Medical Education Unit, Fiona Stanley Fremantle Hospitals Group, Fiona Stanley Hospital, Murdoch, WA, Australia.
School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.
Perspect Med Educ. 2021 Mar;10(2):95-100. doi: 10.1007/s40037-020-00631-y. Epub 2020 Nov 26.
Australian Standards require that clinicians undergo regular training in skills required to respond to the acute deterioration of a patient. Training focuses on the ability to appropriately respond to cardiac arrest, including delivering cardiac compressions, ventilation and appropriate defibrillation. Providing such training comes at a significant cost to the organisation and impacts on clinician time in direct patient care. If effective, the use of an automated manikin could significantly reduce costs and provide consistent training experiences.
Fifty-six resident medical officers were randomised to two groups to test two skills components of hospital life support training under two feedback conditions. The skills components were cardiac compressions and bag-valve-mask ventilation. The feedback conditions were automated feedback delivered by a simulation manikin and traditional feedback delivered by an instructor. All participants were exposed to both skills components and both feedback conditions in a counterbalanced block design. Participants completed surveys before and after training.
The results demonstrated significantly better performance in cardiac compressions under the automated manikin feedback condition compared with the instructor feedback condition. This difference was not observed in bag-valve-mask ventilation. The majority of participants found the automated manikin feedback more useful than the instructor feedback.
Automated manikin feedback was not inferior to instructor feedback for skill acquisition in cardiac compressions training. The automated feedback condition did not achieve the same level of significance in bag-valve-mask ventilation training. Results suggest training with automated feedback presents a cost-effective opportunity to lessen the training burden, whilst improving skill acquisition.
澳大利亚标准要求临床医生定期接受应对患者病情急剧恶化所需技能的培训。培训重点是具备适当应对心脏骤停的能力，包括进行心脏按压、通气和适当除颤。为组织提供此类培训会带来巨大的成本，并影响临床医生直接照顾患者的时间。如果有效，使用自动化模拟人可以显著降低成本并提供一致的培训体验。
将 56 名住院医师随机分为两组，在两种反馈条件下测试医院生命支持培训的两个技能组成部分。技能组成部分是心脏按压和球囊面罩通气。反馈条件是由模拟人提供的自动化反馈和由讲师提供的传统反馈。所有参与者都在平衡块设计中接受了这两个技能组成部分和两种反馈条件的暴露。参与者在培训前后完成了调查。
结果表明，在自动化模拟人反馈条件下，心脏按压的表现明显优于讲师反馈条件。在球囊面罩通气中未观察到这种差异。大多数参与者认为自动化模拟人反馈比讲师反馈更有用。
在心脏按压训练中，自动化模拟人反馈在技能获取方面并不逊于讲师反馈。在球囊面罩通气训练中，自动化反馈条件没有达到相同的显著性水平。结果表明，使用自动化反馈提供了一个具有成本效益的机会，可以减轻培训负担，同时提高技能获取。
