一种采用跨专业培训师培训计划的翻转课堂方法来提高谵妄护理质量。
A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer Program.
作者信息
Sockalingam Sanjeev, James Sandra-Li, Sinyi Rebecca, Carroll Aideen, Laidlaw Jennifer, Yanofsky Richard, Sheehan Kathleen
机构信息
Dr. Sockalingam: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Ms. James: University Health Network, Toronto, ON, Canada. Ms. Sinyi: University Health Network, Toronto, ON, Canada. Ms. Carroll: University Health Network, Toronto, ON, Canada. Dr. Laidlaw: Surrey Memorial Hospital, Surrey, BC, Canada. Dr. Yanofsky: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Dr. Sheehan: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
出版信息
J Contin Educ Health Prof. 2016 Winter;36(1):17-23. doi: 10.1097/CEH.0000000000000025.
INTRODUCTION
Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors.
METHODS
FC Delirium TTT sessions were implemented in a large four-hospital network and consisted of presession online work and a 3-hour in-session component. The 156 TTT interprofessional participants who attended the sessions (ie, trainers) were expected to then deliver delirium training to their patient care units. Delirium care self-efficacy and knowledge test scores were measured before, after, and 6 months after the training session. Clinician delirium assessment rates were measured by chart audits before and 3 months after trainer's implementation of delirium training sessions.
RESULTS
Delirium knowledge test scores (7.8 ± 1.6 versus 9.7 ± 1.2, P < .001) and delirium care self-efficacy were significantly higher immediately after the TTT session compared with those of presession and these differences remained significant at 6-month after the TTT session. Trainer sessions significantly improved clinician delirium assessment rates from 53% for pretraining to 66% for posttraining.
DISCUSSION
Our data suggest that a TTT FC delirium training approach can improve participants' perceived delirium care skills and confidence, and delirium knowledge up to 6 months after the session. This approach provides a model for implementing hospitalwide delirium education that can change delirium assessment behavior while minimizing time and personnel requirements.
引言
鉴于谵妄的患病率和发病率，医疗保健机构需要有效且高效的谵妄培训方法。新型教育方法，特别是“翻转课堂”（FC）和“培训培训师”（TTT），有可能弥补这些谵妄培训差距。本研究评估了TTT FC跨专业谵妄培训计划对参与者感知的谵妄管理能力、谵妄知识以及临床医生谵妄评估行为的影响。
方法
FC谵妄TTT课程在一个大型的四所医院网络中实施，包括课前在线学习和3小时的课堂学习部分。参加课程的156名TTT跨专业参与者（即培训师）随后要为其患者护理单元开展谵妄培训。在培训课程之前、之后以及之后6个月测量谵妄护理自我效能感和知识测试分数。通过图表审核在培训师实施谵妄培训课程之前和之后3个月测量临床医生的谵妄评估率。
结果
与课前相比，TTT课程结束后立即，谵妄知识测试分数（7.8±1.6对9.7±1.2，P<.001）和谵妄护理自我效能感显著更高，并且这些差异在TTT课程之后6个月仍然显著。培训师课程显著提高了临床医生的谵妄评估率，从培训前的53%提高到培训后的66%。
讨论
我们的数据表明，TTT FC谵妄培训方法可以提高参与者感知的谵妄护理技能和信心，以及谵妄知识，并且在课程结束后长达6个月内有效。这种方法提供了一种在全院实施谵妄教育的模式，该模式可以改变谵妄评估行为，同时将时间和人员需求降至最低。
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