Department of Anesthesia, University of Michigan, Ann Arbor, MI; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI.
Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH; UC Health Air Care & Mobile Care, Cincinnati, OH.
Air Med J. 2023 Jul-Aug;42(4):303-306. doi: 10.1016/j.amj.2023.03.004. Epub 2023 Mar 31.
Lateral canthotomy is a rare, emergent, vision-preserving procedure to treat orbital compartment syndrome. Using Ericsson's deliberate practice model, we aimed to develop a multimodal small group intervention including a modified low-fidelity task trainer to improve flight physician knowledge and technical competency for lateral canthotomy in the prehospital context.
Two cohorts of resident (postgraduate year 1) flight physicians received small group training during an all-day competency-based flight physician orientation. The first cohort completed self-report pre- and postintervention assessments. In the second cohort, examiners assessed pre- and postintervention performance.
Comparing pre- and postintervention responses (N = 27), the mean agreement with the knowledge of indications increased from 3.7 to 4.8. The mean agreement regarding confidence in skills increased from 2.2 to 4.2 (P < .001). The majority of participants (20/27) indicated the trainer "definitely helped," whereas 7 of 27 residents indicated the trainer "somewhat helped" them to learn skills. Examiners assessed holistic learner performance (n = 13) as improved from a mean of 3.2 preintervention to 4.7 postintervention, with 11 of 13 learners demonstrating improvement (P < .005).
We demonstrate the feasibility of a brief small group training combining multimodal didactics with a modified low-fidelity task trainer. Resident self-assessment and examiner assessment demonstrated improved procedural skill with lateral canthotomy.
外侧眦切开术是一种罕见的、紧急的、保留视力的手术,用于治疗眼眶间隔综合征。我们利用埃里克森的刻意练习模型,旨在开发一种多模式小组干预措施,包括改良的低保真度任务训练器,以提高飞行医生在院前环境中进行外侧眦切开术的知识和技术能力。
两组住院医师(研究生第 1 年)在为期一天的基于能力的飞行医生入职培训中接受小组培训。第一组完成了干预前后的自我报告评估。在第二组中,评估员评估了干预前后的表现。
比较干预前后的反应(N=27),对适应证的知识的平均一致性从 3.7 增加到 4.8。对技能的信心的平均一致性从 2.2 增加到 4.2(P<.001)。大多数参与者(20/27)表示培训器“肯定有帮助”,而 27 名住院医师中有 7 名表示培训器“有些帮助”他们学习技能。评估员评估整体学习者表现(n=13)从干预前的平均 3.2 提高到干预后的 4.7,其中 11 名学习者表现出改善(P<.005)。
我们证明了结合多模式教学法和改良的低保真度任务训练器的简短小组培训的可行性。住院医师的自我评估和评估员评估都表明,外侧眦切开术的手术技能有所提高。