Barleycorn Donna, Lee Geraldine A
Kingston University and St Georges, University of London, London, UK.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
Int Emerg Nurs. 2018 Sep;40:37-45. doi: 10.1016/j.ienj.2018.03.007. Epub 2018 Apr 25.
Major trauma is a significant public health problem and a leading cause of death for several age groups. To address this issue, Major Trauma Networks were introduced in the UK from 2010, consisting of Major Trauma Centres (MTCs) and a network of linked Trauma Units (TUs).
The aim is to undertake a systematic review to examine how effective is trauma simulation as an educational process for healthcare providers within trauma networks.
The databases searched included Medline, Embase and Cinahl from 2010 to 2016. This time frame was chosen to reflect more contemporaneous research into simulation training since the advent of trauma networks in 2010 and the publication of national trauma guidelines (NICE). Seven observational studies were selected for narrative review. The screening and selection process followed the PRISMA guidance. The method used to assess the selected studies is based on the Scottish Intercollegiate Guidelines Network (SIGN) handbook.
Overall, the studies showed benefits of simulation in trauma training, with some statistical evidence that non-technical skills and overall trauma team performance improved after simulation training, which appears to be effective. Although no studies found any specific correlation of simulation- based learning in trauma to wider effects such as patient outcomes, length of stay or morbidity. Some studies have found that time to diagnosis and treatment arising from improved non-technical trauma team skills from simulation, are a valid surrogate indicator of improved patient outcomes.
Overall, it is evident from this review that trauma simulation is an effective educational tool, which can aid trauma learning, develop team's non-technical skills and increase task completion, having a positive impact on the trauma network. Trauma units should therefore benefit from increased trauma simulation training and accessibility to repeated simulation based courses or workshops.
重大创伤是一个严重的公共卫生问题，也是多个年龄组死亡的主要原因。为解决这一问题，英国于2010年引入了重大创伤网络，该网络由重大创伤中心（MTC）和一系列相连的创伤单元（TU）组成。
旨在进行一项系统综述，以检验创伤模拟作为创伤网络内医疗服务提供者的教育过程的有效性如何。
检索的数据库包括2010年至2016年的Medline、Embase和Cinahl。选择这一时间范围是为了反映自2010年创伤网络出现及国家创伤指南（NICE）发布以来对模拟培训的更多当代研究。选择了七项观察性研究进行叙述性综述。筛选和选择过程遵循PRISMA指南。用于评估所选研究的方法基于苏格兰校际指南网络（SIGN）手册。
总体而言，研究表明模拟在创伤培训中有益处，有一些统计证据表明模拟培训后非技术技能和创伤团队的整体表现有所改善，这似乎是有效的。尽管没有研究发现创伤中基于模拟的学习与诸如患者预后、住院时间或发病率等更广泛影响之间存在任何特定关联。一些研究发现，模拟提高了创伤团队的非技术技能，从而缩短了诊断和治疗时间，这是患者预后改善的一个有效替代指标。
总体而言，从本次综述中可以明显看出，创伤模拟是一种有效的教育工具，可有助于创伤学习、培养团队的非技术技能并提高任务完成率，对创伤网络产生积极影响。因此，创伤单元应受益于增加的创伤模拟培训以及能够参加基于模拟的重复课程或研讨会。
