2nd General Health Battalion, Australian Army, Brisbane, Queensland, Australia
Joint Health Command, Australian Defence Force, Herston, Queensland, Australia.
BMJ Mil Health. 2023 Apr;169(2):122-126. doi: 10.1136/bmjmilitary-2020-001550. Epub 2020 Oct 21.
Care of battle casualties is a central role of military medical practitioners. Historically, certain trauma procedural skills have been learnt through live tissue training. However, faced with opposition from community members and academics, who argue equivalence of non-animal alternatives, this is now being phased out. This study explores Australian military medical practitioners' experiences of and attitudes towards live tissue training.
We performed a phenomenologically driven qualitative exploration of individuals' experiences of live tissue trauma training. 32 medical officers volunteered for the study. In-depth interviews were conducted with 15 practitioners (60% Army, 20% Air Force, 20% Navy; 33% surgical, 53% critical care, 13% general practice). Qualitative data were subjected to content analysis, with key themes identified using manual and computer-assisted coding.
Live tissue training was valued by military medical practitioners, particularly because of the realistic feel of tissues and physiological responsiveness to treatment. Learner-perceived value of live tissue training was higher for complex skills and those requiring delicate tissue handling. 100% of surgeons and critical care doctors regarded live tissue as the only suitable model for learning repair of penetrating cardiac injury. Live tissue training was felt to enhance self-efficacy, particularly for rarely applied skills. Though conscious of the social and ethical context of live tissue training, >90% of participants reported positive emotional responses to live tissue training.
In contrast to published research, live tissue training was thought by participants to possess characteristics that are not yet replicable using alternative learning aids. The experienced positive values of live tissue training should inform the decision to move towards non-animal alternatives.
战场伤员救治是军事医务人员的核心职责。从历史上看，某些创伤程序技能是通过活体组织培训来学习的。然而，由于社区成员和学者的反对，他们认为非动物替代品具有同等效果，因此这种培训方式正在逐步淘汰。本研究探讨了澳大利亚军事医务人员对活体组织培训的经验和态度。
我们对个体对活体组织创伤培训的经验进行了现象学驱动的定性探索。32 名医务人员自愿参加了这项研究。对 15 名从业者（60%陆军、20%空军、20%海军；33%外科医生、53%重症监护医生、13%全科医生）进行了深入访谈。对定性数据进行了内容分析，使用手动和计算机辅助编码来确定关键主题。
活体组织培训受到军事医务人员的重视，特别是因为组织的真实感觉和对治疗的生理反应。学习者对活体组织培训的感知价值在复杂技能和需要精细组织处理的技能方面更高。100%的外科医生和重症监护医生认为活体组织是学习修复穿透性心脏损伤的唯一合适模型。活体组织培训被认为可以提高自我效能感，特别是对于很少应用的技能。尽管意识到活体组织培训的社会和伦理背景，但>90%的参与者报告对活体组织培训有积极的情感反应。
与已发表的研究相比，参与者认为活体组织培训具有其他学习辅助工具尚无法复制的特征。活体组织培训的经验价值应告知向非动物替代品过渡的决策。
