Southern Health Simulation Centre, Monash Medical Centre Moorabbin Campus, Centre Road, East Bentleigh, Melbourne, Australia.
BMC Med Educ. 2012 Jun 7;12:38. doi: 10.1186/1472-6920-12-38.
Effective communication between clinicians is essential for safe, efficient healthcare. We undertook a study to determine the longer-term effectiveness of an education session employing a structured method to teach referral-making skills to medical students.
All final year medical students received a forty-five minute education intervention consisting: discussion of effective telephone referrals; video viewing and critique; explanation, demonstration and practice using ISBAR; provision of a memory aid for use in their clinical work. Audio recordings were taken during a subsequent standardised simulation scenario and blindly assessed using a validated scoring system. Recordings were taken immediately before (control), several hours after (intervention), and at approximately six months after the education. Retention of the acronym and self-reports of transfer to the clinical environment were measured with a questionnaire at eight months.
Referral clarity at six months was significantly improved from pre-intervention, and referral content showed a trend towards improvement. Both measures were lower than the immediate post-education test. The ISBAR acronym was remembered by 59.4% (n = 95/160) and used by the vast majority of the respondents who had made a clinical telephone referral (n = 135/143; 94.4%).
A brief education session improved telephone communication in a simulated environment above baseline for over six months, achieved functional retention of the acronym over a seven to eight month period and resulted in self reports of transfer of the learning into practice.
临床医生之间的有效沟通对于安全、高效的医疗保健至关重要。我们进行了一项研究，以确定采用结构化方法教授医学生转诊技能的教育课程的长期效果。
所有的医学生在学习结束时都会接受 45 分钟的教育干预，包括：讨论有效的电话转诊；观看和点评视频；解释、演示和练习 ISBAR；提供一个记忆辅助工具，用于他们的临床工作。在随后的标准化模拟场景中进行音频录制，并使用经过验证的评分系统进行盲法评估。录制在教育前（对照）、几个小时后（干预）和大约六个月后进行。在八个月时，通过问卷测量对首字母缩略词的记忆和向临床环境的转移的自我报告。
六个月时的转诊清晰度明显优于干预前，转诊内容也显示出改善的趋势。这两个指标都低于教育后的即时测试。有 59.4%（n = 95/160）的人记住了 ISBAR 首字母缩略词，并且绝大多数进行过临床电话转诊的受访者（n = 135/143；94.4%）都使用了它。
简短的教育课程在六个月以上的时间里提高了模拟环境中的电话沟通，在七个到八个月的时间里实现了对首字母缩略词的功能保留，并报告了将学习成果转移到实践中的情况。
