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团队沟通中的跨专业教育:携手合作以提高患者安全。

Interprofessional education in team communication: working together to improve patient safety.

作者信息

Brock Douglas, Abu-Rish Erin, Chiu Chia-Ru, Hammer Dana, Wilson Sharon, Vorvick Linda, Blondon Katherine, Schaad Douglas, Liner Debra, Zierler Brenda

机构信息

Department of Family Medicine and MEDEX Northwest, University of Washington, Seattle, WA 98195, USA.

出版信息

BMJ Qual Saf. 2013 May;22(5):414-23. doi: 10.1136/bmjqs-2012-000952. Epub 2013 Jan 3.

Abstract

BACKGROUND

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication.

METHODS

Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours.

RESULTS

One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001).

CONCLUSIONS

Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

摘要

背景

医疗团队中的沟通失误与医疗差错及不良健康后果相关。这些发现使得人们更加重视培训未来的卫生专业人员,使其能够在团队中高效协作。团队策略与工具以提升绩效和患者安全(TeamSTEPPS)沟通培训模式被广泛用于培训医疗团队,但较少用于培训学生跨专业团队。本研究报告了基于模拟的跨专业TeamSTEPPS培训在影响学生对跨专业沟通的态度、知识和技能方面的有效性。

方法

306名医学四年级、护理三年级、药学二年级和医师助理二年级的学生参加了为期4小时的培训,其中包括1小时的TeamSTEPPS理论课程和3次各1小时的团队模拟及反馈课程。学生们在自选重点领域(成人急症、儿科、产科)按专业课程进行分组。采用预评估和后评估来考察态度、信念以及观察或参与团队沟通行为的报告机会。

结果

149名学生(48.7%)完成了预评估和后评估。在团队沟通态度(p<0.001)、动机(p<0.001)、培训效用(p<0.001)和自我效能(p=0.005)方面发现了显著差异。TeamSTEPPS技能的显著态度转变包括团队结构(p=0.002)、情况监测(p<0.001)、相互支持(p=0.003)和沟通(p=0.002)。在TeamSTEPPS知识(p<0.001)、为患者代言(p<0.001)和跨专业团队沟通(p<0.001)方面报告了显著转变。

结论

有效的团队沟通对患者安全很重要。我们在涉及四个学生专业的大规模基于跨专业TeamSTEPPS的培训中证明了积极的态度和知识影响。

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