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高级联合气道管理系统的开发和评估,用于评估专家急救医学教师在气管插管中的教育效用。

Development and Evaluation of the Advanced Joint Airway Management System for Educational Utility in Endotracheal Intubation, as Assessed by Expert Paramedic Instructors.

机构信息

Center for Research in Educational and Simulation Technologies, Division of Healthcare Simulation Science, UW Medicine, University of Washington, Seattle, WA 98195-6410, USA.

Simagine Health, Seattle, WA 98195-6410, USA.

出版信息

Mil Med. 2024 Aug 19;189(Suppl 3):702-709. doi: 10.1093/milmed/usae234.

Abstract

INTRODUCTION

Between 2011 and 2014, The Combat Casualty Training Consortium research study sought to evaluate all aspects of combat casualty care, including mortality, with a special focus on the incidence and causes of potentially preventable deaths among U.S. combat fatalities. This study identified a major training gap in critical airway management. To address this gap, the Advanced Joint Airway Management System (AJAMS) was designed and assessed for physical fidelity and educational utility in a population of paramedic instructors.

MATERIALS AND METHODS

Paramedic instructors served as participants in this prospective observational pilot study (n = 12). Participants interacted with three airway management trainers: The AJAMS trainer, the Laerdal Airway Management Trainer, and the TruCorp AirSim Advance Bronchi X Trainer. Participants then completed an evaluation of the trainer using a purpose-built data collection instrument that queried the trainer's realism and educational utility. Within-group differences were analyzed via a 1-way repeated measures ANOVA, with a Bonferroni post hoc analysis. Rank data were analyzed via non-parametric Freidman's test, and Wilcoxon signed-rank test post hoc analysis, corrected using the Bonferroni correction.

RESULTS

The AJAMS trainer conveys significantly more physical fidelity (visual: P < .001, ηp2 = 0.977; tactile: P < .001, ηp2 = 0.983; and behavioral: P = .001, ηp2 = 0.971) and overall educational utility (χ2(2) = 15.273, P < .001) than the two commercially available skill trainers.

CONCLUSIONS

These data suggest that physical fidelity is an important attribute in the design of simulators for health care, as perceived by expert instructors. These data illustrate that the AJAMS-integrated simulator demonstrates unparalleled physical fidelity, relative to commercially available airway management skill trainers.

摘要

简介

在 2011 年至 2014 年期间,战斗伤员训练联盟研究项目旨在评估战斗伤员护理的各个方面,包括死亡率,并特别关注美国战斗伤亡人员中潜在可预防死亡的发生率和原因。这项研究发现了严重气道管理方面的一个重大培训差距。为了弥补这一差距,设计了高级联合气道管理系统 (AJAMS),并在一批护理人员教官中评估其物理逼真度和教育实用性。

材料与方法

护理人员教官作为这项前瞻性观察性试点研究的参与者(n=12)。参与者与三种气道管理培训器互动:AJAMS 培训器、Laerdal 气道管理培训器和 TruCorp AirSim Advance Bronchi X 培训器。然后,参与者使用专门设计的数据收集工具对培训器的逼真度和教育实用性进行评估。使用单向重复测量方差分析分析组内差异,并使用 Bonferroni 事后分析进行分析。秩数据通过非参数 Friedman 检验和 Wilcoxon 符号秩检验进行分析,并用 Bonferroni 校正进行事后分析。

结果

AJAMS 培训器在物理逼真度(视觉:P<.001,ηp2=0.977;触觉:P<.001,ηp2=0.983;行为:P=.001,ηp2=0.971)和整体教育实用性(χ2(2)=15.273,P<.001)方面都明显优于两种商业上可用的技能培训器。

结论

这些数据表明,物理逼真度是专家教官在医疗保健模拟设计中认为重要的属性。这些数据表明,与商业上可用的气道管理技能培训器相比,AJAMS 集成模拟器具有无与伦比的物理逼真度。

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