Human Factors Research Group/Horizon Digital Economy Research, University of Nottingham, Nottingham, Nottinghamshire, UK.
Department of Respiratory Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK East Midlands Academic Health Science Network, Nottingham, Nottinghamshire, UK.
BMJ Open. 2015 Feb 16;5(2):e006102. doi: 10.1136/bmjopen-2014-006102.
The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH.
Survey-based cross-sectional study informed by focus groups.
Online survey with participants from five large teaching hospitals across the UK.
300 Medical Students and Doctors
Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care.
The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey 'Task Prioritisation' (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for 'Communication with Senior Doctors', 'Dealing with Clinical Isolation', 'Task Prioritisation' and 'Communication with Patients'. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work.
Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills.
尚未确定初级医生在医院非工作时间（OoH）高效、安全工作所需的技能。尽管 OoH 时间占全年的 75%，且是死亡率最高的时间，但情况依旧如此。我们旨在探讨医学生对 OoH 所需非技术技能的期望，以及初级医生的实际经验。
基于焦点小组的调查性横断面研究。
英国五所大型教学医院的在线调查。
300 名医学生和医生。
参与者根据文献回顾和焦点小组确定的非技术技能重要性进行排名，这些技能是 OoH 护理所需的。
焦点小组共揭示了八项被认为重要的非技术技能。在调查中，“任务优先级”（平均排名 1.617）一直被认为是最重要的非技术技能。培训阶段影响技能排名，“与上级医生沟通”、“应对临床隔离”、“任务优先级”和“与患者沟通”方面存在显著差异。重要的是，医学生的期望与医生的实际工作经验之间存在显著差异。
我们的研究结果表明，医务人员特别重视任务优先级技能；然而，这些技能在医学院并没有得到常规教授。学生的期望和医生的经验之间的差异，印证了培训存在差距的想法。不同年级的医生对特定的非技术技能的重视程度不同，这对研究生培训有影响。医学院和教务长办公室迫切需要审查非技术培训，以包括更多的技能，而不仅仅是沟通技能。
