256 (City of London) Field Hospital, London, UK
Department of Academic Vascular Surgery, Imperial College London, London, UK.
BMJ Mil Health. 2022 Jun;168(3):192-195. doi: 10.1136/bmjmilitary-2020-001438. Epub 2020 May 14.
The use of simulation in clinical environments is a frequently used adjunct to training individuals and teams. The military uses clinical simulation to train large numbers of personnel, standardise patient pathways and sustain specific skills to ensure medical personnel are prepared to deploy in their clinical roles.
As part of a North Atlantic Treaty Organization (NATO) exercise, 256 Field Hospital (Reserves) deployed a team of clinicians to simulate a role 2 basic field hospital. This hospital exercise (HOSPEX) involved training, and a 4-day real-time exercise with casualty simulation. A retrospective survey of all clinical personnel was conducted to analyse the utility of the exercise on their understanding of their job role, the workings of the field hospital and their confidence in deploying on operations.
39 personnel were surveyed, with questions graded on a modified Likert scale. 41% had previous operational experience in their current job role. A significantly higher proportion of respondents graded their understanding of their job role, and the field hospital overall, as good or excellent having completed the exercise (p<0.01), and 90% felt more confident in fulfilling their operational role postexercise. 90% of respondents had previous experience of simulation, and 94% of these rated the military simulation as being more beneficial than civilian equivalents.
With a shift towards simulation in medical training, opportunities have arisen within HOSPEX to develop additional skills for teams and individuals. Simulation is especially important in personnel who have not had previous operational experience, who may deploy on first time operations in senior clinical and leadership roles.
HOSPEXs are perceived as being extremely useful by clinical personnel preparing for future operational deployment. HOSPEX simulation has prepared the military for varied operations since its inception, and the paradigm has potential for extension into civilian training for high intensity medical responses.
在临床环境中使用模拟是培训个人和团队的常用辅助手段。军队利用临床模拟来培训大量人员，使患者路径标准化，并维持特定技能，以确保医务人员能够准备好在其临床角色中部署。
作为北大西洋公约组织（北约）演习的一部分，256 野战医院（预备役）部署了一组临床医生来模拟一个基本野战医院的角色。该医院演习（HOSPEX）涉及培训以及为期 4 天的实时演习，包括伤员模拟。对所有临床人员进行了回顾性调查，以分析演习对他们对工作角色的理解、野战医院的运作以及在行动中部署的信心的作用。
对 39 名人员进行了调查，问题采用改良的李克特量表进行评分。41%的人在当前工作角色中有过以前的行动经验。完成演习后，有更高比例的受访者将他们对工作角色和整个野战医院的理解评为良好或优秀（p<0.01），90%的人在演习后对履行行动角色更有信心。90%的受访者有过模拟经验，其中 94%的人认为军事模拟比民用模拟更有益。
随着医疗培训向模拟的转变，HOSPEX 为团队和个人提供了发展额外技能的机会。对于没有以前行动经验的人员来说，模拟尤其重要，他们可能会在首次担任高级临床和领导角色的行动中部署。
HOSPEX 对准备未来行动部署的临床人员来说非常有用。自成立以来，HOSPEX 模拟为军队进行各种行动做好了准备，该模式有可能扩展到民用培训领域，以应对高强度医疗反应。
