Lefor Alan Kawarai
Department of Surgery Jichi Medical University Shimotsuke Tochigi Japan.
Acute Med Surg. 2018 Jul 1;5(4):299-304. doi: 10.1002/ams2.352. eCollection 2018 Oct.
Simulation has become an important teaching tool, in part because of changes mandated by restrictions in resident work hours. Simulation models include life-like mannequins, tissue, cadavers, and live animal models. The Advanced Trauma Operative Management (ATOM) course teaches a standard approach for the treatment of traumatic injuries. The 1-day course includes six lectures in the morning and a live animal surgery laboratory in the afternoon. The animal laboratory includes five standard injury scenarios. Advanced Trauma Operative Management was brought to Japan in 2008 and has carried out 60 courses, training more than 250 surgeons and 70 instructors at six training sites throughout Japan. There have been a number of innovations initiated by ATOM Japan including Nurse Participation Certificates and a course for Trauma Nurses that runs concurrently with the ATOM course. There are other trauma courses given throughout the world, which are scenario-based and include concurrent nurse training. It is difficult to quantitatively assess the benefits of trauma training to patients. There are a number of documented cases in Japan of surgeons who have had good operative outcomes in the care of traumatically injured patients who attribute the successful management of these patients to participation in the ATOM course. Training in trauma surgery using simulation models and the ATOM course have had a positive impact on surgical training and patient care in Japan. These courses will continue to be modified and refined, resulting in better education and clinical outcomes. Education research is essential to determine the optimum use of the available models.
模拟已成为一种重要的教学工具，部分原因是住院医师工作时间限制所带来的变化。模拟模型包括逼真的人体模型、组织、尸体和活体动物模型。高级创伤手术管理（ATOM）课程教授创伤治疗的标准方法。为期一天的课程上午包括六场讲座，下午有一个活体动物手术实验室。动物实验室包括五种标准损伤场景。高级创伤手术管理于2008年引入日本，已在日本各地的六个培训地点开展了60期课程，培训了250多名外科医生和70名教员。日本的ATOM发起了多项创新，包括护士参与证书以及与ATOM课程同时开设的创伤护士课程。世界各地还有其他基于场景且包括同步护士培训的创伤课程。很难定量评估创伤培训对患者的益处。在日本有许多记录在案的案例，一些外科医生在治疗创伤患者时取得了良好的手术效果，他们将这些患者的成功治疗归功于参加了ATOM课程。在日本，使用模拟模型和ATOM课程进行创伤外科培训对手术培训和患者护理产生了积极影响。这些课程将继续得到改进和完善，从而带来更好的教育效果和临床结果。教育研究对于确定现有模型的最佳使用方式至关重要。
