Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training
Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training
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DOI：
10.1097/00005373-200206000-00009
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发表时间：
2002-06-01
影响因子：
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通讯作者：
Mattox, KL
中科院分区：
文献类型：
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作者：
Holcomb, JB;Dumire, RD;Mattox, KL
背景：自1969年以来，人类患者模拟（HPS）一直用于教学目的。直到最近，技术才发展到可以应用于复杂的创伤复苏领域。我们的研究的目的是验证一个先进的HPS作为评估工具的创伤团队复苏skills.Methods：试点研究评估了10个三人的军事复苏队从社区医院参加了28天的轮换在民间创伤中心。每个小组都由医生、护士和医务人员组成。使用HPS，在抵达时对团队进行评估，并在轮换完成时再次进行评估。此外，10个创伤小组与5个由经验丰富的创伤外科医生和护士组成的专家小组进行了比较。使用了两种标准化的创伤场景，代表一名严重受伤的患者，该患者有多处损伤，损伤严重度评分为41（生存概率为50%）。使用独特的人类表现评估工具，包括五个评分和八个定时任务，通常被认为是创伤患者的初步评估和治疗的关键。评分任务包括气道、呼吸、循环和残疾评估以及整体组织技能和总分。使用非参数Wilcoxon检验比较军事小组在情景1和情景2中的得分，以及军事小组与专家小组的最终得分。P < 0.05的值被认为是显着的。结果：10个军事小组表现出显着的改善，在五个得分（p小于或等于0.05）和八个定时（p小于或等于0.05）任务中的六个在最后的场景。这一改进反映了团队在28天创伤复习课程中积累的教学和临床经验，以及一定程度的模拟器熟悉。提高最终分数反映了高效和协调的团队努力。军事小组的初始分数比专家组在所有类别，但他们的最终得分仅低于专家组在2的13个测量（p小于或等于0.05）。结论：没有研究验证使用的HPS作为一个有效的教学或评估工具，在复杂的创伤复苏领域。这些试点数据证明了以可重复的方式评估创伤团队绩效的能力。此外，我们能够记录在28天的创伤复习课程后团队表现的显着改善，分数接近专家团队。
Background: Human patient simulation (HPS) has been used since 1969 for teaching purposes. Only recently has technology advanced to allow application to the complex field of trauma resuscitation. The purpose of our study was to validate an advanced HPS as an evaluation tool of trauma team resuscitation skills.Methods: The pilot study evaluated 10 three-person military resuscitation teams from community hospitals that participated in a 28-day rotation at a civilian trauma center. Each team consisted of physicians, nurses, and medics. Using the HPS, teams were evaluated on arrival and again on completion of the rotation. In addition, the 10 trauma teams were compared with 5 expert teams composed of experienced trauma surgeons and nurses. Two standardized trauma scenarios were used, representing a severely injured patient with multiple injuries and with an Injury Severity Score of 41 (probability of survival, 50%). Performance was measured using a unique human performance assessment tool that included five scored and eight timed tasks generally accepted as critical to the initial assessment and treatment of a trauma patient. Scored tasks included airway, breathing, circulation, and disability assessments as well as overall organizational skills and a total score. The nonparametric Wilcoxon test was used to compare the military teams' scores for scenarios 1 and 2, and the comparison of the military teams' final scores with the expert teams. A value of p < 0.05 was considered significant.Results: The 10 military teams demonstrated significant improvement in four of the five scored (p less than or equal to 0.05) and six of the eight timed (p less than or equal to 0.05) tasks during the final scenario. This improvement reflects the teams' cumulative didactic and clinical experience during the 28-day trauma refresher course as well as some degree of simulator familiarization. Improved final scores reflected efficient and coordinated team efforts. The military teams' initial scores were worse than the expert group in all categories, but their final scores were only lower than the expert groups in 2 of 13 measurements (p less than or equal to 0.05).Conclusion: No studies have validated the use of the HPS as an effective teaching or evaluation tool in the complex field of trauma resuscitation. These pilot data demonstrate the ability to evaluate trauma team performance in a reproducible fashion. In addition, we were able to document a significant improvement in team performance after a 28-day trauma refresher course, with scores approaching those of the expert teams.