University of Hawaii, Department of Surgery, Honolulu, Hawaii 96813, USA.
J Surg Educ. 2011 Nov-Dec;68(6):472-7. doi: 10.1016/j.jsurg.2011.05.009. Epub 2011 Aug 3.
Evaluate the impact of a team training curriculum for residents and multidisciplinary trauma team members on team communication, coordination and clinical efficacy of trauma resuscitation.
Prospective, cohort intervention comparing pre- vs. post-training performance. The intervention was a human patient simulator (HPS)-based, in situ team training curriculum, comprising a one-hour web based didactic followed by HPS training in the emergency department (ED). Teams were trained in multidisciplinary groups of 5-8 persons. Each HPS session included three fifteen minute scenarios with immediate video-enabled debriefing. Structured debriefing and teamwork assessment was performed with a modified NOTECHS scale for trauma (T-NOTECHS). Teams were assessed for performance changes during HPS-based training, as well as in actual trauma resuscitations.
The Queen's Trauma Center (Level II); the primary teaching hospital for the University of Hawaii Surgical Residency.
137 multidisciplinary trauma team members, including residents (n = 24), ED and trauma attending physicians, nurses, respiratory therapists, and ED technicians.
During HPS-based training sessions, significant improvements in teamwork ratings, and in clinical task speed and completion rates were noted between the first and the last scenario.244 real-life blunt trauma resuscitations were observed for six months before and after training. There was a significant improvement in mean teamwork scores from the pre-to post-training resuscitations. Moreover, there were significant improvements in the objective parameters of speed and completeness of resuscitation. This was manifest by a 76% increase in the frequency of near-perfect task completion (≤ 1 unreported task), and a reduction in the mean overall ED resuscitation time by 16%.
A relatively brief (four-hour) HPS-based curriculum can improve the teamwork and clinical performance of multidisciplinary trauma teams that include surgical residents. This improvement was evidenced both in simulated and actual trauma settings, and across teams of varying composition. HPS-based trauma teamwork training appears to be an educational method that can impact patient care.
评估针对住院医师和多学科创伤团队成员的团队培训课程对团队沟通、协调以及创伤复苏临床效果的影响。
前瞻性队列干预比较培训前后的表现。干预措施是基于人体模拟患者（HPS）的现场团队培训课程，包括一个小时的基于网络的理论教学，随后在急诊部（ED）进行 HPS 培训。团队由 5-8 名多学科成员组成。每次 HPS 课程包括三个 15 分钟的场景，并立即进行视频启用的讨论。使用改良的创伤 NOTECHS 量表（T-NOTECHS）进行结构化讨论和团队协作评估。评估团队在 HPS 培训期间以及实际创伤复苏中的表现变化。
皇后创伤中心（二级）；夏威夷大学外科学术住院医师培训的主要教学医院。
包括住院医师（n = 24）在内的 137 名多学科创伤团队成员，ED 和创伤主治医生、护士、呼吸治疗师和 ED 技师。
在 HPS 培训期间，与第一场景相比，最后一个场景中团队协作评分以及临床任务速度和完成率显著提高。在培训前后的六个月内观察到 244 例真实的钝器创伤复苏。从培训前到培训后的复苏中，团队协作评分有显著提高。此外，在复苏的速度和完整性的客观参数方面也有显著改善。具体表现为近乎完美任务完成（≤ 1 项未报告任务）的频率增加了 76%，总体 ED 复苏时间平均减少了 16%。
一个相对较短的（四小时）基于 HPS 的课程可以提高包括外科住院医师在内的多学科创伤团队的团队协作和临床表现。这一改进在模拟和实际创伤环境中以及不同组成的团队中都得到了证实。基于 HPS 的创伤团队协作培训似乎是一种可以影响患者护理的教育方法。
