Sadideen Hazim, Wilson David, Moiemen Naiem, Kneebone Roger
From the *West Midlands Regional Burns Centre, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, United Kingdom; and †Department of Surgery and Cancer, Imperial College London, United Kingdom.
J Burn Care Res. 2014 Jan-Feb;35(1):62-71. doi: 10.1097/BCR.0b013e31829b371d.
Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named "The Burns Suite" (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained "realism" props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4-5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was "real" and they were "able to behave as if in a real resuscitation environment," and 2) TBS "addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn't" (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience.
教育理论强调情境化模拟对有效学习的重要性。我们在一个新颖、低成本、高保真、便携式、沉浸式模拟环境(称为分布式模拟)中的烧伤场景中探索了这一概念。这种情境化模拟/分布式模拟的组合被命名为“烧伤套件”(TBS)。在学员的高需求之后,选择了一个儿科烧伤复苏场景。它是根据高级创伤生命支持和严重烧伤应急管理原则设计的,并通过认知任务分析利用专家意见进行了完善。TBS包含“逼真”的道具、简报护士和模拟患者。招募了新手和专家。开发了五点李克特式问卷以进行表面效度和内容效度评估。计算了Cronbach's α系数以评估量表的信度。进行了半结构化访谈以获取定性主题分析的回答,从而实现数据三角验证。12名参与者完成了TBS场景。平均表面效度和内容效度评分很高(分别为4.6和4.5;范围为4 - 5)。问题的内部一致性很高。定性数据分析表明,参与者认为:1)这种体验“真实”,他们“能够表现得仿佛置身于真实的复苏环境中”;2)TBS“解决了高级创伤生命支持和严重烧伤应急管理未涉及的问题”(包括纳入非技术技能的效果)。TBS提供了一种新颖、有效的模拟工具,可显著推进烧伤教育的开展。重现临床挑战对于优化模拟训练至关重要。这种低成本方法对外科教育也有重大影响,尤其是在财政紧缩加剧的时期。可以在TBS中重现替代场景和/或程序,提供多样化的教育沉浸式模拟体验。