预计学习Estimated learning time · 225 分钟min

学完这门课，你能……After this course, you can…

将九项技能连接到 xABCDE 对应风险。Connect nine skills to their xABCDE concerns.
为每项模型演练核对准备、客观效果和失败升级。Check readiness, objective effect and failure escalation in each trainer session.
用 OSCE 行为记录规划下一轮改进。Plan the next improvement using OSCE behavior records.

实习：识别与报告；规培：决策时机与监督下关键步骤；青年主治：团队指挥与资源调度。Intern: recognize/report; resident: decision timing and supervised key steps; early attending: team leadership and resources.

先做 5 题前测Start five-question pretest 学完做 5 题后测Complete five-question posttest 本课口袋卡Course pocket card

课前测 · 5 题Pretest · five questions

每题 1 分；用于形成性反馈。One point per item; formative feedback.

合成情境题Synthetic vignette 1. 32岁男性交通伤模拟患者进入技能考站，HR132次/min、BP86/54 mmHg、SpO₂92%。考生发现大腿伤口仍出血，却完成止血带外观固定后停止操作，未检查远端脉搏与止血效果。下一步最合适的是？A 32-year-old male collision simulation patient enters a skills station; HR 132/min, BP 86/54 mmHg, SpO₂ 92%. The candidate stops after positioning a tourniquet although bleeding continues, without checking control or distal pulse. What is the most appropriate next step?该安全行为记0分并核对关键失败项Score the unsafe behavior 0 and assess the critical-failure rule因已套上器械给该项2分Give 2 because the device has been applied以模型生命体征稳定补偿该项失分Compensate the score because simulated vital signs are stable仅按操作速度加分后通过Pass based on speed points alone

合成情境题Synthetic vignette 2. 32岁女性坠落伤模拟患者接受骨盆带考核，HR96次/min、BP118/72 mmHg、SpO₂97%。考生初次定位偏高，经教师提示后在大转子正确放置并复查皮肤和灌注，本次无关键失败条件。下一步最合适的是？A 32-year-old female fall simulation patient is used for a binder assessment; HR 96/min, BP 118/72 mmHg, SpO₂ 97%. The candidate initially positions too high, then correctly relocates to greater trochanters after prompting and checks skin/perfusion; no critical failure remains in this station. What is the most appropriate next step?该观察域记1分，并按清单单独判断关键失败Score this domain 1 and independently assess critical failure最后位置正确即记2分独立完成Score 2 because final placement is correct把所有经提示的域都一律判整站失败Fail the whole station for any prompting只看总分，不记录教师提示Use total score without documenting prompts

3. 5域均2分，技能总分？Five domains receive two points each. Total?10分Ten每域1分共5分One per domain, total 5每域4分共20分Four per domain, total 20

4. 插管后只有听诊，未用波形EtCO₂，如何判断？Intubation is checked only by auscultation without waveform EtCO2. Rating?属于关键失败项，需要重新确认Critical failure; confirm correctly听诊双侧有声音即可免除关键失败Bilateral sounds remove the critical failure一次SpO₂正常就可按安全通过One normal SpO₂ allows a safe pass

5. BVM与胸腔减压对应哪两个轴？Which axes correspond to BVM and chest decompression?A/B呼吸支持轴A/B respiratory-support axes归入C，只看血压变化Classify both as C and observe BP alone归入E，仅处理环境Classify both as E environment only

青年医师 · 模拟训练 · 证据约束Early clinicians · Simulation · Evidence constrained

创伤九项核心技能地图Nine Core Trauma Skills

不是九个孤立的动作视频，而是九条“识别风险—团队准备—受监督演练—核查效果—动态复评”的能力路线。Not nine isolated procedure videos, but nine competency routes: recognise risk, prepare the team, practise under supervision, verify effect, and reassess.

教师预览版Instructor preview9 skills45 competency stations

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课程状态：Course status: 本页给出指南来源的参考数字与关键步骤，按学员层级使用：实习识别与报告；规培在上级监督下执行；主治指挥与资源调度。所有剂量和阈值；以本院规范为准。Evidence locators are established; learner-facing release is not yet approved. The course is for instructor review and supervised simulation design, not bedside procedural instruction.

三组能力域，九项核心技能Three domains, nine core skills

每项课程均包含学习目标、来源定位、视觉需求、模拟病例与形成性 OSCE 域。Each course includes objectives, source locators, visual needs, a synthetic case, and formative OSCE domains.

教学范围

从课程草案到学生发布From course draft to learner release

01来源核验Source verification版本、章节/专题、适用人群与场景。Version, topic locator, population, and setting.
02临床审核Clinical review创伤方向主任医师逐条决定保留、修改或退回。A trauma chief physician decides retain, revise, or return for each claim.
03本地校准Local calibration器材、岗位、转运和升级路径与本院文件对齐。Align equipment, roles, transfer, and escalation with local documents.
04模拟验证Simulation validation用导师观察表验证可教性与高风险错误。Validate teachability and safety-critical errors using instructor observation.

课后测 · 5 题Posttest · five questions

每题 1 分；用于形成性反馈。One point per item; formative feedback.

合成情境题Synthetic vignette 1. 43岁男性交通伤模拟患者进入技能考站，HR144次/min、BP78/48 mmHg、SpO₂90%。考生发现大腿伤口仍出血，却完成止血带外观固定后停止操作，未检查远端脉搏与止血效果。下一步最合适的是？A 43-year-old male collision simulation patient enters a skills station; HR 144/min, BP 78/48 mmHg, SpO₂ 90%. The candidate stops after positioning a tourniquet although bleeding continues, without checking control or distal pulse. What is the most appropriate next step?因已套上器械给该项2分Give 2 because the device has been applied以模型生命体征稳定补偿该项失分Compensate the score because simulated vital signs are stable仅按操作速度加分后通过Pass based on speed points alone按不安全/未完成给0，并审查否决条件Assign 0 for unsafe/incomplete performance and check the veto rule

合成情境题Synthetic vignette 2. 47岁女性坠落伤模拟患者接受骨盆带考核，HR102次/min、BP112/70 mmHg、SpO₂96%。考生初次定位偏高，经教师提示后在大转子正确放置并复查皮肤和灌注，本次无关键失败条件。下一步最合适的是？A 47-year-old female fall simulation patient is used for a binder assessment; HR 102/min, BP 112/70 mmHg, SpO₂ 96%. The candidate initially positions too high, then correctly relocates to greater trochanters after prompting and checks skin/perfusion; no critical failure remains in this station. What is the most appropriate next step?最后位置正确即记2分独立完成Score 2 because final placement is correct把所有经提示的域都一律判整站失败Fail the whole station for any prompting只看总分，不记录教师提示Use total score without documenting prompts记录提示后完成为1分，再查关键安全条件Record prompted completion as 1 and separately check safety criteria

3. 五个观察域均独立完成，总分应记多少？What is the total for independent completion in all five domains?每域1分共5分One per domain, total 5每域4分共20分Four per domain, total 2010分Ten

4. 插管后未确认持续波形CO₂，是否只影响普通分数？Is omitted sustained waveform CO₂ confirmation only an ordinary scoring deduction?听诊双侧有声音即可免除关键失败Bilateral sounds remove the critical failure一次SpO₂正常就可按安全通过One normal SpO₂ allows a safe pass属于关键失败项，需要重新确认Critical failure; confirm correctly

5. 辅助通气和胸部减压应归入哪个观察轴？Which assessment axes cover assisted ventilation and chest decompression?归入C，只看血压变化Classify both as C and observe BP alone归入E，仅处理环境Classify both as E environment onlyA/B呼吸支持轴A/B respiratory-support axes