当事情出错时要做什么:对大量出血控制的模拟
Brandon Cowan1, Mandeep Kaur2, Scott Drapeau3
1Department of Surgery, University of California, San Francisco, CA.
Surgery
|August 20, 2025
概括
一个新的手术危机模拟器有效地训练了住院医生和实习生处理严重的腹部出血. 模拟突出了技术技能,非技术技能和压力下的表现之间的联系.
科学领域:
- 外科教育
- 医疗模拟
- 危机管理
背景情况:
- 在面临压力事件时,
- 开发了一种新的模拟模型来评估在手术内危机中学习者的表现.
研究的目的:
- 在模拟的手术内危机中评估学习者的经验和表现.
- 评估一种新的腹部大出血模拟器的有效性.
主要方法:
- 一个专注于精神运动,领导力和压力管理技能的课程被实施.
- 外科住院生和研究员使用模拟器进行主要腹部出血,包括血管修复,血液损失,技术技能客观结构评估 (OSATS) 和外科医生非技术技能 (NOTSS) 评估.
- 聚焦小组和采访的定性分析探讨了压力和认知负载.
主要成果:
- 实习生在20分钟内完成模拟的表现优异 (P = .02) 和更高的OSATS分数 (P = .01).
- 在74%的住宿者和60%的研究员中发生了显著的血液损失 (> 1000毫升).
- 主题分析揭示了技术和非技术技能之间的相互关系,需要有条不的应对,以及与经验和绩效相关的压力水平.
结论:
- 这种新型的模拟有效地挑战了初级住院人员,
- 有机会通过有针对性的培训来提高学员的非技术技能.
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