以模擬人實例演練急重症病況之教學成效探討

Effects of Education on Emergent and Critical Case-Oriented Simulation Practice

黃國巡(Go-Shine Huang) ； 黃湃翔(Pai-Hsiang Huang) ； 鄭宸寰(Chen-Hwan Cherng) ； 姜椿泰(Chun-Tai Jiang) ； 謝正源(Jane-Yane Shieh) ； 潘照文(Chao-Wen Pan) ； 黃楸萍(Cho-Pin Huang) ； 林作舟(Tso-Chou Lin) ； 廖文進(Wen-Jinn Liaw)

《重症醫學雜誌》 9卷4期 (2008/12) Pp. 228-241

https://doi.org/10.30035/TCCM.200812.0002

摘要

模擬人(SimMan)模擬病人的眞實病況，以避免以眞人實習的道德爭議，降低罹病率及醫療疏失。模擬人有主述病況及呈現心跳、血壓、脈搏、血氧飽和度、心電圖等功能。
本研究以問卷評估108位實習醫學生對於接受模擬人教學及演練之成效。其進行步驟包括：1.麻醉部及外科加護中心的標準訓練課程及臨床實做；2.遇到急重症病況的臨床觀摩、與上級醫師的討論及求證於書上的資料；3.以影片播放模擬人演練的範例，並說明影片中急救過程的優缺點；4.讓學生至模擬人身邊並爲其講解模擬人具備之功能及如何操作；5.演練前告知實習醫學生測驗內容，即當月所過之實際重症案例，並要求其事先進行小組間討論；6.運用模擬人以重現實際案例之急重症病況，並演練其處置，及全程錄影；7.演練後立即給予簡短講解及回饋；8.播放本次演練錄影之影片，並說明急救演練過程之優缺點。
研究結果顯示，整體而言，本訓練課程受到醫學生正面肯定，整體滿意度達95.4%。其中以提升自信心和提升知識學習成效最受肯定，且領導者比非領導者持較正向的看法。此外，大多數醫學生認爲理想訓練次數必須大於一次，顯示模擬人的訓練很有趣且有效，學生需要更多的訓練次數。但是此項訓練會受限於人力、場景及硬體等相關設備之不足。總括而言，善用模擬人教學可以有效提升實習醫學生（特別是領導者）之自信心與知識學習成效，得到良好的教學目地。

關鍵字

模擬人 ； 急重症 ； 教學 ； 醫學生

並列摘要

SimMan can simulate real patient's condition to avoid morality conflict, reduce morbidity and medical negligence. SimMan has functions of chief complain, heart rate, blood pressure, pulse, oxygen saturation and so on. The aim of our study was to evaluate the education effects of SimMan simulation practice on 108 medical students.
The following procedures done by or for the students were included: 1. to do standard clinical practice in clinical anesthesia and surgical intensive care unit; 2. to inspect and learn from clinical emergent and critical ill patients, discuss with the superior doctors, and refer to textbooks; 3. to watch a video of simulation practice made previously, and then illustrate the weak or strong points; 4. to realize the function of and know how to practice the SimMan; 5. to be informed with the same emergent and critical conditions they met previously in clinic were included in the simulation practice before the test; 6. to do simulation practice with video recorded simultaneously; 7. to receive briefing immediately after the practice; 8. to watch the recorded video and illustrate the weak and strong points.
Our results reveal that most of the medical students were satisfied (95.4%) with the SimMan practice, especially in promoting self-confident and knowledge learning. In addition, the leaders showed more positive response in this simulation practice. Furthermore, most of them regard that they need more practice than one time. That is, simulation practice is interesting and effective. Nevertheless, this attempt will be impeded by inadequate manpower and facility resources. However, our conclusion demonstrates that provides optimal simulation practice training can promote students' self-confident and knowledge learning, especially the leadership.

並列關鍵字

SimMan ； Emergency and critical condition ； Education ； Medical students