Validation of the Simulated Ward Environment for Assessment of Ward-Based Surgical Care
Validation of the Simulated Ward Environment for Assessment of Ward-Based Surgical Care
复制标题
验证模拟病房环境以评估病房外科护理
作者：
P. Pucher;R. Aggarwal;Tharanny Srisatkunam;A. Darzi
目的：评估开发一个模拟病房环境的可行性，在该环境中，评估不同经验水平的临床医生对外科患者的病房护理（结构验证）。背景：越来越多的证据表明，术后或以病房为基础的外科护理阶段在决定患者预后方面的重要性。基于病房的护理由临床医生查房决定，模拟病房环境可能为培训和评估提供安全的环境。方法：开发一个逼真的外科病房环境。初级和高级学员进行了3个标准化手术患者的病房查房，并使用评估和管理护理流程，修改NOTECHS评分和保真度问卷的检查表进行评估。结果：观察到9名高年级和9名低年级学员。进行一轮所需时间无显著差异（37.6 ± 2.7 vs 32.6 ± 1.9分钟，P = 0.16）。高级培训生完成更多的评估过程（73% ± 2.8%vs63% ± 2.5%，P = 0.016），完成更多的管理任务（73% ± 4.5%vs59.4% ± 5%，P = 0.058）。初级学员发生了15起不良事件，而高级学员发生了8起不良事件（P < 0.001）。老年人的非技术能力得分较高（NOTECHS得分21.8 ± 0.61 vs 18.1 ± 1.12，P = 0.017）。所有受试者都认为病房、患者和场景是真实的。结论：一个高保真，沉浸式，建设有效的病房模拟器已经开发出来，观察和评估病房为基础的外科护理过程。
Objective:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). Background:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical care in determining patient outcomes. Ward-based care is determined by the clinician ward round, with the simulated ward environment potentially providing a safe environment for training and assessment. Methods:A high-fidelity surgical ward environment was developed. Junior and senior trainees conducted ward rounds of 3 standardized surgical patients and were assessed using a checklist of assessment and management care processes, modified NOTECHS score, and fidelity questionnaire. Results:Nine senior and 9 junior trainees were observed. There was no significant difference in time taken to conduct the round (37.6 ± 2.7 vs 32.6 ± 1.9 minutes, P = 0.16). Senior trainees performed significantly more assessment processes (73% ± 2.8% vs 63% ± 2.5%, P = 0.016) and completed more management tasks (73% ± 4.5% vs 59.4% ± 5%, P = 0.058). Fifteen adverse events were committed by junior trainees versus 8 by seniors (P < 0.001). Seniors scored higher on nontechnical ability (NOTECHS score 21.8 ± 0.61 vs 18.1 ± 1.12, P = 0.017). All of subjects felt the ward, patients, and scenarios were realistic. Conclusions:A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.
影响因子：
158.5
作者：
Ghaferi, Amir A.;Birkmeyer, John D.;Dimick, Justin B.
通讯作者：
Dimick, Justin B.