An Integrated Review of Simulation Use in Aeromedical Evacuation Training

The Royal Flying Doctor Service Initiation of Helicopter Video Simulation Orientation Training for Air Medical Crews in Western Australia: A Pilot Study

OBJECTIVE

In May 2022, the Royal Flying Doctor Service Western Operations in Western Australia pioneered the introduction of the first organizational helicopter emergency service with 2 Eurocopter EC145 helicopters. This article describes the pilot study undertaken, assessing the implementation and flight crew confidence outcomes of the supplementation of video simulation training to standard clinical training for helicopter air medical retrieval.

METHODS

Survey assessments using a 5-point Likert scale provided anonymous demographic data with summarized results of the means and standard deviations. Nonparametric tests were used to compare responses between the control and experimental groups from pretraining to postintervention to postpractical.

RESULTS

The findings showed an increase in confidence rates after a classroom session and further increases after a practical session in the control group. The intervention group showed a small rise in overall confidence levels after being shown video simulations following the completion of their classroom session before commencing their practical session. This study established that regardless of the airframe, clinical staff, often with significant experience in air medical retrieval and critical care medicine, do not automatically have confidence in performing critical care procedures in a new aircraft type to which they have not previously been oriented. The results display a statistically significant increase in confidence levels in procedural performance after the classroom session compared with the pretraining questionnaire, with a subtle further rise when video simulations are included in the classroom session. When a classroom session is subsequently supplemented with a practical simulation session, confidence levels continue to rise.

CONCLUSION

Implementing a comprehensive educational strategy including classroom and practical elements for clinical staff in their orientation to new aircraft improves their confidence in performing critical care procedures if required in flight. The addition of in-flight prerecorded videos demonstrating these critical care procedures is a useful adjunct to simulation training for flight crew in air medical retrieval, and further analytical studies may indeed show a statistically significant improvement in staff confidence.

The effect of breast self-examination training on nursing students by using hybrid-based simulation on knowledge, skills, and ability to correctly evaluate pathological findings: Randomized Controlled Study

AIM

To investigate the effectiveness of hybrid simulation-based training and classical-based training with the Miller pyramids' ability to evaluate students' knowledge, skills and pathologies in breast self-examination.

BACKGROUND

Breast cancer incidence is becoming more common among women in developed and developing countries. Nurses should be capable of evaluating breast self-examination knowledge, abilities and pathologies.

METHOD

A randomized full experimental design was used. Two groups were formed: a hybrid simulation-based training group (n = 36) and a classical-based training group (n = 36)-students in the hybrid simulation-based group trained on a standardized patient with a wearable breast attachment. The classical-based training group received training on the breast model. The laboratory performance of the students was evaluated one week after the training. Their performance on the standardized patient was evaluated against the checklist in the clinical setting one week after the laboratory. Before and after the training, each student's knowledge of basic and Application steps was evaluated. Students completed the self-description form regarding the clinical process after the clinical performance. All participants received 60 min of theoretical and 60 min of demonstration training. While the students in the hybrid simulation-based training group completed the 55-minute simulation training, the students in the Classic-based training group practised on the desktop breast model for 10 min. The hybrid simulation-based training group received 175 min of total training time, whereas the classical-based training group received 130 min.

RESULTS

Compared with classical-based training, teaching BSE with hybrid simulation-based training raised students' total knowledge score, application step score, skill score and pathological evaluation score (p < 0.05). Students who trained using hybrid simulation-based training experienced low levels of anxiety but increased levels of excitement and motivation (p < 0.05). The education and counselling scores of students who received hybrid simulation -based simulation training were higher than those who received classical-based training (p < 0.05). There was no statistically significant difference between the groups' BSE mean pre-test basic knowledge scores (p = 0.186). BSE mean application steps knowledge scores difference (pre-test-post-test) of the groups was found to be statistically significant (p < 0.001) CONCLUSION: The ability to accurately evaluate breast self-examination on knowledge, skills and pathological findings of students in the hybrid simulation-based training group was higher than in the classical-based training group. Besides, the students' perceived communication, education and counselling efficiency in the hybrid simulation-based training group were higher compared with the classical-based training group.

Gap Analysis to Identify Clinical Education Needs of Aeromedical Evacuation Clinicians

BACKGROUND

The Air Force has unique challenges in ensuring clinical proficiency for en route care clinicians. These challenges pertain to existing care environments, training opportunities, and the spectrum of training needed to care for patients with polytrauma and complicated medical conditions while being transported between medical treatment facilities.

OBJECTIVE

The purpose of this study was to identify the clinical education needs of students entering the United States Air Force School of Aerospace Medicine Flight Nurse (FN) or Aeromedical Evacuation Technician (AET) course and Air Force FNs and AETs assigned to active duty aeromedical evacuation units.

METHOD

We recruited 198 students enrolled in the FN or AET course and 103 active duty FN and AET aircrew members and conducted a gap analysis to identify the clinical education needs of Air Force FNs and AETs.

RESULTS

Training gaps were identified for active duty Air Force, Air Force Reserve, and Air National Guard FNs and AETs. The greatest learning needs included use of the portable therapeutic liquid oxygen unit, manual resuscitators, and negative pressure wound therapy systems, and care of special populations such as patients with a burn injury or mental health disorder.

CONCLUSIONS

Results of the gap analysis can be used to select and develop educational and simulation training scenarios designed to foster clinical competence.

An Evaluation of Education Methods Used to Train United States Air Force Air Medical Evacuation Crewmembers on Aircraft Systems

OBJECTIVE

United States Air Force air medical evacuation crewmembers (AECMs) are responsible for the safe air medical evacuation of casualties in dynamic environments and must be highly proficient in the C-17, C-130H/J, and KC-135R/T aircraft. Current methods to train AECMs on their aircraft proficiency include computer-based simulation training (CBT) or instructor-based training (IBT) on an actual aircraft. This study compares the aircraft proficiency scores between AECMs who were trained via CBT and IBT methods.

METHODS

An experimental prospective design was chosen, introducing the independent variable of CBT to the dependent variable of AECM aircraft system proficiency. Proficiency evaluation scores of the control group (n = 10) trained via IBT were compared against the scores of the intervention group (n = 10).

RESULTS

A Mann-Whitney U test was conducted using a significance level of α = .05 and a confidence interval of 95%. The test revealed an exact significance 2-tailed P = .045 ≤ .05. AECMs trained via IBT had statistically higher aircraft proficiency evaluation scores than AECMs trained via CBT.

CONCLUSION

These findings show that using IBT and a real aircraft to train AECMs is a superior training method versus CBT.

Advancing renal education: hybrid simulation, using simulated patients to enhance realism in haemodialysis education

BACKGROUND

Simulation is a well-established and proven teaching method, yet its use in renal education is not widely reported. Criticisms of simulation-based teaching include limited realism and a lack of authentic patient interaction.

METHOD

This paper discusses the benefits and challenges of high-fidelity simulation and suggests hybrid simulation as a complementary model to existing simulation programmes.

CONCLUSION

Through the use of a simulated patient, hybrid simulation can improve the authenticity of renal simulation-based education while simultaneously teaching and assessing technologically enframed caring.