Developing an Effective Team-Based Emergency Training Program for Medical Students

Pinter Hartono, Bowo Adiyanto, Rifdhani Fakhrudin Nur, Cornelia Ancilla, Aulia Zuhria Rahma
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Abstract

Introduction: Team-based patient management in critical care demands a knowledgeable, skillful, and responsive doctor who collaborates well on teams. Medical education is responsible for producing competent graduates who meet the above requirements. However, the current medical curriculum in Indonesia tends to focus only on individual knowledge and appraisal. There was no standardized university-based group emergency training and examination with comprehensive emergency topics beyond cardiac and trauma cases. Objective: This study aimed to develop and evaluate a team-based emergency training program that enhances medical students' preparedness and teamwork skills in dealing with future emergencies in the workplace. Materials and Methods: We developed Acute Life Threatening Events Management (ALTEM), a three-day emergency training program consisting of pre-test, lectures, guided skill practice, group (case-based) simulation exam, and post-test. Group simulation occurred in a virtual hospital with high-fidelity mannequins, actual medical equipment (i.e., beds, monitors, drugs, tools, pads), two-way mirror rooms, and simulated patient family to resemble real hospital situations. The program was then evaluated by a modified Kirkpatrick evaluation model, which measures individual perception, satisfaction, understanding, and performance related to the program. Results: A total of 114 participants were involved in this study. Most subjects (>80%) had a good experience with the program. ALTEM training program significantly increased communication and teamwork (p <0.001) and decision-making towards critical patients (p <0.001) in the univariate analysis. Communication and teamwork remained related considerably in the multivariate analysis (aOR 7.866; p = 0.005). Conclusion: The ALTEM simulation program obtained a good response from the subjects and was a prospective program to improve medical students' competence and teamwork skills in emergencies.
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为医科学生制定有效的团队急救培训计划
导言:重症监护中以团队为基础的病人管理要求医生知识渊博、技术精湛、反应敏捷,并能在团队中良好协作。医学教育有责任培养出符合上述要求的合格毕业生。然而,印尼目前的医学课程往往只注重个人知识和评估。除了心脏和外伤病例之外,还没有以大学为基础的、包含综合急诊主题的标准化集体急诊培训和考试。研究目的本研究旨在开发和评估一个以团队为基础的急诊培训项目,以提高医学生在未来工作场所处理紧急情况时的准备能力和团队合作技能。材料与方法:我们开发了急性生命威胁事件管理(ALTEM),这是一个为期三天的急诊培训项目,包括前测、讲座、指导性技能练习、小组(基于病例)模拟考试和后测。小组模拟在虚拟医院内进行,医院内有高仿真人体模型、实际医疗设备(如病床、监护仪、药品、工具、护垫)、双向镜室和模拟病人家庭,以模拟真实的医院情况。然后,通过修改后的柯克帕特里克评估模型对该计划进行评估,该模型可测量与该计划相关的个人感知、满意度、理解力和绩效。结果:共有 114 人参与了这项研究。大多数受试者(>80%)对该项目体验良好。在单变量分析中,ALTEM 培训计划明显提高了沟通和团队合作能力(P <0.001),以及对危重病人的决策能力(P <0.001)。在多变量分析中,沟通和团队合作仍有很大关系(aOR 7.866; p = 0.005)。结论ALTEM模拟项目在受试者中反响良好,是提高医学生在紧急情况下的能力和团队合作技能的前瞻性项目。
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