Sergeev Ilia, Lipsky Ari M, Ganor Ori, Lending Gadi, Abebe-Campino Gadi, Morose Alex, Katzenell Udi, Ash Nachman, Glassberg Elon
Trauma Branch, Surgeon General Headquarters, Medical Corps, Israel Defense Forces, Ramat Gan, Israel.
Mil Med. 2012 Aug;177(8):901-6. doi: 10.7205/milmed-d-12-00018.
Physicians and paramedics in the Israel Defense Forces are trained to perform advanced medical procedures using standardized training modalities, such as manikins. We studied the association of experience using these training modalities with self-reported confidence in procedure performance.
Providers were sent a questionnaire regarding their experience with and self-confidence levels for performing endotracheal intubation, cricothyroidotomy, needle chest decompression, tube thoracostomy, and intraosseous infusion.
Provider level (physician or paramedic) and gender were associated with reported self-confidence levels. Manikin and supervised and unsupervised patient experience exhibited positive associations with self-confidence, but (animal) model experience did not. For many procedure-training modality pairs, we identified a plateau level above which additional experience was minimally associated with an increase in self-confidence.
Among military advanced life support providers, self-confidence levels in procedure performance are positively associated with experience gained from manikins and supervised and unsupervised patient application. We were not able to demonstrate a clear benefit of an animal model in increasing self-confidence. A plateau was generally identified, indicating decreased benefit from the use of a particular training modality for a particular procedure. Modifying training regimens in light of these findings may help maximize the self-confidence of advanced life support providers more efficiently.
以色列国防军的医生和护理人员接受使用标准化训练方式（如人体模型）进行高级医疗程序的培训。我们研究了使用这些训练方式的经验与自我报告的程序操作信心之间的关联。
向医疗服务提供者发放了一份问卷，内容涉及他们进行气管插管、环甲膜切开术、针胸减压、胸腔置管引流术和骨内输液的经验及自信程度。
医疗服务提供者的级别（医生或护理人员）和性别与报告的自信程度相关。人体模型以及有监督和无监督的患者经验与自信呈正相关，但（动物）模型经验并非如此。对于许多程序 - 训练方式组合，我们确定了一个平稳水平，超过该水平，额外的经验与自信增加的关联极小。
在军事高级生命支持医疗服务提供者中，程序操作的自信程度与从人体模型以及有监督和无监督的患者应用中获得的经验呈正相关。我们未能证明动物模型在增强自信方面有明显益处。通常确定了一个平稳水平，表明针对特定程序使用特定训练方式的益处减少。根据这些发现修改训练方案可能有助于更有效地使高级生命支持医疗服务提供者的自信最大化。
