Development And Preliminary Application Of Standardized Wounded Soldier Grading Evaluation Indicator System Of Naval Pre-hospital Care Training

ObjectiveThe research is designed to explore the capability requirements of Standardized Wounded Soldier(SWS)in Naval Pre-hospital Care Training,to develop a grading evaluation indicator system of SWS,and to apply the indicator system in naval forces and naval academy of China,so as to provide a quantifiable reference for training,assessment,and evaluation of SWS,to provide strong support for objectively evaluating the simulation ability of SWS,improving the evaluation system of SWS,and enhancing the effect of naval realistic military training.Methods(1)The literature review and semi-structure interview were used to understand the current status and capability requirements of SWS.A theoretical framework of SWS simulation quality and a preliminary draft of the indicator system were formed based on the IDEA framework,competency theory model and interview results.(2)The SWS grading evaluation indicator system was formed through two-round Delphi expert consultation(divided into two SWS indicator systems: basic-level and professional-level);The analytic hierarchy process was used to determine the weights of the first-and second-level indicators,and the weights of the third-level indicators were determined by the expert consultation method through the third round.(3)The SWS grading evaluation related tools were developed according to the preliminary established indicator system,and determined by the expert meeting.(4)30 soldiers of 15 naval forces were trained to be basic-level SWS and 6 students in a naval college were trained to be professional-level SWS.Convenient sampling method was used to select medics,instructors and SWS as evaluators.Based on the relevant tools,the simulation quality of two levels of SWS was evaluated through self-and other-evaluation,to validate the feasibility and effectiveness of the indicator system.Results(1)Three themes were extracted: Lack of evaluation criteria and system training were major problem;Special skills,professional knowledge,comprehensive ability and personal traits were main capability requirements;Self-combined with other-evaluation was an expectant model.(2)The experts' authority coefficient was 0.91,and the overall indicators' coordination coefficient after two rounds was 0.41-0.46(P<0.01).Levels of indicator system were determined by the training goal and medical background: the basic-level including 4 first-,13 second-and 28 third-class indicators was applicable to warriors and commanders without medical foundation;the professional-level including 4 first-,15 second-and 40 third-class indicators was applicable to military medical students and health care workers with medical foundation.Weights of indicators were established,and the consistency ratio of single-and total-sort of two levels were both logically(CR<0.1).(3)The SWS grading evaluation related tools included Case Library(35 cases),SWS knowledge questionnaire and SWS simulation ability questionnaire.(4)The indicator system was transformed into two parts of knowledge questionnaire and SWS simulation ability questionnaire and verified separately.The test-retest reliability and the equivalent-forms reliability of two levels of knowledge questionnaire(A,B volumes)were between 0.666-0.844 and 0.509-0.857;the total Cronbach's ? coefficient was between 0.621-0.634 and 0.715-0.750;the overall difficulty coefficient was between 0.57-0.61 and 0.64-0.68;the discrimination was mostly above 0.4,suggesting the reliability,discrimination and difficulty of the knowledge questionnaire was good.The total Cronbach's ? coefficient of the two levels of SWS simulation ability questionnaire was 0.958 and 0.938;content validity was 0.988 and 0.964;the correlation coefficient between the first-class indicator score and total score ranged from 0.746 to 0.884 of basic-level SWS(P<0.01),from 0.548 to 0.929 of professional-level SWS(P<0.01),suggesting the reliability and validity of questionnaire was good.The evaluators recognized the SWS acted by warriors and students.The general evaluation of the professional-level SWS was superior to the basic-level SWS.ConclusionSWS grading evaluation indicator system for different evaluation objects was developed through literature review,semi-structured interview,expert consultation,expert meetings and statistical analysis.The preliminary application indicated that the reliability and validity of the indicator system was good and feasible,which could be used as an effective evaluation tool for SWS simulation capability evaluation,and provided a plan and basis for reasonably evaluating the simulation quality of SWS and enhancing the effect of the realistic military training simultaneously.This research is conducive to promote the popularization and application of SWS in the field of military medical simulation.