生理驱动高仿真模拟人在全科医生急救非技术技能培训中的应用
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摘要
目的探讨生理驱动高仿真模拟人在全科医生急救非技术技能培训中的应用效果。方法选择在首都医科大学宣武医院进行急救技能培训的59名全科医生,随机分成对照组29名和观察组30名。对照组采用传统理论授课和简单演练的教学模式进行急救技能培训。观察组设计全科医生临床常见的过敏性休克、心衰及心脏骤停等急救病例,把这些病例的抢救流程输入生理驱动高仿真模拟人,在生理驱动高仿真模拟人上运行这些病例程序,应用生理驱动高仿真模拟人进行急救培训。培训结束后应用麻醉医师的非技术技能(anesthetists’non-technical skills,ANTS)系统分别对2组全科医生进行技能考核,比较2组全科医生的非技术技能和抢救成功率的差异。发放调查问卷,分析全科医生对急救技能培训效果的评价。结果经过培训后观察组全科医生的任务管理分数为10. 29±4. 53,高于对照组的分数7. 65±4. 67(P=0. 031),判断决策能力分数为8. 42±3. 82,高于对照组的分数6. 12±3. 73(P=0. 023),团队协作能力分数为13. 01±4. 69,高于对照组的分数9. 17±4. 72(P=0. 003),情景意识的分数为8. 62±3. 48,高于对照组的分数6. 57±3. 92(P=0. 038);调查问卷显示观察组在提高学习兴趣、提高综合能力和团队精神培养方面分数均高于对照组(均P <0. 05)。结论应用生理驱动高仿真模拟人进行急救技能培训可以显著提高全科医生的非技术技能,提高抢救成功率,增加学习兴趣,促进团队精神的培养。
Objective To explore the application effect of the physiological driving fidelity human patient simulator in the training of non-technical skills of general practitioner first aid. Methods The 59 general practitioners were selected to carry out first-aid skills training at Xuanwu Hospital of Capital Medical University,who were randomly divided into control group including 29 cases and observation group including 30 cases. The teaching model of traditional theory and simple drill were used in the control group. First aid cases,such as anaphylactic shock,heart failure and cardiac arrest,were designed for general practitioner in the observation group,and the rescue process of these cases were put into the physiological driving fidelity human patient simulator,and the case program was run on the physiological driving fidelity human patient simulator,and the physiological driving fidelity human patient simulator was used to carry out first aid training in the observation group. After training,the anesthesiologist' non-technical skills system( ANTS) were used to evaluate the non-technical skills of 2 groups,the differences of non-technical ability and rescue success rate were compared between the 2 groups. The questionnaire was issued to analyze the evaluation of the effect of the general practitioner on first-aid skills training. Results After training,the score of the task management of the general practitioner in the observation group was 10. 29 ± 4. 53,which was larger than that of the control group 7. 65 ± 4. 67( P = 0. 031). The score of decision making ability was 8. 42 ± 3. 82,which was larger than that of the control group 6. 12 ± 3. 73( P = 0. 023),and the team cooperation ability score was 13. 01 ± 4. 69,which was higher than that of the control group 9. 17 ± 4. 72( P =0. 003),The score of situational awareness was 8. 62 ± 3. 48,which was higher than that of the control group 6. 57 ±3. 92( P = 0. 038). The questionnaire showed that the scores of the observation group in improving learning interest,improving comprehensive ability and team spirit training were higher than those in the control group( P < 0. 05). Conclusion The application of physiological driving fidelity human patient simulator in first-aid skills training could significantly improve the non-technical skills of general practitioners,improve the success rate of rescue,and increase interest in learning and promote team spirit.
Objective To explore the application effect of the physiological driving fidelity human patient simulator in the training of non-technical skills of general practitioner first aid. Methods The 59 general practitioners were selected to carry out first-aid skills training at Xuanwu Hospital of Capital Medical University,who were randomly divided into control group including 29 cases and observation group including 30 cases. The teaching model of traditional theory and simple drill were used in the control group. First aid cases,such as anaphylactic shock,heart failure and cardiac arrest,were designed for general practitioner in the observation group,and the rescue process of these cases were put into the physiological driving fidelity human patient simulator,and the case program was run on the physiological driving fidelity human patient simulator,and the physiological driving fidelity human patient simulator was used to carry out first aid training in the observation group. After training,the anesthesiologist' non-technical skills system( ANTS) were used to evaluate the non-technical skills of 2 groups,the differences of non-technical ability and rescue success rate were compared between the 2 groups. The questionnaire was issued to analyze the evaluation of the effect of the general practitioner on first-aid skills training. Results After training,the score of the task management of the general practitioner in the observation group was 10. 29 ± 4. 53,which was larger than that of the control group 7. 65 ± 4. 67( P = 0. 031). The score of decision making ability was 8. 42 ± 3. 82,which was larger than that of the control group 6. 12 ± 3. 73( P = 0. 023),and the team cooperation ability score was 13. 01 ± 4. 69,which was higher than that of the control group 9. 17 ± 4. 72( P =0. 003),The score of situational awareness was 8. 62 ± 3. 48,which was higher than that of the control group 6. 57 ±3. 92( P = 0. 038). The questionnaire showed that the scores of the observation group in improving learning interest,improving comprehensive ability and team spirit training were higher than those in the control group( P < 0. 05). Conclusion The application of physiological driving fidelity human patient simulator in first-aid skills training could significantly improve the non-technical skills of general practitioners,improve the success rate of rescue,and increase interest in learning and promote team spirit.
引文
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[11] KANG E,MASSEY D,GILLESPIE B M. Factors that influence the non-technical skills performance of scrub nurses:a prospective study[J]. J Adv Nurs,2015,71(12):2846-2857.
[12]陈璠,刘耕.情景教学在医学高级模拟教学中的应用[J].中国病案,2018,19(3):95-96,112.
[13] MCCLELLAND G. Factors that affect scrub practitioner non-technical skills:A literature review[J]. J Perioper Pract,2018,28(4):75-82.
[14] GALLAND J,ABBARA S,TERRIER B,et al. Simulation-based learning and internal medicine:Opportunities and current perspectives for a national harmonized program[J]. Rev Med Interne,2018,39(6):414-420.
[15] CHEN R,GRIERSON L E,NORMAN G R. Evaluating the impact of high-and low-fidelity instruction in the development of auscultation skills[J]. Med Educ,2015,49(3):276-285.
[16]王长远,曹涛,秦俭,等. CBL结合高仿真电脑模拟人在急救培训中的应用[J].中国急救复苏与灾害医学杂志,2016,11(4):350-352.
[2]郑建军,蒋巧巧,陈琳,等.探讨全科医师急诊急救能力与培养[J].中国毕业后医学教育,2018,2(2):126-132.
[3] NEUSCHWANDER A,JOB A,YOUNES A,et al. Impact of sleep deprivation on anaesthesia residents’non-technical skills:a pilot simulation-based prospective randomized trial[J]. Br J Anaesth,2017,119(1):125-131.
[4] YULE J,HILL K,YULE S. Development and evaluation of a patientcentred measurement tool for surgeons’non-technical skills[J]. Br J Surg,2018,105(7):876-884.
[5] YULE S,GUPTA A,GAZARIAN D,et al. Construct and criterion validity testing of the Non-Technical Skills for Surgeons(NOTSS)behaviour assessment tool using videos of simulated operations[J]. Br J Surg,2018,105(6):719-727.
[6]叶子辉,邵利明,吴文君.健康中国视域下的全科医学教育发展研究[J].中国全科医学,2017,20(19):2283-1188.
[7]宋向东,杨昱,于先清,等.加强全科医学教育培训促进全科医生队伍建设——安徽省全科医学教育培训工作实践与思考[J].中华全科医学,2018,16(1):1-4.
[8] O’HAGAN A D,ISSARTEL J,MCGINLEY E,et al. A Pilot Study Exploring the Effects of Sleep Deprivation on Analogue Measures of Pilot Competencies[J]. Aerosp Med Hum Perform,2018,89(7):609-615.
[9] LACERENZA C N,MARLOW S L,TANNENBAUM S I,et al. Team development interventions:Evidence-based approaches for improving teamwork[J].AmPsychol,2018,73(4):517-531.
[10]盛露露,许兵,黄剑吟,等.团队情景模拟在急诊心肺复苏培训中的应用效果研究[J].中国继续医学教育,2017,9(32):3-5.
[11] KANG E,MASSEY D,GILLESPIE B M. Factors that influence the non-technical skills performance of scrub nurses:a prospective study[J]. J Adv Nurs,2015,71(12):2846-2857.
[12]陈璠,刘耕.情景教学在医学高级模拟教学中的应用[J].中国病案,2018,19(3):95-96,112.
[13] MCCLELLAND G. Factors that affect scrub practitioner non-technical skills:A literature review[J]. J Perioper Pract,2018,28(4):75-82.
[14] GALLAND J,ABBARA S,TERRIER B,et al. Simulation-based learning and internal medicine:Opportunities and current perspectives for a national harmonized program[J]. Rev Med Interne,2018,39(6):414-420.
[15] CHEN R,GRIERSON L E,NORMAN G R. Evaluating the impact of high-and low-fidelity instruction in the development of auscultation skills[J]. Med Educ,2015,49(3):276-285.
[16]王长远,曹涛,秦俭,等. CBL结合高仿真电脑模拟人在急救培训中的应用[J].中国急救复苏与灾害医学杂志,2016,11(4):350-352.