Planchon Jerome, Vacher Anthony, Comblet Jeremy, Rabatel Eric, Darses Françoise, Mignon Alexandre, Pasquier Pierre
Department of Anaesthesiology and Intensive Care, Begin Military Teaching Hospital, French Military Medical Service, Saint Mande, France.
Action and Cognition in Operational Situations Department, Institut de Recherche Biomedicale des Armées, French Military Medical Service, Brétigny sur Orge, France.
Injury. 2018 Jan;49(1):86-92. doi: 10.1016/j.injury.2017.10.025. Epub 2017 Oct 12.
In modern warfare, almost 25% of combat-related deaths are considered preventable if life-saving interventions are performed. Therefore, Tactical Combat Casualty Care (TCCC) training for soldiers is a major challenge. In 2014, the French Military Medical Service supported the development of 3D-SC1, a serious game designed for the French TCCC program, entitled Sauvetage au Combat de niveau 1 (SC1). Our study aimed to evaluate the impact on performance of additional training with 3D-SC1.
The study assessed the performance of soldiers randomly assigned to one of two groups, before (measure 1) and after (measure 2) receiving additional training. This training involved either 3D-SC1 (Intervention group), or a DVD (Control group). The principal measure was the individual performance (on a 16-point scale), assessed by two investigators during a hands-on simulation. First, the mean performance score was compared between the two measures for Intervention and Control groups using a two-tailed paired t-test. Second, a multivariable linear regression was used to determine the difference in the impacts of 3D-SC1 and DVD training, and the order of presentation of the two scenarios, on the mean change from baseline in performance scores.
A total of 96 subjects were evaluated: seven could not be followed-up, while 50 were randomly allocated to the Intervention group, and 39 to the Control group. Between measure 1 and measure 2, the mean (SD) performance score increased from 9.9 (3.13) to 14.1 (1.23), and from 9.4 (2.97) to 12.5 (1.83), for the Intervention group and Control group, respectively (p<0.0001). The adjusted mean difference in performance scores between 3D-SC1 and DVD training was 1.1 (95% confidence interval -0.3, 2.5) (p=0.14). Overall, the study found that supplementing SC1 training with either 3D-SC1 or DVD improved performance, assessed by a hands-on simulation. However, our analysis did not find a statistically significant difference between the effects of these two training tools. 3D-SC1 could be an efficient and pedagogical tool to train soldiers in life-saving interventions. In the current context of terrorist threat, a specifically-adapted version of 3D-SC1may be a cost-effective and engaging way to train a large civilian public.
在现代战争中,如果实施救生干预措施,近25%与战斗相关的死亡被认为是可预防的。因此,对士兵进行战术战斗伤员护理(TCCC)培训是一项重大挑战。2014年,法国军事医疗服务部门支持开发了3D-SC1,这是一款为法国TCCC计划设计的严肃游戏,名为“一级战斗救援(SC1)”。我们的研究旨在评估使用3D-SC1进行额外培训对表现的影响。
该研究评估了随机分配到两组之一的士兵在接受额外培训之前(测量1)和之后(测量2)的表现。这种培训要么是3D-SC1(干预组),要么是DVD(对照组)。主要测量指标是个人表现(16分制),由两名调查人员在实际操作模拟过程中进行评估。首先,使用双尾配对t检验比较干预组和对照组在两种测量中的平均表现得分。其次,使用多变量线性回归来确定3D-SC1和DVD培训的影响差异,以及两种场景的呈现顺序,对表现得分相对于基线的平均变化的影响。
总共评估了96名受试者:7名无法进行随访,而50名被随机分配到干预组,39名被分配到对照组。在测量1和测量2之间,干预组和对照组的平均(标准差)表现得分分别从9.9(3.13)提高到14.1(1.23),以及从9.4(2.97)提高到12.5(1.83)(p<0.0001)。3D-SC1和DVD培训之间表现得分的调整后平均差异为1.1(95%置信区间-0.3,2.5)(p=0.14)。总体而言,该研究发现,用3D-SC1或DVD补充SC1培训均可提高通过实际操作模拟评估的表现。然而,我们的分析未发现这两种培训工具的效果之间存在统计学上的显著差异。3D-SC1可能是一种培训士兵进行救生干预的有效且有教学意义的工具。在当前恐怖主义威胁的背景下,一个经过特别改编的3D-SC1版本可能是一种经济高效且引人入胜的方式来培训大量平民大众。