Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.
Disaster response team FAST skills training with a portable ultrasound simulator compared to traditional training: pilot study.
复制标题
DOI：
10.5811/westjem.2015.1.23720
复制
发表时间：
2015-03
期刊：
影响因子：
--
通讯作者：
Sergel MJ
中科院分区：
文献类型：
--
作者：
Paddock MT;Bailitz J;Horowitz R;Khishfe B;Cosby K;Sergel MJ
院前超声创伤评估（FAST）已被有效地用于改善世界各地多起大规模伤亡事件中的患者护理。尽管灾难响应团队成员现在可以远程学习必要的FAST知识，但传统的现场教师和模型实践FAST技能培训在后勤上仍然具有挑战性。这项试点研究的目的是比较一种新型的便携式超声（US）模拟器与传统的FAST技能培训部署的混合供应商灾难响应团队的有效性。我们将参与者随机分为三个培训组之一，按提供者的角色分层：A组。传统技能培训，B组。美国模拟器技能训练，和C组。传统技能培训加上美国模拟器技能培训。在技能培训后，我们使用标准化直接观察工具（SDOT）测量了参与者的FAST图像采集和解读技能，并使用健康模型和FAST患者图像进行了审查。还使用先前验证的多项选择评价评估了课程前和课程后的US和FAST知识。我们使用方差分析程序来确定各组技能得分均值之间差异的统计学显著性。配对样本t检验用于确定组内课程前和课程后平均知识得分的统计学显著性。我们招募了36名参与者，12名随机分配到每个训练组。随机化导致培训组之间的参与者在提供者角色、年龄、性别和既往美国培训方面分布相似。对于FAST SDOT图像采集和判读平均技能评分，培训组之间无统计学显著差异。对于US和FAST平均知识得分，每组内的课程前和课程后得分之间有统计学显著改善，但培训组之间也没有统计学显著差异。这项试点研究部署的混合供应商灾难响应团队表明，一种新型的便携式美国模拟器可以提供相当于传统的现场教练和模型培训的技能培训。需要进一步研究更大的样本量和其他短期和长期临床性能指标。
Pre-hospital focused assessment with sonography in trauma (FAST) has been effectively used to improve patient care in multiple mass casualty events throughout the world. Although requisite FAST knowledge may now be learned remotely by disaster response team members, traditional live instructor and model hands-on FAST skills training remains logistically challenging. The objective of this pilot study was to compare the effectiveness of a novel portable ultrasound (US) simulator with traditional FAST skills training for a deployed mixed provider disaster response team. We randomized participants into one of three training groups stratified by provider role: Group A. Traditional Skills Training, Group B. US Simulator Skills Training, and Group C. Traditional Skills Training Plus US Simulator Skills Training. After skills training, we measured participants’ FAST image acquisition and interpretation skills using a standardized direct observation tool (SDOT) with healthy models and review of FAST patient images. Pre- and post-course US and FAST knowledge were also assessed using a previously validated multiple-choice evaluation. We used the ANOVA procedure to determine the statistical significance of differences between the means of each group’s skills scores. Paired sample t-tests were used to determine the statistical significance of pre- and post-course mean knowledge scores within groups. We enrolled 36 participants, 12 randomized to each training group. Randomization resulted in similar distribution of participants between training groups with respect to provider role, age, sex, and prior US training. For the FAST SDOT image acquisition and interpretation mean skills scores, there was no statistically significant difference between training groups. For US and FAST mean knowledge scores, there was a statistically significant improvement between pre- and post-course scores within each group, but again there was not a statistically significant difference between training groups. This pilot study of a deployed mixed-provider disaster response team suggests that a novel portable US simulator may provide equivalent skills training in comparison to traditional live instructor and model training. Further studies with a larger sample size and other measures of short- and long-term clinical performance are warranted.