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《布什大师行动对高压力、实战环境下医学生决策的影响》。

The Impact of Operation Bushmaster on Medical Student Decision-making in a High-Stress, Operational Environment.

机构信息

Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, USA.

George Washington School of Medicine and Health Sciences, Washington, DC 20037, USA.

出版信息

Mil Med. 2023 May 24;188(Suppl 3):28-33. doi: 10.1093/milmed/usac373.

Abstract

INTRODUCTION

Operation Bushmaster is a high-fidelity military medical field practicum for fourth-year medical students at the Uniformed Services University. During Operation Bushmaster, students treat live-actor and mannequin-based simulated patients in wartime scenarios throughout the five-day practicum. This study explored the impact of participating in Operation Bushmaster on students' decision-making in a high-stress, operational environment, a crucial aspect of their future role as military medical officers.

MATERIALS AND METHODS

A panel of emergency medicine physician experts used a modified Delphi technique to develop a rubric to evaluate the participants' decision-making abilities under stress. The participants' decision-making was assessed before and after participating in either Operation Bushmaster (control group) or completing asynchronous coursework (experimental group). A paired-samples t-test was conducted to detect any differences between the means of the participants' pre- and posttest scores. This study was approved by the Institutional Review Board at Uniformed Services University #21-13079.

RESULTS

A significant difference was detected in the pre- and posttest scores of students who attended Operation Bushmaster (P < .001), while there was no significant difference in the pre- and posttest scores of students who completed online, asynchronous coursework (P = .554).

CONCLUSION

Participating in Operation Bushmaster significantly improved the control group participants' medical decision-making under stress. The results of this study confirm the effectiveness of high-fidelity simulation-based education for teaching decision-making skills to military medical students.

摘要

简介

“布什大师行动”是美国武装部队大学四年级医学生的一项高仿真军事医学现场实习。在“布什大师行动”中,学生在为期五天的实习中处理基于现场演员和人体模型的模拟患者,模拟战时场景。本研究探讨了参与“布什大师行动”对学生在高压力、作战环境下做出决策的影响,这是他们未来作为军事医务人员角色的关键方面。

材料和方法

一组急诊医学专家使用改良 Delphi 技术制定了一个评估参与者在压力下决策能力的评分表。参与者在参加“布什大师行动”(对照组)或完成异步课程(实验组)前后进行决策能力评估。采用配对样本 t 检验来检测参与者前后测分数均值之间的差异。本研究得到了美国武装部队大学 21-13079 号机构审查委员会的批准。

结果

参加“布什大师行动”的学生前后测分数有显著差异(P <.001),而完成在线异步课程的学生前后测分数无显著差异(P =.554)。

结论

参加“布什大师行动”显著提高了对照组参与者在压力下的医疗决策能力。本研究结果证实了高保真模拟教学在向军事医学生传授决策技能方面的有效性。

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