電子假人在危急病例處置之教學應用

蔡淳娟; 張倍榮; 方詩元; 林其和

doi:10.6145/jme.200606_10(2).0004

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P115 - 125

医药卫生 > 医药总论
社会科学 > 教育学

DOI： 10.6145/jme

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电子假人在危急病例处置之教学应用

A Mannequin-based Simulation for Teaching Emergent Crisis Care

蔡淳娟(Tsuen-Chiuan Tsai) ；张倍荣(Pei-Jung Chang) ；方诗元(Shin-Yuan Fang) ；林其和(Chyi-Her Lin)

Journal of Medical Education ； 10 卷 2 期 (2006 / 06 / 01) ， P115 - 125

繁体中文 DOI： 10.6145/jme.200606_10(2).0004

拟真；医学教育；急诊；评量；休克；呼吸窘迫； simulation ； medical education ； emergency ； assessment ； shock ； respiratory distress

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摘要 │ 参考文献 (16) │ 被引用文献 (2) │ 国际计量

摘要〈TOP〉

Teaching medical students to appropriately manage critical cases is, typically, quite a challenge, such students usually having limited opportunity to demonstrate prompt patient assessment, rapid decision making and accurate management for ”real” patients. A simulation that uses a mannequin for repeated practice of clinical skills and experimentation in patient care in a controlled, safe learning environment is one apparent solution to such a problem. This study was intended to determine the (student) learning gains derived from experience with a mannequin-based simulation as part of teaching year-6 medical students and PGY 1 (Postgraduate year one) residents as regards the appropriate management of critical patients. 0 DQG This study featured a case-control pretest-posttest design. We used a Laerdal SimMan mannequin herein, in order to simulate dealing with real patients suffering from shock and/or respiratory distress. The individuals participating in this study were year-6 medical students and PGY 1 residents, who were randomly divided into one of two groups: one which featured study participants who underwent simulation-based training and who were pre- and posttested for simulation performance, the other featuring participants who did not undergo such training. A specific measurement tool was used to assess participants' psychomotor and behavioral scores for performance by two independent qualified raters. 5H VXQV A total of 60 participants were enrolled into this study, and a total of 120 simulations were undertaken, such an exercise yielding 204 valid test scores (51 individuals participating in 102 scenarios of shock/respiratory distress as determined by two independent raters. Participants (16 year-6 medical students and 35 PGY 1 residents) were deemed incompetent in pre-test as regards the following items: endotracheal intubation, delivery of CPR, demonstrating an acceptable time period for initiating treatment and vigilance. The performance scores did not appear to be significantly different between pretest and posttest situations, although posttest scores were generally greater than corresponding pretest scores. For the experimental group, ie the group, the members of which underwent mannequin training, significant learning gains were apparent (ie as evidenced by the difference between such individuals' pretest and posttest scores) for 14 separate items (p＜0.05), however, when compared to the control group, the learning gain for members of the experimental group was significantly greater for only one item (decision-making as regards the necessity, or otherwise, for endotracheal intubation). &RQ FOXVLRQ The simulation training program referred to herein has been successful as regards identifying young physicians' problems and also as regards appropriate teaching of individuals for appropriately managing critical cases. Further modifying the simulation scenarios with appropriate difficulty level to enhance learning in emergent crisis care is clearly warranted.

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参考文献 ( 16 ) 〈TOP〉

Byrne AJ,Jones JG(1997).Responses to simulated anaesthetic emergencies by anaesthetists with different durations of clinical experience.Br J Anaesth,78,553-556.
Denson IS,Abrahamson S(1969).A computer-controlled patient simulator.JAMA,208,504-508.
Gaba DM,DeAnda A(1988).A comprehensive anesthesia simulation environment: re-creating the operating room for research and training.Anesthesiology,69(3),387-394.
Gaba DM,DeAnda A(1989).The response of anesthesia trainees to simulated critical incidents.Anesth Analg,68,444-451.
Gordon JA,Wilkerson WM,Shaffer DW(2001)."Practicing" medicine without risk: Students` and educators` responses to high-fidelity patient simulation.Acad Med,76,469-472.

被引用文献 ( 2 ) 〈TOP〉

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