Simulation in a Disaster Drill: Comparison of High-fidelity Simulators versus Trained Actors
Simulation in a Disaster Drill: Comparison of High-fidelity Simulators versus Trained Actors
复制标题
DOI：
10.1111/j.1553-2712.2008.00198.x
复制
发表时间：
2008-11-01
影响因子：
4.4
通讯作者：
Arquilla, Bonnie
中科院分区：
文献类型：
--
作者：
Gillett, Brian;Peckler, Brad;Arquilla, Bonnie
高保真病人模拟提供了逼真的医疗场景与实时压力。大规模伤亡演习必须构建一个现实的事件，其中提供者照顾多个受伤的病人，同时应对众多的压力源，旨在征税机构的资源。本研究以2006年12月和2007年3月的两次大规模伤亡演习为研究对象，对模拟病人和现场病人的价值进行了前瞻性研究。在现场演员-患者和模拟器中测试了提供者完成关键动作的能力。一项事后调查比较了参与者对模拟器和现场演员受害者的“现实”感知。大规模伤亡演习的受害者（n = 130）都有烧伤，爆炸或吸入相关的伤害。参与者包括医生，居民，医学生，职员和护理人员。作者比较了团队在模拟器和现场演员-患者之间执行136个关键动作（17个关键动作x 8个场景）的情况。模拟器组和现场演员组分别仅遗漏了一个关键动作，导致遗漏率为0.74%（95%置信区间[CI] = 0.01%至4.5%）。所有问卷均被退回并进行分析。绝大多数参与者不同意或强烈反对模拟器分散了灾难演习的注意力。超过96%的人同意或强烈同意他们将推荐模拟器作为培训工具。所有参与者的平均调查分数表明，模拟器密切模仿现实生活中的场景，准确地表示疾病状态，并提高了患者评估和治疗方案的现实性，但护士参与者除外，这项研究表明，模拟器与真人演员相比，患者在大规模伤亡演习中的关键行动方面具有相同的结果，并增加了这种演习的感知现实性。
High-fidelity patient simulation provides lifelike medical scenarios with real-time stressors. Mass casualty drills must construct a realistic incident in which providers care for multiple injured patients while simultaneously coping with numerous stressors designed to tax an institution's resources. This study compared the value of high-fidelity simulated patients with live actor-patients.A prospective cohort study was conducted during two mass casualty drills in December 2006 and March 2007. The providers' completion of critical actions was tested in live actor-patients and simulators. A posttest survey compared the participants' perception of "reality" between the simulators and live actor victims.The victims (n = 130) of the mass casualty drill all had burn-, blast-, or inhalation-related injuries. The participants consisted of physicians, residents, medical students, clerks, and paramedics. The authors compared the team's execution of the 136 critical actions (17 critical actions x 8 scenarios) between the simulators and the live actor-patients. Only one critical action was missed in the simulator group and one in the live actor group, resulting in a miss rate of 0.74% (95% confidence interval [CI] = 0.01% to 4.5%). All questionnaires were returned and analyzed. The vast majority of participants disagreed or strongly disagreed that the simulators were a distraction from the disaster drill. More than 96% agreed or strongly agreed that they would recommend the simulator as a training tool. The mean survey scores for all participants demonstrated agreement that the simulators closely mimicked real-life scenarios, accurately represented disease states, and heightened the realism of patient assessment and treatment options during the drill with the exception of nurse participants, who agreed slightly less strongly.This study demonstrated that simulators compared to live actor-patients have equivalent results in prompting critical actions in mass casualty drills and increase the perceived reality of such exercises.