Steinemann Susan, Kurosawa Gene, Wei Alexander, Ho Nina, Lim Eunjung, Suares Gregory, Bhatt Ajay, Berg Benjamin
Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI; Department of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.
Am J Surg. 2016 Feb;211(2):482-8. doi: 10.1016/j.amjsurg.2015.11.001. Epub 2015 Dec 12.
Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment.
Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations. After each resuscitation, nurses and teamwork experts independently scored teamwork (T-NOTECHS). After video debriefing, nurses repeated T-NOTECHS self-assessment.
Nurses and surgeons assumed significantly more responsibility by their own profession for 71% of resuscitation tasks. Nurses' overall T-NOTECHS ratings were slightly higher than experts'. This was evident in all T-NOTECHS subdomains except "leadership," but despite statistical significance the difference was small and clinically irrelevant. Video debriefing did not improve the accuracy of self-assessment.
Nurses and physicians demonstrated discordant perceptions of responsibilities. Nurses' self-assessment of teamwork was statistically, but not clinically significantly, higher than experts' in all domains except physician leadership.
创伤护理需要协调一个跨专业团队，并对团队合作技能提供形成性反馈。我们假设护士和外科医生在复苏过程中对各自角色的认知不同；护士对团队合作的自我评估与专家不同，并且视频汇报可能会提高自我评估的准确性。
对创伤护士和外科医生进行了关于复苏职责的调查。随后，护士加入跨专业团队进行模拟创伤复苏。每次复苏后，护士和团队合作专家分别对团队合作进行评分（T-NOTECHS）。在视频汇报后，护士重复进行T-NOTECHS自我评估。
护士和外科医生在71%的复苏任务中，各自承担了明显更多的本专业职责。护士的总体T-NOTECHS评分略高于专家。除“领导力”外，在所有T-NOTECHS子领域中均如此，但尽管具有统计学意义，差异很小且与临床无关。视频汇报并未提高自我评估的准确性。
护士和医生对职责的认知不一致。在除医生领导力外的所有领域中，护士对团队合作的自我评估在统计学上高于专家，但在临床上无显著差异。
