Auten Jonathan D, Ross Elliot M, French Michelle A, Li Ivy Z, Robinson Lovette, Brown Nanette, King Kerry J, Tanen David A
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.
J Emerg Med. 2015 Mar;48(3):344-50. doi: 10.1016/j.jemermed.2014.09.032. Epub 2014 Nov 27.
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.
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.
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.
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).
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.
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。
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。
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。
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)。
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。