Brandstorp Helen, Halvorsen Peder A, Sterud Birgitte, Haugland Bjørgun, Kirkengen Anna Luise
a National Centre of Rural Medicine, Department of Community Medicine, Faculty of Health Sciences , University of Tromsø , Norway ;
b Department of Community Medicine , Faculty of Health Sciences , University of Tromsø , Norway ;
Scand J Prim Health Care. 2016 Sep;34(3):295-303. doi: 10.1080/02813432.2016.1207150. Epub 2016 Jul 21.
The purpose of our study was to explore the local learning processes and to improve in situ team training in the primary care emergency teams with a focus on interaction.
DESIGN, SETTING AND SUBJECTS: As participating observers, we investigated locally organised trainings of teams constituted ad hoc, involving nurses, paramedics and general practitioners, in rural Norway. Subsequently, we facilitated focus discussions with local participants. We investigated what kinds of issues the participants chose to elaborate in these learning situations, why they did so, and whether and how local conditions improved during the course of three and a half years. In addition, we applied learning theories to explore and challenge our own and the local participants' understanding of team training.
In situ team training was experienced as challenging, engaging, and enabling. In the training sessions and later focus groups, the participants discussed a wide range of topics constitutive for learning in a sociocultural perspective, and topics constitutive for patient safety culture. The participants expanded the types of training sites, themes and the structures for participation, improved their understanding of communication and developed local procedures. The flexible structure of the model mirrors the complexity of medicine and provides space for the participants' own sense of responsibility.
Challenging, monthly in situ team trainings organised by local health personnel facilitate many types of learning. The flexible training model provides space for the participants' own sense of responsibility and priorities. Outcomes involve social and structural improvements, including a sustainable culture of patient safety. KEY POINTS Challenging, monthly in situ team trainings, organised by local health personnel, facilitate many types of learning. The flexible structure of the training model mirrors the complexity of medicine and the realism of the simulation sessions. Providing room for the participants' own priorities and sense of responsibility allows for improvement on several levels. The participants demonstrated a consistent, long-term motivation to strengthen safety, both for their patients and for themselves.
我们研究的目的是探索本地学习过程，并改进基层医疗急救团队的现场团队培训，重点是互动。
设计、地点和研究对象：作为参与观察人员，我们调查了挪威农村地区由护士、护理人员和全科医生临时组成的团队进行的本地组织培训。随后，我们组织了与当地参与者的焦点讨论。我们调查了参与者在这些学习情境中选择阐述的问题类型、他们这样做的原因，以及在三年半的时间里当地情况是否以及如何得到改善。此外，我们应用学习理论来探索和挑战我们自己以及当地参与者对团队培训的理解。
现场团队培训被认为具有挑战性、引人入胜且富有成效。在培训课程以及随后的焦点小组讨论中，参与者从社会文化角度讨论了一系列构成学习的主题，以及构成患者安全文化的主题。参与者扩大了培训地点、主题和参与结构的类型，提高了对沟通的理解，并制定了当地程序。该模式的灵活结构反映了医学的复杂性，并为参与者自身的责任感提供了空间。
由当地卫生人员组织的具有挑战性的每月一次现场团队培训促进了多种类型的学习。灵活的培训模式为参与者自身的责任感和优先事项提供了空间。成果包括社会和结构方面的改进，包括可持续的患者安全文化。要点由当地卫生人员组织的具有挑战性的每月一次现场团队培训促进了多种类型的学习。培训模式的灵活结构反映了医学的复杂性和模拟课程的真实性。为参与者自身的优先事项和责任感留出空间可以在多个层面上实现改进。参与者表现出持续的长期动力，以加强对患者和自身的安全保障。
