Hoang Tuan N, LaPorta Anthony J, Malone John D, Champagne Roland, Lavell Kit, De La Rosa Gabriel M, Gaul Lawrence, Dukovich Mitchell
Naval Surface Forces, US Pacific Fleet, San Diego, California, USA.
Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA.
Trauma Surg Acute Care Open. 2020 Mar 10;5(1):e000393. doi: 10.1136/tsaco-2019-000393. eCollection 2020.
Surgical trauma care requires excellent multidisciplinary team skills and communication to ensure the highest patient survival rate. This study investigated the effects of Hyper-realistic immersive surgical team training to improve individual and team performance. A Hyper-realistic surgical training environment is defined as having a high degree of fidelity in the replication of battlefield conditions in a training environment, so participants willingly suspend disbelief that they become totally immersed and eventually stress inoculated in a way that can be measured physiologically.
Six multispecialty member US Navy Fleet Surgical/US Army Forward Surgical Teams (total n=99 evaluations) underwent a 6-day surgical training simulation using movie industry special effects and role players wearing the Human Worn Surgical Simulator (Cut Suit). The teams were immersed in trauma care scenarios requiring multiple complex interventions and decision making in a realistic, fast-paced, intensive combat trauma environment.
Hyper-realistic immersive simulation training enhanced performance between multidisciplinary healthcare team members. Key efficacy quantitative measurements for the same simulation presented on day 1 compared with day 6 showed a reduction in resuscitation time from 24 minutes to 14 minutes and critical error decrease from 5 to 1. Written test scores improved an average of 21% (Medical Doctors 11%, Registered Nurses 25%, and Corpsman/Medics 26%). Longitudinal psychometric survey results showed statistically significant increases in unit readiness (17%), combat readiness (12%), leadership quality (7%), vertical cohesion (7%), unit cohesion (5%), and team communication (3%). An analysis of salivary cortisol and amylase physiologic biomarkers indicated an adaptive response to the realistic environment and a reduction in overall team stress during performance evaluations.
Hyper-realistic immersive simulation training scenarios can be a basis for improved military and civilian trauma training.
Level III.
外科创伤护理需要出色的多学科团队技能和沟通能力，以确保患者的最高生存率。本研究调查了超逼真沉浸式外科团队培训对提高个人和团队绩效的影响。超逼真的外科培训环境被定义为在培训环境中高度逼真地模拟战场条件，使参与者愿意暂时放下怀疑，完全沉浸其中，并最终以一种可以通过生理指标测量的方式进行压力预适应。
六个多专业成员的美国海军舰队外科/美国陆军前沿外科团队（共99次评估）参加了为期6天的外科培训模拟，使用电影行业特效和穿着人体穿戴式手术模拟器（切割服）的角色扮演。团队沉浸于创伤护理场景中，在逼真、节奏快、高强度的战斗创伤环境中需要进行多次复杂干预和决策。
超逼真沉浸式模拟培训提高了多学科医疗团队成员之间的绩效。与第1天相比，第6天进行的相同模拟的关键疗效定量测量显示，复苏时间从24分钟减少到14分钟，严重错误从5次减少到1次。笔试成绩平均提高了21%（医生提高11%，注册护士提高25%，卫生员/医护兵提高26%）。纵向心理测量调查结果显示，单位准备度（17%）、战斗准备度（12%）、领导素质（7%）、纵向凝聚力（7%）、单位凝聚力（5%）和团队沟通（3%）在统计学上有显著提高。对唾液皮质醇和淀粉酶生理生物标志物的分析表明，在绩效评估期间，对逼真环境有适应性反应，团队整体压力降低。
超逼真沉浸式模拟培训场景可作为改进军事和民用创伤培训的基础。
三级。
