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低逼真度混合性侵犯模拟训练对住院医师舒适度和能力的影响。

Low-fidelity hybrid sexual assault simulation training's effect on the comfort and competency of resident physicians.

作者信息

Auten Jonathan D, Ross Elliot M, French Michelle A, Li Ivy Z, Robinson Lovette, Brown Nanette, King Kerry J, Tanen David A

机构信息

Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, California.

Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, California.

出版信息

J Emerg Med. 2015 Mar;48(3):344-50. doi: 10.1016/j.jemermed.2014.09.032. Epub 2014 Nov 27.

Abstract

BACKGROUND

Alternative training methods are needed for resident physicians to ensure that care is not compromised should they practice in settings without well-established Sexual Assault Nurse Examiner (SANE) programs.

OBJECTIVE

The purpose of this study is to determine the effectiveness of a simulation-based sexual assault response course for resident physicians at an institution without an on-site SANE program.

METHODS

Educational intervention study of 12 emergency medicine residents using a low-fidelity hybrid simulation model. The study was comprised of eight male and four female physicians at a military medical center in San Diego, CA. Assessment occurred using three separate metrics. The first was a written knowledge test. The second was a simulated interview and evidentiary examination. These metrics were given 1 month before and 3 months after an 8-h training course. The final metric was Likert-scale questionnaires surveying pre- and post-course feelings of competency and comfort.

RESULTS

The emergency medicine residents showed a 13% improvement (95% confidence interval [CI] 7-20%) in written examination scores pre and post intervention. Post-course interview and examinations reflected a 44% improvement (95% CI 24-64%) in critical action completion. Pre-course comfort and competency questionnaires were a median of 2 (interquartile range [IQR] 1-3) on a Likert Scale. Post-course survey responses were a median of 4 (IQR 2-5).

CONCLUSIONS

Low-fidelity hybrid simulation is a useful tool to train inexperienced physicians to perform evidentiary examinations and interviews without sacrificing the privacy and direct care of sexual assault victims.

摘要

背景

住院医师需要其他培训方法,以确保在没有完善的性侵犯护士检查官(SANE)项目的环境中执业时,医疗护理不受影响。

目的

本研究的目的是确定在一个没有现场SANE项目的机构中,针对住院医师开展的基于模拟的性侵犯应对课程的有效性。

方法

采用低保真混合模拟模型对12名急诊医学住院医师进行教育干预研究。该研究在加利福尼亚州圣地亚哥的一家军事医疗中心进行,包括8名男性和4名女性医生。使用三个不同的指标进行评估。第一个是书面知识测试。第二个是模拟访谈和证据检查。这些指标在为期8小时的培训课程前1个月和课程后3个月进行。最后一个指标是李克特量表问卷,调查课程前后的能力和舒适度感受。

结果

急诊医学住院医师在干预前后的书面考试成绩提高了13%(95%置信区间[CI]7-20%)。课程后的访谈和检查显示关键行动完成情况提高了44%(95%CI 24-64%)。课程前的舒适度和能力问卷在李克特量表上的中位数为2(四分位间距[IQR]1-3)。课程后的调查回复中位数为4(IQR 2-5)。

结论

低保真混合模拟是一种有用的工具,可用于培训缺乏经验的医生进行证据检查和访谈,同时不牺牲性侵犯受害者的隐私和直接护理。

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