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血流动力学监测与机械通气的模拟训练:对医生表现的评估

Simulation Training in Hemodynamic Monitoring and Mechanical Ventilation: An Assessment of Physician's Performance.

作者信息

Havaldar Amarja A, Krishna Bhuvana, Sampath Sriram, Paramasivam Saravana K

机构信息

Department of Critical Care, St. John's Medical College, Koramangala, Bengaluru, Karnataka, India.

Department of Critical Care, Kauvery Hospital, Tiruchirappalli, Tamil Nadu, India.

出版信息

Indian J Crit Care Med. 2020 Jun;24(6):423-428. doi: 10.5005/jp-journals-10071-23458.

Abstract

BACKGROUND

Simulation is to imitate or replicate real-life scenarios in order to improve cognitive, diagnostic and therapeutic skills. An ideal model should be good enough to output realistic clinical scenarios and respond to interventions done by trainees in real time. Use of simulation-based training has been tried in various fields of medicine. The aim of our study was to prospectively evaluate the effectiveness of simulation model "CRITICA"™ (MEDUPLAY systems) in training critical care physicians.

MATERIALS AND METHODS

The advanced intensive care unit (ICU) simulator "CRITICA"™ (MEDUPLAY systems) was developed as a joint collaboration between the Indian Institute of Science, Bengaluru and St John's Medical College, Bengaluru. Two-day workshop was conducted. Intensive didactic and case-based scenarios were simulated to formally teach principles of advanced ICU scenarios. The physicians were tested on clinical scenarios in hemodynamic monitoring and mechanical ventilation displayed on the simulator. Assessment of the analytical thinking and pattern recognition ability was carried out before and after the display of the scenarios. Pre- and posttest scores were collected.

RESULTS

The postsimulation test scores were higher than pretest scores and were statistically significant in hemodynamic monitoring and mechanical ventilation module. [Hemodynamic monitoring pre- and posttest scores 4.41 (2.06) vs 5.23 (2.22) < 0.001] [Mechanical ventilation pre- and posttest scores 4 (2-5.5) vs 7.5 (6.5-8.5) < 0.001]. A greater increase in posttest scores was seen in the mechanical ventilation module as compared to hemodynamic module. There was no effect of specialty or designation of a trainee on difference in pre- and posttest scores.

CONCLUSION

Simulator-based training in hemodynamic monitoring and mechanical ventilation was effective. Comparison of routine classroom teaching and simulator-based training needs to be evaluated prospectively.

HOW TO CITE THIS ARTICLE

Havaldar AA, Krishna B, Sampath S, Paramasivam SK. Simulation Training in Hemodynamic Monitoring and Mechanical Ventilation: An Assessment of Physician's Performance. Indian J Crit Care Med 2020;24(6):423-428.

摘要

背景

模拟是为了提高认知、诊断和治疗技能而对现实生活场景进行模仿或复制。一个理想的模型应该足够好,能够输出逼真的临床场景,并实时响应学员所做的干预。基于模拟的培训已在医学的各个领域进行尝试。我们研究的目的是前瞻性评估模拟模型“CRITICA”™(MEDUPLAY系统)在培训重症医学医师方面的有效性。

材料与方法

先进重症监护病房(ICU)模拟器“CRITICA”™(MEDUPLAY系统)是由班加罗尔的印度科学研究所和班加罗尔的圣约翰医学院联合开发的。举办了为期两天的研讨会。模拟了强化的理论教学和基于病例的场景,以正式教授高级ICU场景的原则。对医师进行了模拟器上显示的血流动力学监测和机械通气临床场景测试。在场景展示前后对分析思维和模式识别能力进行评估。收集了测试前和测试后的分数。

结果

模拟后测试分数高于测试前分数,在血流动力学监测和机械通气模块中具有统计学意义。[血流动力学监测测试前和测试后分数4.41(2.06)对5.23(2.22)<0.001] [机械通气测试前和测试后分数4(2 - 5.5)对7.5(6.5 - 8.5)<0.001]。与血流动力学模块相比,机械通气模块的测试后分数增加更大。学员的专业或职称对测试前和测试后分数的差异没有影响。

结论

基于模拟器的血流动力学监测和机械通气培训是有效的。需要前瞻性评估常规课堂教学与基于模拟器的培训的比较。

如何引用本文

哈瓦尔达尔AA,克里希纳B,桑帕特S,帕拉马西瓦姆SK。血流动力学监测和机械通气的模拟培训:医师表现的评估。《印度重症监护医学杂志》2020;24(6):423 - 428。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/244d/7435101/25d0019ff39b/ijccm-24-423-g001.jpg

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