Tan Shaw Boon, Pena Guilherme, Altree Meryl, Maddern Guy J
University of Adelaide, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
ANZ J Surg. 2014 Jul-Aug;84(7-8):515-22. doi: 10.1111/ans.12478. Epub 2013 Dec 2.
Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre.
A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes.
1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes.
Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety.
对手术室不良事件的分析表明,许多错误是由非技术技能和团队协作失误导致的。虽然模拟已成功用于教学和提高技术技能,但最近多学科模拟已用于团队技能培训。我们假设这种类型的培训是可行的,并能提高手术室的团队技能。
2012年11月和12月对文献进行系统检索,以查找描述真正多学科手术室团队模拟的研究。我们研究了团队模拟项目的特点和结果。
最初检索到1636篇文章。通过逐步评估过程,26篇文章被纳入综述。研究表明,多学科手术室模拟已用于提供技术和非技术技能培训,帮助实施新技术和技术,并识别卫生系统内潜在的弱点。大多数纳入的研究是对证据水平较低的培训项目的描述。未发现随机对照试验。在所有研究中,参与者对培训项目的反应都是积极的;然而,没有一项研究能够客观地证明从模拟中获得的技能会转移到手术室,或在患者结局方面显示出明显的益处。
多学科手术室团队模拟是可行的,并被参与者广泛接受。需要更多研究来评估这种类型的培训对手术操作表现和患者安全的影响。