Li Ka Shing Knowledge Institute of St, Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.
BMC Med. 2011 Mar 28;9:29. doi: 10.1186/1741-7015-9-29.
Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown.
A single-arm intervention study tested the association between simulated team practice and measures of interprofessional collaboration, nurse-physician relationships, and attitudes toward health care teams. Participants were 154 post-licensure nurses, allied health professionals, and physicians. Self- and proxy-report survey measurements were taken before simulation training and two and six weeks after.
Multilevel modeling revealed little change over the study period. Variation in interprofessional collaboration and attitudes was largely attributable to between-person characteristics. A constructed categorical variable indexing 'leadership capacity' found that participants with highest and lowest values were more likely to endorse shared team leadership over physician centrality.
Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care.
健康职业教育计划使用模拟来教授和维持临床程序技能。模拟学习活动也成为了跨专业教育的有用教学方法。跨专业培训的模拟环境允许参与者探索改善临床护理沟通方面的协作方式。模拟已经在医疗保健专业内部和之间显示出了沟通的改善,但团队合作模拟对他人跨专业实践的看法以及对团队合作的态度的影响在很大程度上是未知的。
一项单臂干预研究测试了模拟团队实践与跨专业协作、护士与医生关系以及对医疗团队态度的衡量标准之间的关联。参与者是 154 名持照后的护士、辅助医疗专业人员和医生。在模拟培训之前和两周后和六周后进行自我和代理报告调查测量。
多层次建模显示研究期间变化很小。跨专业协作和态度的变化主要归因于个体间的特征。一个指示“领导能力”的构造分类变量发现,具有最高和最低值的参与者更有可能支持共享的团队领导而不是医生的中心地位。
这项研究的结果表明,将跨专业模拟教育重点放在共享领导上可能为改善跨专业护理提供最大的影响力。