Fisher James, Martin Richard, Tate David
North Tyneside General Hospital, North Shields, UK.
Clin Teach. 2014 Oct;11(6):425-8. doi: 10.1111/tct.12180.
In hospital, doctors and nurses frequently discuss acutely unwell patients via the telephone. Telephone communication can be challenging, yet medical students receive little training in how to conduct such interactions. We aimed to provide a simple, innovative, simulation session to address this learning need for third-year medical students at Newcastle University.
Groups of students were given a pager and a supervising tutor. Students responded to a 'bleep' from a nurse practitioner in a different room, who role-played a ward nurse concerned about a patient. Speakerphones were used, allowing the entire conversation to be audible. After the call, a student-led debriefing session took place. After the debriefing another student 'held' the bleep and a different scenario ensued. Following a resuscitation scenario, students made telephone contact with the medical registrar to hand over information pertaining to the case. Before and after the session, students rated their confidence in telephone interaction and handover using a 10-point Likert scale. Students also completed a feedback questionnaire.
Fifty-four students attended the session. A statistically significant improvement in student confidence in telephone communication and handover was seen after the session. Free-text feedback highlighted that students had not received teaching on this previously, and that they welcomed opportunities to practise such skills within a controlled, safe environment.
Simulation training can be costly, but speakerphones are cheap and readily available. Given the frequency of telephone interaction in hospital, we believe all medical students should receive telephone communication training. Locally, our department has now incorporated these teaching methods into simulation sessions elsewhere in the curriculum. Medical students receive little training in how to conduct [telephone] interactions.
在医院里，医生和护士经常通过电话讨论病情危急的患者。电话沟通可能具有挑战性，但医学生在如何进行此类互动方面接受的培训很少。我们旨在为纽卡斯尔大学的三年级医学生提供一个简单、创新的模拟课程，以满足这一学习需求。
将学生分成小组，给他们配备传呼机和一名指导教师。学生们回应来自另一个房间的执业护士发出的“哔哔声”，该护士模拟一名担心患者情况的病房护士。使用免提电话，使整个对话都能被听到。通话结束后，进行由学生主导的汇报环节。汇报结束后，另一名学生“接听”传呼，接着出现不同的场景。在模拟复苏场景后，学生们与内科住院医生进行电话联系，交接与该病例相关的信息。在课程前后，学生们使用10分制李克特量表对他们在电话互动和交接方面的信心进行评分。学生们还完成了一份反馈问卷。
54名学生参加了该课程。课程结束后，学生在电话沟通和交接方面的信心有了统计学上的显著提高。自由文本反馈强调，学生此前未接受过这方面的教学，并且他们欢迎在可控、安全的环境中练习此类技能的机会。
模拟培训可能成本高昂，但免提电话价格便宜且容易获得。鉴于医院中电话互动的频率，我们认为所有医学生都应该接受电话沟通培训。在本地，我们部门现已将这些教学方法纳入课程其他部分的模拟课程中。医学生在如何进行[电话]互动方面接受的培训很少。
