Chung Tae Nyoung, Kim Sun Wook, You Je Sung, Chung Hyun Soo
Department of Emergency Medicine, CHA University School of Medicine, Seongnam, Korea.
Department of Emergency Medicine, Changwon Fatima Hospital, Changwon, Korea.
Clin Exp Emerg Med. 2016 Mar 31;3(1):16-19. doi: 10.15441/ceem.15.097. eCollection 2016 Mar.
Tube thoracostomy (TT) is a commonly performed intensive care procedure. Simulator training may be a good alternative method for TT training, compared with conventional methods such as apprenticeship and animal skills laboratory. However, there is insufficient evidence supporting use of a simulator. The aim of this study is to determine whether training with medical simulator is associated with faster TT process, compared to conventional training without simulator.
This is a simulation study. Eligible participants were emergency medicine residents with very few (≤3 times) TT experience. Participants were randomized to two groups: the conventional training group, and the simulator training group. While the simulator training group used the simulator to train TT, the conventional training group watched the instructor performing TT on a cadaver. After training, all participants performed a TT on a cadaver. The performance quality was measured as correct placement and time delay. Subjects were graded if they had difficulty on process.
Estimated median procedure time was 228 seconds in the conventional training group and 75 seconds in the simulator training group, with statistical significance (P=0.040). The difficulty grading did not show any significant difference among groups (overall performance scale, 2 vs. 3; P=0.094).
Tube thoracostomy training with a medical simulator, when compared to no simulator training, is associated with a significantly faster procedure, when performed on a human cadaver.
胸腔闭式引流术（TT）是一种常见的重症监护操作。与学徒制和动物技能实验室等传统方法相比，模拟器训练可能是TT训练的一种良好替代方法。然而，支持使用模拟器的证据不足。本研究的目的是确定与无模拟器的传统训练相比，使用医学模拟器训练是否与更快的TT操作过程相关。
这是一项模拟研究。符合条件的参与者为胸腔闭式引流术经验极少（≤3次）的急诊医学住院医师。参与者被随机分为两组：传统训练组和模拟器训练组。模拟器训练组使用模拟器进行TT训练，传统训练组观看教员在尸体上进行TT操作。训练后，所有参与者在尸体上进行一次TT操作。以正确放置和时间延迟来衡量操作质量。如果受试者在操作过程中遇到困难，则进行评分。
传统训练组预计中位操作时间为228秒，模拟器训练组为75秒，具有统计学意义（P=0.040）。难度分级在各组之间未显示出任何显著差异（总体表现评分，2比3；P=0.094）。
与无模拟器训练相比，使用医学模拟器进行胸腔闭式引流术训练，在人体尸体上进行操作时，操作过程明显更快。
