Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Technology, Dresden, Germany.
Minerva Anestesiol. 2012 Aug;78(8):901-9. Epub 2012 Apr 13.
We developed a 1.5 days crew resource management (CRM) course on situation awareness (SA) to improve the participants' ability to recognise critical situations in crisis scenarios. Objective of the study was to evaluate the influence of the CRM course on SA and medical performance in crisis scenarios and to compare the results with the effects of a purely clinical simulator training.
Sixty-one final-year medical students, randomized into three groups, took part in a pre-intervention test scenario of septic shock in a patient simulator setting. Medical performance and SA were assessed using a checklist and the Situation Awareness Global Assessment Tool (SAGAT), respectively. All students received a lecture about the sepsis guidelines. The simulator (SIM) group took part in a 1.5-day simulator training on sepsis resuscitation. The CRM group took part in a course on situation awareness. The control group (CG) did not obtain any training. All students accomplished a post-intervention test scenario comparable to the pre-intervention scenario.
The SAGAT score rose from 10.6±2.3 to 11.9±1.7 (preintervention vs. postintervention test, P=0.04) in the SIM group, whereas no significant changes could be shown in the CRM group and the control group, respectively. The clinical performance scores in the post-intervention test did not differ from those in the preintervention test.
Neither the 1.5 days simulator training nor the 1.5 days CRM course did influence the clinical performance scores. SAGAT scores were higher after the simulator training, but not after the CRM training.
我们开发了一个为期 1.5 天的机组资源管理（CRM）课程，以提高参与者在危机情况下识别关键情况的能力。本研究的目的是评估 CRM 课程对危机情况下的情景意识（SA）和医疗表现的影响，并将结果与单纯的临床模拟器培训的效果进行比较。
61 名即将毕业的医学生随机分为三组，在患者模拟器环境中进行感染性休克的预干预测试场景。使用检查表和情景意识全局评估工具（SAGAT）分别评估医疗表现和 SA。所有学生都接受了关于败血症指南的讲座。模拟器（SIM）组参加了为期 1.5 天的关于败血症复苏的模拟器培训。CRM 组参加了关于情景意识的课程。对照组（CG）没有接受任何培训。所有学生都完成了与预干预场景相当的干预后测试场景。
SIM 组的 SAGAT 评分从 10.6±2.3 上升到 11.9±1.7（预干预与干预后测试，P=0.04），而 CRM 组和对照组的评分没有显著变化。干预后测试的临床表现评分与预干预测试的评分没有差异。
1.5 天的模拟器培训和 1.5 天的 CRM 课程都没有影响临床表现评分。模拟器培训后 SAGAT 评分较高，但 CRM 培训后则不然。
