Division of Urology, St. Michael's Hospital, Toronto, Ontario, Canada.
J Urol. 2012 Apr;187(4):1385-91. doi: 10.1016/j.juro.2011.11.106. Epub 2012 Feb 16.
Simulation based team training provides an opportunity to develop interdisciplinary communication skills and address potential medical errors in a high fidelity, low stakes environment. We evaluated the implementation of a novel simulation based team training scenario and assessed the technical and nontechnical performance of urology and anesthesiology residents.
Urology residents were randomly paired with anesthesiology residents to participate in a simulation based team training scenario involving the management of 2 scripted critical events during laparoscopic radical nephrectomy, including the vasovagal response to pneumoperitoneum and renal vein injury during hilar dissection. A novel kidney surgical model and a high fidelity mannequin simulator were used for the simulation. A debriefing session followed each simulation based team training scenario. Assessments of technical and nontechnical performance were made using task specific checklists and global rating scales.
A total of 16 residents participated, of whom 94% rated the simulation based team training scenario as useful for communication skill training. Also, 88% of urology residents believed that the kidney surgical model was useful for technical skill training. Urology resident training level correlated with technical performance (p=0.004) and blood loss during renal vein injury management (p=0.022) but not with nontechnical performance. Anesthesia resident training level correlated with nontechnical performance (p=0.036). Urology residents consistently rated themselves higher on nontechnical performance than did faculty (p=0.033). Anesthesia residents did not differ in the self-assessment of nontechnical performance compared to faculty assessments.
Residents rated the simulation based team training scenario as useful for interdisciplinary communication skill training. Urology resident training level correlated with technical performance but not with nontechnical performance. Urology residents consistently overestimated their nontechnical performance.
基于模拟的团队培训为发展跨学科沟通技能提供了机会，并在高保真、低风险的环境中解决潜在的医疗错误。我们评估了一种新的基于模拟的团队培训方案的实施情况，并评估了泌尿科和麻醉科住院医师的技术和非技术表现。
泌尿科住院医师与麻醉科住院医师随机配对，参与一项基于模拟的团队培训方案，涉及腹腔镜根治性肾切除术期间 2 个脚本关键事件的管理，包括气腹引起的血管迷走反应和肾门解剖期间肾静脉损伤。使用新型肾脏手术模型和高保真人体模拟器进行模拟。每次模拟团队培训后进行一次汇报。使用特定任务检查表和总体评分量表评估技术和非技术表现。
共有 16 名住院医师参加，其中 94%的人认为基于模拟的团队培训方案对沟通技能培训有用。此外，88%的泌尿科住院医师认为肾脏手术模型对技术技能培训有用。泌尿科住院医师的培训水平与技术表现相关（p=0.004）和肾静脉损伤管理期间的失血量相关（p=0.022），但与非技术表现无关。麻醉科住院医师的培训水平与非技术表现相关（p=0.036）。泌尿科住院医师在非技术表现方面的自评始终高于教员（p=0.033）。麻醉科住院医师在非技术表现方面的自我评估与教员评估没有差异。
住院医师认为基于模拟的团队培训方案对跨学科沟通技能培训有用。泌尿科住院医师的培训水平与技术表现相关，但与非技术表现无关。泌尿科住院医师在非技术表现方面的自评始终高于教员。
