Roy E, Quinsat V E, Bazin O, Lesclous P, Lejus-Bourdeau C
Laboratoire Expérimental de Simulation en Médecine Intensive de l'Université (LE SiMU), Nantes, France.
Service d'Odontologie Conservatrice et Pédiatrique, Centre de Soins Dentaires, C.H.U. Nantes, Nantes, France.
Eur J Dent Educ. 2018 May;22(2):e261-e268. doi: 10.1111/eje.12284. Epub 2017 Aug 23.
Any dental surgeon may be faced with a critical life-threatening emergency situation. In our university, all students in dentistry receive a standard course on emergency first aid. The aim of this prospective, comparative, single-centre study was to determine whether additional training on a high-fidelity patient simulator would improve student performance.
After approval by an Ethical Committee and written informed consent, the students of the Simulation group (n=42) had full-scale high-fidelity training on a patient simulator SimMan 3G (3 hours by six students). They participated in pairs in two scenarios (airway obstruction, seizures, allergies, vasovagal syncope, asthma, chest pain). The first scenario was simple, and the second was a progression to cardiac arrest. Three months later, the Simulation group and the Control group (n=42) participated in a test session with two scenarios. The primary end point was the score at the test session (with a standardised scoring grill, direct observation and audio-video recording). Data were median and 25%-75% percentiles.
High-fidelity training strongly improved the score on the test obtained by the students of the Simulation group (146 [134-154]) which was much higher (P<.0001) than in the Control group (77 [67-85]). Technical as well as non-technical skills components of the scores were improved. In addition, performances of the Simulation group were increased between the training and the test. Simulation session was very positively assessed by the students.
The results support the systematic introduction of training to critical life-threatening emergency situations on high-fidelity patient simulators the dentistry curriculum. The impact on clinical practice in the dental office remains to be assessed.
任何牙科医生都可能面临危及生命的紧急情况。在我们大学,所有牙科专业的学生都接受标准的急救课程培训。这项前瞻性、对比性、单中心研究的目的是确定在高仿真模拟病人上进行额外培训是否能提高学生的表现。
经伦理委员会批准并获得书面知情同意后,模拟组(n = 42)的学生在SimMan 3G模拟病人上进行了全面的高仿真培训(六名学生一组,共3小时)。他们两人一组参与了两种场景的模拟(气道阻塞、癫痫发作、过敏、血管迷走性晕厥、哮喘、胸痛)。第一种场景较为简单,第二种场景则发展到心脏骤停。三个月后,模拟组和对照组(n = 42)参加了包含两种场景的测试环节。主要终点是测试环节的得分(使用标准化评分量表、直接观察和音频视频记录)。数据为中位数以及第25百分位数和第75百分位数。
高仿真培训显著提高了模拟组学生在测试中的得分(146 [134 - 154]),该得分比对照组(77 [67 - 85])高得多(P <.0001)。得分中的技术和非技术技能部分均有所提高。此外,模拟组在培训和测试之间的表现有所提升。学生们对模拟环节的评价非常积极。
研究结果支持在牙科课程中系统引入在高仿真模拟病人上进行危及生命紧急情况的培训。其对牙科诊所临床实践的影响仍有待评估。