Weldon Sharon-Marie, Ralhan Shvaita, Paice Elisabeth, Kneebone Roger, Bello Fernando
Faculty of Medicine, Imperial College London, Chelsea and Westminster Campus, Fulham Road, London, SW10 9NH, UK.
BMC Fam Pract. 2015 Aug 27;16:109. doi: 10.1186/s12875-015-0327-5.
An evaluation of an effective and engaging intervention for educating general practice (GP) receptionists about integrated care and the importance of their role within the whole system was conducted.
Workshops took place in North West London, one of England's 14 'Integrated Care Pioneers.' Three training days featuring Sequential Simulations (SqS) were held. Forty GP receptionists attended on each day, as well as 5-6 patients and 8-9 healthcare professionals. The SqS developed was from a collection of patient stories, the key scene of which featured a GP receptionist. The scenes were designed to show the consequences for the patient of professionals working in silos. This provided the focus for facilitated table discussions. The discussants suggested ways in which an unfortunate series of events could have been dealt with differently. These suggestions were then incorporated in a re-designed SqS. Evaluation was conducted through questionnaires, field notes and analysis of video material. Descriptive statistics and thematic analysis were applied.
Ninety three participants responded to the questionnaire out of 131 attendees. All (93/93) respondents reported that the event was a powerful learning experience and that they had gained confidence in improving patient care. 98 % (91/93) reported that their knowledge of integrated care had improved. The simulation was rated highly as a learning experience [60 % (57/93) - excellent, 39 % (37/93) good]. Further evidence of educational benefit was expressed through comments such as: 'The simulations really got me thinking about the patient as a human with many problems and situations.'
SqS is an innovative and practical way of presenting current care pathways and health care scenarios in order to create a shared focus, engage the emotions of the participants and bring the principles of integrated care to life. Facilitated table discussions are an opportunity to see events from multiple perspectives, share reactions and ideas, and practise co-producing service reforms with patients. We believe this approach is a useful way of preparing front-line staff to participate in integrated care.
开展了一项评估，以确定一种有效且引人入胜的干预措施，用于教育全科医生（GP）接待员有关综合医疗服务以及他们在整个系统中角色的重要性。
研讨会在伦敦西北部举行，伦敦西北部是英格兰14个“综合医疗服务先锋地区”之一。举办了为期三天、以序列模拟（SqS）为特色的培训。每天有40名全科医生接待员参加，还有5 - 6名患者和8 - 9名医疗保健专业人员。所开发的序列模拟基于一系列患者故事，其中关键场景以一名全科医生接待员为特色。这些场景旨在展示各专业人员各自为政给患者带来的后果。这为引导式小组讨论提供了焦点。讨论者提出了一系列不幸事件本可通过不同方式处理的建议。然后这些建议被纳入重新设计的序列模拟中。通过问卷调查、现场记录和视频材料分析进行评估。应用了描述性统计和主题分析。
131名参与者中有93人回复了问卷。所有（93/93）受访者都表示该活动是一次强有力的学习经历，并且他们在改善患者护理方面获得了信心。98%（91/93）的受访者表示他们对综合医疗服务的了解有所提高。该模拟作为一种学习体验得到了高度评价[60%（57/93）评价为优秀，39%（37/93）评价为良好]。通过诸如“这些模拟真的让我开始将患者视为一个面临诸多问题和情况的人”等评论，进一步证明了其教育益处。
序列模拟是一种创新且实用的方式，用于呈现当前的护理路径和医疗场景，以创造共同焦点、激发参与者的情感并使综合医疗服务的原则变得生动。引导式小组讨论提供了一个从多个角度看待事件、分享反应和想法以及与患者共同开展服务改革实践的机会。我们认为这种方法是让一线工作人员为参与综合医疗服务做好准备的一种有用方式。
