Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Massachusetts General Physicians Organization, Boston, MA, USA.
Simul Healthc. 2011 Aug;6(4):231-8. doi: 10.1097/SIH.0b013e31821da9ec.
We developed a training program to introduce managers and informal leaders of healthcare organizations to key concepts of teamwork, safety leadership, and simulation to motivate them to act as leaders to improve safety within their sphere of influence. This report describes the simulation scenario and debriefing that are core elements of that program. Twelve teams of clinician and nonclinician managers were selected from a larger set of volunteers to participate in a 1-day, multielement training program. Two simulation exercises were developed: one for teams of nonclinicians and the other for clinicians or mixed groups. The scenarios represented two different clinical situations, each designed to engage participants in discussions of their safety leadership and teamwork issues immediately after the experience. In the scenarios for nonclinicians, participants conducted an anesthetic induction and then managed an ethical situation. The scenario for clinicians simulated a consulting visit to an emergency room that evolved into a problem-solving challenge. Participants in this scenario had a limited time to prepare advice for hospital leadership on how to improve observed safety and cultural deficiencies. Debriefings after both types of scenarios were conducted using principles of "debriefing with good judgment." We assessed the relevance and impact of the program by analyzing participant reactions to the simulation through transcript data and facilitator observations as well as a postcourse questionnaire. The teams generally reported positive perceptions of the relevance and quality of the simulation with varying types and degrees of impact on their leadership and teamwork behaviors. These kinds of clinical simulation exercises can be used to teach healthcare leaders and managers safety leadership and teamwork skills and behaviors.
我们开发了一项培训计划，旨在向医疗保健组织的管理人员和非正式领导者介绍团队合作、安全领导力和模拟的关键概念，以激励他们在自己的影响范围内充当领导者，以提高安全性。本报告介绍了该计划的核心要素，即模拟场景和汇报。从更大的志愿者群体中选择了 12 个临床医生和非临床医生管理人员团队，参加为期 1 天的多要素培训计划。开发了两个模拟练习：一个用于非临床医生团队，另一个用于临床医生或混合团队。这些场景代表了两种不同的临床情况，每个场景都旨在让参与者在体验后立即就安全领导力和团队合作问题展开讨论。在非临床医生的场景中，参与者进行了麻醉诱导，然后处理了一个伦理问题。针对临床医生的场景模拟了一次到急诊室的咨询访问，随后演变成了一个解决问题的挑战。在这种情况下，参与者只有有限的时间为医院领导准备关于如何改进观察到的安全和文化缺陷的建议。使用“有判断力的汇报”原则对这两种类型的场景进行了汇报。我们通过分析参与者对模拟的反应，包括转录数据和主持人的观察，以及课程结束后的问卷调查，来评估该计划的相关性和影响力。团队普遍对模拟的相关性和质量有积极的评价，对他们的领导力和团队合作行为有不同类型和程度的影响。这些类型的临床模拟练习可以用于教授医疗保健领导者和管理人员安全领导力和团队合作技能和行为。
