McMaster Scott, Ledrick David J, Stausmire Julie M, Burgard Kristina
Southern District Health Board, Invercargill, New Zealand (Dr McMaster).
Mercy St. Vincent Medical Center, Emergency Medicine (Dr Ledrick).
Wilderness Environ Med. 2014 Dec;25(4):416-24. doi: 10.1016/j.wem.2014.06.001. Epub 2014 Oct 1.
The aim of this study was to evaluate the effectiveness of a fishhook removal simulation workshop using investigator-developed diagrams, practice models, and a teaching video.
This was a descriptive, prospective educational study with Institutional Review Board approval. The primary outcomes were the learner's perception of ease of learning, performance ability, and amount of tissue damage for each technique. A 2¾-minute educational video, instructional visual diagrams, and a simulated model were created to teach 4 techniques: simple retrograde, string pull, advance and cut, and needle cover. Learners performed each technique on a model to assess whether they could remove the hook on the first attempt for each technique. They then rank ordered their technique preferences for ease of learning, performance, perceived tissue damage, and overall choice.
Of a total of 34 participants who completed the study, 71% of learners were emergency medicine residents or faculty, 65% were male, 42% were recreational fishers, and 68% had previous fishhook removal experience. On first attempt, more than 88% of participants demonstrated successful fishhook removal using all techniques except needle cover (47%). Simple retrograde was rated easiest to learn (74%) and perform (59%), was perceived to cause the least tissue damage (44%), and was the overall preferred technique. Needle cover was ranked hardest to learn (88%) and perform (82%), was perceived to cause the worst tissue damage (41%), and was the overall least preferred technique.
This study is the first to describe a simulation training program for uncomplicated fishhook removal, and to experimentally evaluate physician learning and preferences for fishhook removal techniques. After a brief educational session, physicians could effectively use all techniques except needle cover. Simple retrograde was the overall preferred technique.
本研究旨在评估使用研究者绘制的示意图、练习模型和教学视频开展的鱼钩取出模拟工作坊的有效性。
这是一项经机构审查委员会批准的描述性前瞻性教育研究。主要结果是学习者对每种技术的学习难易程度、操作能力和组织损伤量的感知。制作了一个2分45秒的教育视频、教学可视化示意图和一个模拟模型,用于教授4种技术:简单逆行法、拉线法、推进切割法和针套法。学习者在模型上执行每种技术,以评估他们是否能在首次尝试时成功取出鱼钩。然后,他们按顺序对学习难易程度、操作表现、感知到的组织损伤和总体选择等技术偏好进行排序。
在完成研究的34名参与者中,71%的学习者是急诊医学住院医师或教员,65%为男性,42%是休闲渔民,68%有过鱼钩取出经验。在首次尝试时,除针套法(47%)外,超过88%的参与者使用所有技术成功取出了鱼钩。简单逆行法被评为最容易学习(74%)和操作(59%),被认为造成的组织损伤最小(44%),是总体上最受欢迎的技术。针套法被列为最难学习(88%)和操作(82%),被认为造成的组织损伤最严重(41%),是总体上最不受欢迎的技术。
本研究首次描述了一种针对简单鱼钩取出的模拟培训计划,并通过实验评估了医生对鱼钩取出技术的学习情况和偏好。经过简短的教育课程后,医生可以有效地使用除针套法之外的所有技术。简单逆行法是总体上最受欢迎的技术。