Leszczyński Piotr, Muraczyńska Bożena, Wejnarski Arkadiusz, Baczewska Bożena, Malm Maria, Drop Bartłomiej
Faculty of Medical Sciences and Health Sciences, University of Natural Sciences and Humanities, Siedlce, Poland.
Chair of Internal Medicine and Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland.
BMC Med Educ. 2021 Jan 21;21(1):67. doi: 10.1186/s12909-021-02498-x.
Paramedics are authorised to perform emergency procedures, including trauma assessment according to global standards. The aim of the study was to answer the question whether the use of cadavers in teaching practical competencies to medical rescue students, in the field of trauma assessment, is necessary as a supplement to learning in simulated conditions with the use of mannequins.
Research included several stages. The first stage was conduction of classes for 27 students in the field of rapid trauma assessment, in accordance with the guidelines of the International Trauma Life Support. In the second stage, a plan of a test in which students had to perform an analogous procedure of rapid trauma assessment, but with the use of cadavers, human unfixed specimens, was prepared. The Delphi method was used to develop and approve checklists, as well as a scale to assess the global correctness of identification of head, torso and limb injuries by medical rescue students.
The identification rate was 76.54% in the head area, 67.90% in the torso area, while in the limb area it equalled 44.45%. A significant difference in scores, compared to the examination performed on a mannequin, was observed (Wilcoxon = 4.541; p = 0.000). The most difficult to make a correct diagnosis were injuries related to a fracture of the proximal end of the femur and a dislocated wrist (only 18.52% of correct answers). The students highly rated the usefulness of the examination, by awarding it an average of 4.76 points (SD ± 0.56) on the Likert scale (0-5).
The study shows that the use of cadavers to teach practical competencies in the field of trauma assessment to medical rescue students can be an effective supplement to simulated learning. Students could feel the difference between the human body and the mannequin. More research is needed to assess whether realistic simulation translates into objective endpoints, such as the effectiveness of diagnosis in the examination of trauma patients. However, it should be remembered that the introduction of this teaching method is expensive and requires adequate base, as well as the compliance with a number of formal requirements.
护理人员被授权执行紧急程序,包括按照全球标准进行创伤评估。本研究的目的是回答在创伤评估领域,使用尸体向医学救援专业学生传授实践能力作为在模拟条件下使用人体模型学习的补充是否必要这一问题。
研究包括几个阶段。第一阶段是按照国际创伤生命支持指南,为27名学生开展快速创伤评估领域的课程。在第二阶段,制定了一项测试计划,学生必须执行类似的快速创伤评估程序,但使用尸体,即未固定的人体标本。采用德尔菲法制定和批准检查表,以及一个用于评估医学救援专业学生对头部、躯干和肢体损伤识别整体正确性的量表。
头部区域的识别率为76.54%,躯干区域为67.90%,而肢体区域为44.45%。与在人体模型上进行的检查相比,观察到分数有显著差异(Wilcoxon = 4.541;p = 0.000)。最难做出正确诊断的是股骨近端骨折和手腕脱位相关损伤(正确答案仅为18.52%)。学生对该检查的有用性评价很高,在李克特量表(0 - 5)上平均给予4.76分(标准差±0.56)。
该研究表明,使用尸体向医学救援专业学生传授创伤评估领域的实践能力可以成为模拟学习的有效补充。学生能够感受到人体与人体模型之间的差异。需要更多研究来评估逼真的模拟是否能转化为客观终点,如创伤患者检查中诊断的有效性。然而,应该记住,引入这种教学方法成本高昂,需要足够的基础,以及符合一些正式要求。