Olson Nathan, Griggs Joseph, Balhara Kamna S, Kann Kristen, April Michael D, Olson Adriana S
Emergency Medicine, University of Chicago, Chicago, USA.
Emergency Medicine, Bayne-Jones Army Community Hospital, Fort Polk South, USA.
Cureus. 2022 Jul 19;14(7):e27030. doi: 10.7759/cureus.27030. eCollection 2022 Jul.
Background Fractures are common in the emergency department, and fracture management training poses certain challenges. Recent emergency medicine (EM) residency graduates feel only somewhat prepared to manage fractures. In this study, our objectives were to determine the effect of introducing a wrist fracture simulator (Sawbones®) to traditional EM fracture management education and to assess resident attitudes, comfort with fracture management, and perceptions of the simulator. Methodology This six-month prospective study involved postgraduate year one residents at two academic EM programs. For convenience, each residency was considered as one test group. One residency group was deemed the traditional group (n = 10), while the other was the intervention simulator group (n = 16). Identical traditional lectures and buddy splinting workshops were provided. The simulator group received supplemental training with the Sawbones® simulator. Groups were filmed using this simulator for fracture management before the teaching sessions and at six months. Grading utilized a 27-point scale, with a subscale covering reduction. Data were collected regarding attitudes, comfort with fracture management, and perceptions of the simulator. Results In total, 26 residents participated in the study. There was no significant difference between groups at six months in overall fracture management scores (traditional group: 15.8 ± 3.1; simulator group: 15.4 ± 3.9; p = 0.92). On the subscale of fracture reduction skills, the simulator group showed significant improvement (p = 0.0078), while the traditional training group did not (p = 0.065). Both groups reported satisfaction with the simulator, improved comfort, and knowledge of fracture management. Conclusions Fracture management is an essential competency, and prior research has shown that most graduating EM residents do not feel comfortable with these skills. All participating residents in this study struggled with adequate fracture management, even after the teaching session. Our study suggests that there is a benefit to supplementing traditional training with a fracture simulator.
背景 骨折在急诊科很常见,骨折处理培训面临一定挑战。近期急诊医学(EM)住院医师毕业生感觉在处理骨折方面准备不足。在本研究中,我们的目标是确定引入腕部骨折模拟器(Sawbones®)对传统EM骨折处理教育的影响,并评估住院医师的态度、对骨折处理的舒适度以及对模拟器的看法。方法 这项为期六个月的前瞻性研究涉及两个学术性EM项目的一年级住院医师。为方便起见,每个住院医师培训项目被视为一个测试组。一个住院医师培训组被视为传统组(n = 10),另一个是干预模拟器组(n = 16)。两组都接受了相同的传统讲座和伙伴夹板固定工作坊。模拟器组接受了使用Sawbones®模拟器的补充培训。在教学课程前和六个月时,使用该模拟器对两组进行骨折处理拍摄。评分采用27分制,其中一个子量表涵盖复位情况。收集了关于态度、对骨折处理的舒适度以及对模拟器看法的数据。结果 共有26名住院医师参与了研究。六个月时,两组在总体骨折处理评分上无显著差异(传统组:15.8±3.1;模拟器组:15.4±3.9;p = 0.92)。在骨折复位技能子量表上,模拟器组有显著改善(p = 0.0078),而传统培训组没有(p = 0.065)。两组都报告对模拟器满意,舒适度提高,且对骨折处理的知识有所增加。结论 骨折处理是一项重要能力,先前研究表明大多数即将毕业的EM住院医师对这些技能并不自信。本研究中所有参与的住院医师即使在教学课程后,在充分的骨折处理方面仍有困难。我们的研究表明,用骨折模拟器补充传统培训是有益的。