National implementation of in situ simulation training in Helicopter Emergency Medical Services: A multicenter study (original) (raw)
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In situ simulation training in helicopter emergency medical services: feasible for on-call crews?
Advances in Simulation, 2020
Simulation-based training of emergency teams offers a safe learning environment in which training in the management of the critically ill patient can be planned and practiced without harming the patient. We developed a concept for in situ simulation that can be carried out during on-call time. The aim of this study is to investigate the feasibility of introducing in situ, simulation-based training for the on-call team on a busy helicopter emergency medical service (HEMS) base. We carried out a one-year prospective study on simulation training during active duty at a busy Norwegian HEMS base, which has two helicopter crews on call 24/7. Training was conducted as low fidelity in situ simulation while the teams were on call. The training took place on or near the HEMS base. Eight scenarios were developed with learning objectives related to the mission profile of the base which includes primary missions for both medical and trauma patients of all ages, and interhospital transport of adults, children, and neonates. All scenarios included learning objectives for non-technical skills. A total of 44 simulations were carried out. Total median (quartiles) time consumption for on-call HEMS crew was 65 (59-73) min. Time for preparation of scenarios was 10 (5-11) min, time for simulations was 20 (19-26) min, cleaning up 7 (6-10) min, and debrief 35 (30-40) min. For all items on the questionnaire, the majority of respondents replied with the two most positive categories on the Likert scale. Our results demonstrate that in situ simulation training for on-call crews on a busy HEMS base is feasible with judicious investment of time and money. The participants were very positive about their experience and the impact of this type of training.
BMC Medical Education, 2006
Background: This study assessed the feasibility, self-efficacy and cost of providing a high fidelity medical simulation experience in the difficult environment of an air ambulance helicopter. Methods: Seven of 12 EM residents in their first postgraduate year participated in an EMS flight simulation as the flight physician. The simulation used the Laerdal SimMan™ to present a cardiac and a trauma case in an EMS helicopter while running at flight idle. Before and after the simulation, subjects completed visual analog scales and a semi-structured interview to measure their self-efficacy, i.e. comfort with their ability to treat patients in the helicopter, and recognition of obstacles to care in the helicopter environment. After all 12 residents had completed their first non-simulated flight as the flight physician; they were surveyed about self-assessed comfort and perceived value of the simulation. Continuous data were compared between pre-and post-simulation using a paired samples t-test, and between residents participating in the simulation and those who did not using an independent samples t-test. Categorical data were compared using Fisher's exact test. Cost data for the simulation experience were estimated by the investigators. Results: The simulations functioned correctly 5 out of 7 times; suggesting some refinement is necessary. Cost data indicated a monetary cost of $440 and a time cost of 22 hours of skilled instructor time. The simulation and nonsimulation groups were similar in their demographics and pre-hospital experiences. The simulation did not improve residents' self-assessed comfort prior to their first flight (p > 0.234), but did improve understanding of the obstacles to patient care in the helicopter (p = 0.029). Every resident undertaking the simulation agreed it was educational and it should be included in their training. Qualitative data suggested residents would benefit from high fidelity simulation in other environments, including ground transport and for running codes in hospital. Conclusion: It is feasible to provide a high fidelity medical simulation experience in the difficult environment of the air ambulance helicopter, although further experience is necessary to eliminate practical problems. Simulation improves recognition of the challenges present and provides an important opportunity for training in challenging environments. However, use of simulation technology is expensive both in terms of monetary outlay and of personnel involvement. The benefits of this technology must be weighed against the cost for each institution.
Advances in Simulation
Introduction Facilitators play an essential role in simulation-based training on helicopter emergency medical services (HEMS) bases. There is scant literature about the barriers to the implementation of simulation training in HEMS. The purpose of this explorative interview study was to identify factors that the local facilitators anticipated would challenge the smooth implementation of the program, and their strategies to overcome these before the national implementation of in situ simulation-based training locally, and subsequently, one year after the programme was initiated, to identify the actual challenges they had indeed experienced, and their solutions to overcome these. Methods A qualitative study with semi-structured group interviews of facilitators was undertaken before and after one year of simulation-based training on all HEMS bases and one Search and Rescue base. Systematic text condensation was used to extract facilitators’ expectations and experiences. Results Facilita...
ASM Science Journal
Medical emergency on board is a new phenomenon that lack of attention. Despite the presence of cabin crew who is certified to provide medical care to the passenger, failure to acquire the non-technical skills and low level of knowledge and technical skills retention is reported to be major challenges in developing a highly competent cabin crew in providing effective medical care. Having the ability to design simulations, implement it into teaching, and effectively evaluate simulated performance is starting to become a key role for educators in health care. For most educators, a practical knowledge and skills gap resides between the need for simulation learning and proficiencies in designing and utilising simulation. The purpose of this model was to develop a 'trained educators' from the aviation industry with the knowledge and skills to utilise simulation effectively. The steps involve identification, development, and integration with a follow-up assessment. The implementation of the program yielded a significant improvement on the participants' knowledge, t (129) =-6.27, p < .001 together with a total DASH-SV score of 6.32. The barriers, including difficulties encountered executing the model, are discussed combined with the implication for future application. This model is an effective approach for developing a trained educator in first aid for aviation incorporated with simulation learning. The trained educator will then become a pioneer and train another organisation.
How Modeling and Simulation Can Support MEDEVAC Training
Proceedings of the First …, 2002
Airborne medical evacuation (MEDEVAC) is vital for maintaining a safe lifeline for military personnel in tactical operations. Medical evacuation must be reliable and efficient, independent of the threat level of the operation. Not only must the medical personnel be proficient in trauma surgery, they also must be able to work as a team in the confined environment of a helicopter. The various stages of MEDEVAC training reviewed in this paper, from individual skill training to full-scale, applied tactical training, lend themselves to a variety of simulation tools and devices. Promising modeling and simulation methods and tools for training individuals, teams, and taskforces are identified. Finally, we discuss how present and future means of modeling and simulation can support and enable MEDEVAC training to meet today's changing and challenging missions.
A 'mixed reality' simulator concept for future Medical Emergency Response Team training
Journal of the Royal Army Medical Corps, 2017
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other plat...
Effect of Simulation on the Clinical Competence of Swedish Ambulance Nurses
Simulation has become an established method for education and training of Emergency Medical Services personnel in different skills such as advanced airway techniques, also in evaluation and initial care of stroke patients and in pre-hospital trauma. Simulation can be a useful method to improve learning. To our knowledge, there are only a few studies that relate simulation to the effect on clinical skills. The aim of the present study was to investigate the effect of simulation on the clinical competence in a pre-hospital trauma care course for ambulance nurses.
International Journal of Paramedicine
Objectives: This systematic review (SR) describes how simulation-based training (SBT) is utilized by paramedics and emergency medical technicians (EMTs). Data sources: PubMed, CINAHL, Cochrane CENTRAL, Scopus, Web of Science, and Google Scholar were searched from 2010 to 2021. Review methods: Standard SR methodology was utilized according to PRISMA guidelines. Eligibility criteria included English studies conducted in the United States or Canada published and published between 2010 and 2021. Study designs were somewhat heterogeneous and included quantitative, qualitative, and mixed-methods projects. The specific populations included paramedics and EMTs. Results: 595 articles were initially identified and reviewed, 25 of which met our inclusion criteria. Of them, the most common SBT areas of focus documented in the literature was general assessment and treatment (7 studies) and airway management (7 studies). The majority of the studies were conducted in a mobile simulation lab (6 s...