Cahan Mitchell A, Larkin Anne C, Starr Susan, Wellman Scott, Haley Heather-Lyn, Sullivan Kate, Shah Shimul, Hirsh Michael, Litwin Demetrius, Quirk Mark
Department of Surgery, University of Massachusetts Medical School, Worcester, 01655, USA.
Arch Surg. 2010 Dec;145(12):1151-7. doi: 10.1001/archsurg.2010.252.
Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery.
In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time.
University of Massachusetts Medical School.
A total of 148 third-year medical students in required 12-week surgical clerkship rotations.
Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills.
Empathetic communication skill, teamwork, and patient safety attitudes and self-reported use of time management strategies.
Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P = .007; pilot 2, t = 2.65, P = .01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2.
The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.
在外科实习课程中尽早引入全天的人为因素培训体验,将传授有效的沟通技巧和策略,以使学生从外科职业生涯中获得职业满足感。
在2007年7月1日至2008年12月31日进行的试点1中,50名学生接受了培训,50名学生未接受培训;所有人在轮转结束时都接受了测试,以比较对照组与干预组的表现。在试点2中,共有50名学生接受了培训,并在轮转前后接受了测试,以检查个体随时间的变化。
马萨诸塞大学医学院。
总共148名三年级医学生参加为期12周的外科实习轮转。
由外科医生和教育工作者共同授课,进行全天的培训,包括讲座和小组练习,重点是共情沟通、时间管理和团队合作技能。
共情沟通技巧、团队合作、患者安全态度以及自我报告的时间管理策略的使用情况。
在试点1中,接受培训组与未接受培训组的共情得分没有更高,但在试点2中,在5分制量表上从2.32提高到了3.45(P <.001)。在团队沟通培训后,学生也更有可能询问护士的观点并就行动计划寻求共识(试点1,f = 7.52,P =.007;试点2,t = 2.65,P =.01)。工作与生活平衡方面的结果喜忧参半,在试点1中,一些接受培训的组得分明显低于未接受培训的组,在试点2中没有显示出显著改善。
学生与患者沟通得分的显著提高表明,简短的重点介绍后进行困难患者遭遇场景的模拟可能会成功。视频演示可以改善跨学科团队合作。