Fujita Koji, Yoshimura Ryo, Tanaka Yoshiyuki, Kawabata Masayuki, Masumitsu Akane, Kawasaki Sadao, Kato Yoko, Kato Seiya, Nakao Naoyuki
Department of Neurological Surgery, Naga Municipal Hospital, Kinokawa, Japan.
Department of Neurological Surgery, Hashimoto Municipal Hospital, Hashimoto, Japan.
Asian J Neurosurg. 2020 Oct 19;15(4):970-975. doi: 10.4103/ajns.AJNS_254_20. eCollection 2020 Oct-Dec.
The Immediate Stroke Life Support (ISLS) course run in Wakayama (Wakayama-ISLS course) is an off-the-job training course for understanding the initial treatment of acute stroke. A total of 22 Wakayama-ISLS courses have been held in Wakayama Prefecture since 2008. To begin with, the case presentation was performed using human-like, mechanical manikins for simulation training. However, as the course progressed, we found the students paying great attention to the display monitor, and less to the patients' neurological status.
From the fourth Wakayama-ISLS course onward, we conducted the group work with the facilitators pretending to be patients, i.e., without medical training manikins.
When the facilitators acted as patients, the students gained a more realistic and expressive perception of neurological symptoms. As a result, they expressed a high level of satisfaction with the course in the questionnaire sent immediately afterwards, regardless of their profession or prior experience. Moreover, as we did not need to transfer medical training simulators, we were able to carry out three ISLS courses at locations some distance from Wakayama city on a low-cost basis. This also enabled the regional medical staff in rural hospitals to participate in the courses easily.
The Wakayama-ISLS course without medical training manikins is an entirely feasible off-the-job training course, which provides training on fast and excellent treatment of acute stroke problems based on clinical practice. The course has the potential to spread not only across Japan but throughout the world, including to developing countries, given the cost perspective.
在和歌山县开展的即时卒中生命支持(ISLS)课程是一项用于了解急性卒中初始治疗的非在职培训课程。自2008年以来,和歌山县共举办了22期和歌山 - ISLS课程。起初,病例演示使用类人机械模型进行模拟训练。然而,随着课程的推进,我们发现学生们过于关注显示屏,而对患者的神经学状态关注较少。
从第四期和歌山 - ISLS课程开始,我们开展小组活动,由 facilitators 假装成患者,即不使用经过医学培训的模型。
当 facilitators 扮演患者时,学生们对神经症状有了更真实、更具表现力的认知。结果,无论他们的职业或先前经验如何,在之后立即发放的问卷中,他们对该课程都表达了高度的满意度。此外,由于我们无需搬运医学培训模拟器,我们能够以低成本在距离和歌山市有一定距离的地点开展三期ISLS课程。这也使农村医院的地区医务人员能够轻松参加这些课程。
不使用经过医学培训模型的和歌山 - ISLS课程是一项完全可行的非在职培训课程,它基于临床实践提供关于快速、优质治疗急性卒中问题的培训。从成本角度来看,该课程不仅有潜力在日本全国推广,而且有可能推广到包括发展中国家在内的全世界。