Jones Jana L, Rinehart Jim, Spiegel Jacqueline Jordan, Englar Ryane E, Sidaway Brian K, Rowles Joie
Midwestern University College of Veterinary Medicine, Animal Health Institute, 5715 W. Utopia Road, Glendale, AZ 85308 USA.
Clinical Skills and Simulation Center, Midwestern University, 19555 N. 59th Avenue, Glendale, AZ 85308 USA, and Instructor, Arizona College of Osteopathic Medicine.
J Vet Med Educ. 2018 Summer;45(2):232-240. doi: 10.3138/jvme.1016-163r.
Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access. The simulation outputs are determined by a script that outlines routine anesthesia scenarios and describes the consequences of students' hands-on actions and interventions during preestablished anesthetic tasks and critical incidents. Patients' monitored physiologic parameters may be changed according to predetermined learner events and students' interventions to provide immediate learner feedback and clinical realism. A total of 96 students from the pre-clinical anesthesia course participated in the simulations and the pre- and post-simulation surveys evaluating students' perspectives. Results of the surveys and comparisons of overall categorical cumulative responses in the pre- and post-simulation surveys indicated improvement in learners' perceived preparedness and confidence as a result of the simulated anesthesia experience, with significant improvement in the strongly agree, moderately agree, and agree categories (p<.05 at a 95% CI). These results suggest that anesthesia simulations in the VASE may complement traditional teaching methods through experiential learning and may help foster classroom-to-clinic transference of knowledge and skills without harm to an animal.
几十年来,麻醉模拟技术一直应用于临床前医学培训,以帮助学习者在手术室环境中获得信心和专业技能,同时不会对真实患者造成危险。作者描述了一种兽医麻醉模拟环境(VASE),该环境开发了麻醉场景,旨在在实施麻醉时重现兽医的任务环境。VASE使用先进的计算机技术,其模拟器输入来自兽医麻醉期间常用的标准监测设备以及一个商用犬类训练模型,该模型允许进行插管、通气和静脉通路操作。模拟输出由一个脚本决定,该脚本概述了常规麻醉场景,并描述了学生在既定麻醉任务和关键事件中的实际操作和干预的后果。患者的监测生理参数可以根据预先确定的学习者事件和学生的干预措施进行更改,以提供即时的学习者反馈和临床真实感。来自临床前麻醉课程的96名学生参与了模拟以及评估学生观点的模拟前和模拟后调查。调查结果以及模拟前和模拟后调查中总体分类累积反应的比较表明,由于模拟麻醉体验,学习者的感知准备度和信心有所提高,在强烈同意、中度同意和同意类别中均有显著改善(95%置信区间,p<.05)。这些结果表明,VASE中的麻醉模拟可以通过体验式学习补充传统教学方法,并可能有助于促进知识和技能从课堂到临床的转化,同时不会对动物造成伤害。