired infections.
由于对患者安全的担忧,医学生的操作训练变得越来越有限。由于模拟教育已被证明对早期技能培训有效,我们使用细菌模拟来教授导尿术(UC)中的手卫生原则和无菌技术。我们假设,培训后,学生的熟练程度可以与外科住院医师相媲美。
75 名临床实习医生、二年级医学生接受了模拟培训。64 名志愿者自愿将其无菌分数与 21 名有资格进行 UC 放置的住院医师进行比较。我们使用模拟细菌客观地量化 UC 期间洗手和维持无菌技术的有效性。还使用了特定于任务的检查表来评估 UC 技能。学生完成培训后反馈调查。
与住院医师相比,模拟训练后的学生在基线时洗手效果相当(P = 0.2),保持更好的无菌性(P = 0.05),并且在 UC 期间具有更高的技术熟练程度得分(P < 0.001)。学生认为使用模拟细菌突出洗手效果是个好主意(100%),他们表示在洗手时会格外注意(97%)。
我们描述了一种新的细菌模拟方法和一种在 UC 中教授无菌技术的培训方法。学生报告在手卫生和无菌预防措施期间对 UC 的重要性有了更高的认识。需要进一步的研究来确定这是否可以减少医院获得性感染。