Jones Mark, Howells Nick, Mitchell Steve, Burnand Henry, Mutimer Jon, Longman Robert
Department of Trauma and Orthopaedics, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, UK.
Clin Teach. 2014 Jun;11(3):165-9. doi: 10.1111/tct.12147.
Shortcomings in non-technical skills have frequently been shown to play a role in adverse events during surgery. Human-factors training has an increasing role to play in enhancing patient safety and reducing medical errors. Programmes in non-technical skills are promoted by the surgical Royal Colleges in the UK and Ireland, and are currently aimed at consultants, senior trainees and theatre teams. Since 2009, the Severn Postgraduate Deanery School of Surgery in the UK has developed a 1-day human-factors training course specifically designed for junior surgical trainees.
Analysis of post-course feedback on self-assessed confidence in the use of non-technical skills was undertaken for all junior surgical trainees undertaking the course in 2012/13.
Thirty-three junior surgical trainees attended the 1-day human-factors training course. In all, 91 per cent of trainees reported that the course would change their practice. There was a statistically significant difference between the self-assessed confidence of trainees in the use of all four categories of non-technical skills (p ≤ 0.001) before and after the course.
The Severn Deanery offers a compulsory human-factors training course for surgeons at the start of their career. Given the importance of reducing human error, maintaining patient safety and the introduction of competency-based training with an emphasis on simulation, human-factors training has a vital place in surgical training, and is highly recommended to others involved in training junior surgical trainees.
非技术技能方面的缺陷经常被证明在手术期间的不良事件中起作用。人为因素培训在提高患者安全和减少医疗差错方面发挥着越来越重要的作用。英国和爱尔兰的皇家外科医学院推动了非技术技能培训项目,目前这些项目针对的是顾问医生、高级实习医生和手术室团队。自2009年以来,英国塞文研究生医学教育中心外科学校为初级外科实习医生专门开发了一个为期一天的人为因素培训课程。
对2012/13年参加该课程的所有初级外科实习医生课程结束后的自我评估非技术技能使用信心反馈进行分析。
33名初级外科实习医生参加了为期一天的人为因素培训课程。总体而言,91%的实习医生报告称该课程会改变他们的实践。课程前后实习医生在使用所有四类非技术技能方面的自我评估信心存在统计学上的显著差异(p≤0.001)。
塞文医学教育中心在外科医生职业生涯开始时提供强制性的人为因素培训课程。鉴于减少人为错误、维护患者安全以及引入以能力为基础且强调模拟的培训的重要性,人为因素培训在外科培训中占有重要地位,强烈推荐给其他参与培训初级外科实习医生的人员。