Mobile in Situ Simulation as a Tool for Evaluation and Improvement of Trauma Treatment in the Emergency Department

Amiel, Imri; Simon, Daniel; Merin, Ofer; Ziv, Amitai

doi:10.1016/j.jsurg.2015.08.013

Cited by 34 publications

(53 citation statements)

References 23 publications

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“…[3][4][5][6][7][8] Simulation training can also be used as a tool to identify latent errors within hospital systems and as part of a participant or team assessment process. [9][10][11][12][13][14][15] The majority of simulations occur either in a purpose built centre or in the real clinical environment (in situ). A recent paper by Couto et al 16 summarises the differences between the two environments and these are described in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

O’Leary

Pegiazoglou

McGarvey

et al. 2017

Emerg Medicine Australasia

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Objective: To measure scenario participant and faculty self-reported realism, engagement and learning for the low fidelity, in situ simulations and compare this to high fidelity, centre-based simulations. Methods: A prospective survey of scenario participants and faculty completing in situ and centre-based paediatric simulations.Results: There were 382 responses, 276 from scenario participants and 106 from faculty with 241 responses from in situ and 141 from centre-based simulations. Scenario participant responses showed significantly higher ratings for the centre-based simulations for respiratory rate (P = 0.007), pulse (P = 0.036), breath sounds (P = 0.002), heart sounds (P < 0.001) and patient noises (P < 0.001). There was a significant difference in overall rating of the scenario reality by scenario participants in favour of the centre-based simulations (P = 0.005); however, there was no significant difference when rating participant engagement (P = 0.11) and participant learning (P = 0.77). With the centre-based scenarios, nurses rated the reality of the respiratory rate (P < 0.001), blood pressure (P = 0.016) and abdominal signs (P = 0.003) significantly higher than doctors. Nurses rated the overall reality higher than doctors for the centre simulations (96.8% vs 84.2% rated as realistic, P = 0.041), which was not demonstrated in the in situ scenarios (76.2% vs 73.5%, P = 0.65). Conclusion: Some aspects of in situ simulations may be less 'real' than centre-based simulations, but there was no significant difference in selfreported engagement or learning by scenario participants. Low fidelity, in situ simulation provides adequate realism for engagement and learning.

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Section: Introductionmentioning

confidence: 99%

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

O’Leary

Pegiazoglou

McGarvey

et al. 2017

Emerg Medicine Australasia

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“…These initiatives appear to be feasible and practical 18,19 and may enable training and assessment over a 1-week trauma course 20 . However, to the authors' knowledge, no studies have addressed rural mobile emergency simulation programs.…”

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confidence: 99%

Mobile emergency simulation training for rural health providers

Martin

Bekiaris²,

Hansen³

2017

RRH

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“…Medical personnel come to training with experience, knowledge and skills, and the trainer needs to make the training relevant to the learners. Studies have shown that one way of learning is when the trainee can relate new material to what is already known and needs new knowledge to build up logically with clear objectives [75,76].…”

Section: Teaching Models and Environmentsmentioning

confidence: 99%

“…Activation can facilitate "in action learning" by methods such as simulated emergency scenarios [56,75].…”

Section: Teaching Models and Environmentsmentioning

confidence: 99%

TRIAGE : Management of the trauma patient

Lampi¹

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Triage, derived from the French word for sorting, aims to assess and prioritize injured patients, regardless of whether the injuries are sustained from everyday road traffic accident with few injured or a mass casualty incident. Triage seeks to provide the greatest benefit to the largest number of casualties in order to minimize morbidity and mortality. Triage in a pre-hospital setting entails management and sorting of patients according to an assessment of medical need, prioritization, and evacuation. In-hospital triage aims to rapidly identify the most injured and ensure timely and appropriate treatment according to the patient's clinical urgency. A number of different systems for performing triage have been established and implemented globally. The methodology is recognized and utilized but there is still a need for an evidence-based strategy to optimize training and the efficacy of the different systems.The main aim of this thesis was to determine triage performance among prehospital personnel and investigate the potential advantage of a triage system for trauma patients. The papers included in this thesis evaluated the triage skills of physicians, pre-hospital personnel, and rescue services personnel by testing their performance before and after an educational intervention. The last paper evaluated potential benefits of using a triage system for trauma patients admitted to the emergency department at MOI Teaching and Referral Hospital in Eldoret, Kenya.The results presented in this thesis illustrate that triage skills are lacking among physicians. Experienced pre-hospital personnel are more skilled in performing triage than physicians. The triage skills of the rescue services personnel improved significantly after the educational intervention. Moreover, the potential benefit to trauma patients of implementing an in-hospital triage system in a resource-poor environment was shown. In conclusion, health care personnel, especially physicians without experience but highly involved in trauma patient management, seem to be in need of triage training. How to train, how to implement, and how to evaluate triage skills must be considered in order to develop effective training. POPULÄRVETENSKAPLIG SAMMANFATTNINGOrdet triage kommer från franskans "sortera" och är ett av det första stegen i omhändertagandet av skadade när det råder resursbrist. Från 1800-talets blodiga slagfält, till dagens skadeplats och akutmottagningar har sättet att triagera patienter utvecklats. Men då, som nu, är grundtanken den samma, att sortera och prioritera de skadade utifrån tillgängliga resurser och patienternas vårdbehov. Följaktligen har begreppet kommit att bli centralt inom ämnet katastrofmedicin. Att avlida till följd av skador i samband med allvarliga händelser men också skador i till exempel vardagstrafiken är ett globalt hälsoproblem. Tiden från olycka till sjukhusbehandling är en viktig och ofta avgörande överlevnadsfaktor för en patient. I det här sammanhanget talas det om "den gyllene timmen", som påvisar vikten av att få ...

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Mobile in Situ Simulation as a Tool for Evaluation and Improvement of Trauma Treatment in the Emergency Department

Cited by 34 publications

References 23 publications

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

Realism in paediatric emergency simulations: A prospective comparison of in situ, low fidelity and centre‐based, high fidelity scenarios

Mobile emergency simulation training for rural health providers

TRIAGE : Management of the trauma patient

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