O'Connor Paul
Irish Centre for Applied Patient Safety and Simulation and the Discipline of General Practice, National University of Ireland Galway, Galway, Ireland.
BMJ Simul Technol Enhanc Learn. 2020 Mar 4;6(4):193-195. doi: 10.1136/bmjstel-2020-000602. eCollection 2020.
As the use of simulation has become more established in the delivery of healthcare education and training, there has been a corresponding increase in healthcare simulation research. Simulation-based research can be divided into research about simulation (answers research questions in which the focus is on simulation itself) and research through simulation (simulation as a method/tool for research). However, there are barriers, particularly for smaller less well-resourced simulation centres, that may prohibit participation in research. Therefore, it is suggested that quality improvement (QI) through simulation may be a pragmatic way in which simulation centres of all sizes can contribute to improving patient care beyond education and training. QI is defined as systematic, data-guided activities designed to bring about immediate, positive changes in the delivery of healthcare. Although not the case in healthcare, other industries routinely used simulation to support QI. For example, in aviation simulation is used to inform the design of the working environment, the appropriate use of technology, to exercise emergency procedures and to 're-fly' flights following an adverse event as part of the mishap investigation. Integrating simulation within healthcare QI can support the development of novel interventions as well helping to address heretofore intractable issues.
随着模拟技术在医疗保健教育与培训中的应用日益成熟，医疗保健模拟研究也相应增加。基于模拟的研究可分为关于模拟的研究（回答以模拟本身为重点的研究问题）和通过模拟进行的研究（模拟作为一种研究方法/工具）。然而，存在一些障碍，特别是对于规模较小、资源较少的模拟中心而言，这些障碍可能会阻碍其参与研究。因此，有人建议通过模拟进行质量改进（QI）可能是一种务实的方式，各类规模的模拟中心都可以借此在教育和培训之外为改善患者护理做出贡献。质量改进被定义为旨在给医疗保健服务带来即时积极变化的系统性、数据导向型活动。虽然在医疗保健领域并非如此，但其他行业经常使用模拟来支持质量改进。例如，在航空业，模拟用于为工作环境设计提供信息、指导技术的正确使用、演练应急程序以及在发生不良事件后“重演”航班飞行情况，作为事故调查的一部分。将模拟整合到医疗保健质量改进中，可以支持新型干预措施的开发，同时也有助于解决迄今难以解决的问题。
