Learning by simulation in prehospital emergency care - an integrative literature review
Sammanfattning
Background: Acquiring knowledge and experience on high-energy trauma is often difficult due to
infrequent exposure. This creates a need for training which is specifically tailored for complex
prehospital conditions. Simulation provides an opportunity for ambulance nurses to focus on the
actual problems in clinical practice and to develop knowledge regarding trauma care. The aim of this
study was to describe what ambulance nurses and paramedics in prehospital emergency care
perceive as important for learning when participating in simulation exercises.
Methods: An integrative literature review was carried out. Criteria for inclusion were primary
qualitative and quantitative studies, where research participants were ambulance nurses or
paramedics, working within prehospital care settings, and where the research interventions involved
simulation.
Results: It was perceived important for the ambulance nurses' learning that scenarios were advanced
and possible to simulate repeatedly. The repetitions contributed to increase the level of experience,
which in turn improved the patients care. Moreover, realism in the simulation and being able to
interact and communicate with the patient were perceived as important aspects, as was debriefing,
which enabled the enhancement of knowledge and skills. The result is presented in the following
categories: To gain experience, To gain practice and To be strengthened by others.
Conclusion: Learning through simulation does not require years of exposure to accident scenes. The
simulated learning is enhanced by realistic, stressful scenarios where ambulance nurses interact
with the patients. In this study, being able to communicate with the patient was highlighted as a
positive contribution to learning. However, this has seldom been mentioned in a previous research
on simulation. Debriefing is important for learning as it enables scrutiny of one's actions and thereby
the possibility to improve and adjust one's caring. The effect of simulation exercises is important on
patient outcome. Published by arrangement with John Wiley & Sons.