Watters Colm, Reedy Gabriel, Ross Alastair, Morgan Nicola J, Handslip Rhodri, Jaye Peter
Simulation and Interactive Learning (SaIL) Centre at St Thomas House, Kings Health Partners, London, UK.
Simulation and Interactive Learning (SaIL) Centre at St Thomas House, Kings Health Partners, London, UK King's Learning Institute, King's College London, London, UK.
BMJ Open. 2015 Jan 13;5(1):e005472. doi: 10.1136/bmjopen-2014-005472.
In this work, we have compared uniprofessional and interprofessional versions of a simulation education intervention, in an attempt to understand more about whether it improves trainees' self-efficacy.
Interprofessionalism has been climbing the healthcare agenda for over 50 years. Simulation education attempts to create an environment for healthcare professionals to learn, without potential safety risks for patients. Integrating simulation and interprofessional education can provide benefits to individual learners.
The intervention took place in a high-fidelity simulation facility located on the campus of a large urban hospital. The centre provides educational activities for an Academic Health Sciences Centre. Approximately 2500 staff are trained at the centre each year.
One hundred and fifteen nurses and midwives along with 156 doctors, all within the early years of their postgraduate experience participated. All were included on the basis of their ongoing postgraduate education.
Each course was a one-day simulation course incorporating five clinical and one communication scenarios. After each a facilitated debriefing took place. A mixed methods approach utilised precourse and postcourse questionnaires measuring self-efficacy in managing emergency situations, communication, teamwork and leadership.
Thematic analysis of qualitative data showed improvements in communication/teamwork and leadership, for doctors and nurses undergoing simulation training. These findings were confirmed by statistical analysis showing that confidence ratings improved in nurses and doctors overall (p<0.001). Improved outcomes from baseline were observed for interprofessional versus uniprofessional trained nurses (n=115; p<0.001). Postcourse ratings for doctors showed that interprofessional training was significantly associated with better final outcomes for a communication/teamwork dimension (n=156; p<0.05).
This study provides evidence that simulation training enhances participants' self-efficacy in clinical situations. It also leads to increases in their perceived abilities relating to communication/teamwork and leadership/management of clinical scenarios. Interprofessional training showed increased positive effects on self-efficacy for nurses and doctors.
在本研究中,我们比较了模拟教育干预的单专业和跨专业版本,以进一步了解其是否能提高学员的自我效能感。
跨专业协作在医疗保健议程上已占据了五十多年的时间。模拟教育旨在为医疗保健专业人员创造一个学习环境,同时避免给患者带来潜在的安全风险。将模拟与跨专业教育相结合能使个体学习者受益。
干预在一家大型城市医院校园内的高保真模拟设施中进行。该中心为一个学术健康科学中心提供教育活动。每年约有2500名工作人员在此接受培训。
115名护士和助产士以及156名医生参与其中,他们均处于研究生经历的早期阶段。所有人都是基于其正在进行的研究生教育而被纳入研究。
每门课程为期一天,包含五个临床场景和一个沟通场景的模拟课程。每次模拟后都会进行引导式总结汇报。采用混合方法,利用课前和课后问卷来测量在处理紧急情况、沟通、团队合作和领导力方面的自我效能感。
定性数据的主题分析表明,接受模拟培训的医生和护士在沟通/团队合作和领导力方面有所改善。这些发现通过统计分析得到证实,表明护士和医生的总体信心评分有所提高(p<0.001)。与单专业培训的护士相比(n = 115;p<0.001),跨专业培训的护士从基线开始有更好的结果。医生的课后评分显示,跨专业培训与沟通/团队合作维度的更好最终结果显著相关(n = 156;p<0.05)。
本研究提供了证据表明模拟培训可提高参与者在临床情境中的自我效能感。它还会使他们在沟通/团队合作以及临床场景的领导力/管理方面的感知能力有所提升。跨专业培训对护士和医生的自我效能感显示出更大的积极影响。