Paediatric Cardiorespiratory Intensive Care Unit, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London SW3 6NP, UK.
Intensive Care Med. 2012 Jan;38(1):99-104. doi: 10.1007/s00134-011-2371-5. Epub 2011 Oct 1.
To evaluate the impact of an embedded simulation-based team training programme on perceived performance and to compare the effect over different phases of the programme.
This was a prospective, single-centre, longitudinal study over the first 2 years of the programme. A total of 219 multidisciplinary health-care professionals participated in simulation sessions, followed by anonymous evaluation questionnaires. The programme was divided into three different phases: introductory (first 6 months), intermediate (second 6 months) and established phase (second year).
A total of 88.7% of participants evaluated the impact on overall practice as effective, 56.5% reported a highly effective impact. A total of 90.9% (391/430) of questions on non-technical skills (communication and teamwork) showed an effective impact, 55.6% a highly effective impact, whereas only 70.2% (262/373) of questions on technical skills showed an effective impact. There was a significant (p < 0.001) increased score for effective impact in all categories between the introductory and intermediate phase, which was maintained throughout the established phase. Overall, 72.7% of the participants felt more confident to attend a future critical event, 32.5% were highly confident. In the longitudinal analysis there was a stepwise significant (p < 0.05) increase of confidence of participants. In a subgroup analysis (n = 143) there was a significant (p < 0.001) higher confidence in participants who had attended at least 3 sessions (90.7 vs. 61%).
There is a 6- to 12-month learning curve in the implementation of an embedded multidisciplinary team training programme. Repeated exposure to simulation is most beneficial to crisis resource management training and single, isolated exposure may not be sufficient.
评估基于嵌入式模拟的团队培训计划对感知绩效的影响，并比较该计划不同阶段的效果。
这是一个前瞻性、单中心、纵向研究，在计划的头 2 年进行。共有 219 名多学科医疗保健专业人员参加了模拟课程，并随后进行了匿名评估问卷。该计划分为三个不同阶段：入门阶段（前 6 个月）、中级阶段（第 6 至 12 个月）和成熟阶段（第 2 年）。
共有 88.7%的参与者评估对整体实践的影响是有效的，56.5%报告影响是高度有效的。共有 90.9%（391/430）的非技术技能（沟通和团队合作）问题显示出有效的影响，55.6%显示出高度有效的影响，而只有 70.2%（262/373）的技术技能问题显示出有效的影响。在入门阶段和中级阶段，所有类别的有效影响评分均显著增加（p<0.001），并且在成熟阶段保持不变。总体而言，72.7%的参与者更有信心参加未来的重大事件，32.5%的参与者非常有信心。在纵向分析中，参与者的信心呈逐步显著增加（p<0.05）。在亚组分析（n=143）中，参加至少 3 次模拟课程的参与者的信心显著增加（p<0.001）。
在实施嵌入式多学科团队培训计划时，存在 6 至 12 个月的学习曲线。重复暴露于模拟对危机资源管理培训最有益，而单次孤立的暴露可能不足。
