Tan Ting Xu, Buchanan Paula, Quattromani Erin
Department of Surgery, Division of Emergency Medicine, Saint Louis University School of Medicine, 3635 Vista Ave, St. Louis, Missouri, 63110, USA.
Center for Health Outcomes Research, Saint Louis University, 3545 Lafayette Ave, Room 409B, St. Louis, MO 63108, USA.
Emerg Med Int. 2018 Jul 24;2018:9179042. doi: 10.1155/2018/9179042. eCollection 2018.
To compare simulation task trainers (sim) with cadaver for teaching chest tube insertion to junior residents.
Prospective study involving postgraduate year (PGY) one and two emergency medicine (EM) and PGY-1 surgery residents. Residents were randomized into sim or cadaver groups based on prior experience and trained using deliberate practice. Primary outcomes were confidence in placing a chest tube and ability to place a chest tube in a clinical setting during a seven-month follow-up period. Secondary outcomes include skill retention, using an objective assessment checklist of 15 critical steps in chest tube placement, and confidence after seven months.
Sixteen residents were randomized to cadaver (n=8) and simulation (n=8) groups. Both groups posttraining had statistically significant increase in confidence. No significant difference existed between groups for median posttraining assessment scores (13.5 sim v 15 cadaver). There was no statistically significant difference between groups for confidence at any point measured. There was moderate correlation (0.58) between number of clinical attempts reported in a seven-month follow-up period and final assessment score.
Both sim and cadaver models are effective modalities for teaching chest tube placement. Medical education programs can use either modalities to train learners without notable differences in confidence.
比较模拟任务训练器（sim）与尸体在向低年资住院医师教授胸腔置管方面的效果。
一项前瞻性研究，纳入了一年级和二年级的急诊医学（EM）研究生以及一年级外科住院医师。根据既往经验将住院医师随机分为模拟组或尸体组，并采用刻意练习的方式进行培训。主要结局指标为在七个月的随访期内放置胸腔引流管的信心以及在临床环境中放置胸腔引流管的能力。次要结局指标包括技能保持情况（使用一份包含胸腔置管15个关键步骤的客观评估清单）以及七个月后的信心。
16名住院医师被随机分为尸体组（n = 8）和模拟组（n = 8）。两组培训后信心均有统计学显著提高。培训后评估分数中位数在两组间无显著差异（模拟组为13.5，尸体组为15）。在任何测量时间点，两组间信心均无统计学显著差异。在七个月的随访期内报告的临床尝试次数与最终评估分数之间存在中度相关性（0.58）。
模拟训练器和尸体模型都是教授胸腔置管的有效方式。医学教育项目可以使用任何一种方式来培训学习者，在信心方面无显著差异。
