Stewart-Parker Emma, Galloway Robert, Vig Stella
Department of General Surgery, Croydon University Hospital, Croydon, Surrey, United Kingdom.
Brighton and Sussex University Hospitals, United Kingdom.
J Surg Educ. 2017 Jan-Feb;74(1):137-144. doi: 10.1016/j.jsurg.2016.06.020. Epub 2016 Sep 20.
Possessing adequate nontechnical skills (NTS) in operating theaters is of increasing interest to health care professionals, yet these are rarely formally taught. Teams make human errors despite technical expertise and knowledge, compromising patient safety. We designed a 1-day, multiprofessional, multidisciplinary course to teach, practice, and apply these skills through simulation.
The course, "S-TEAMS," comprised a morning of lectures, case studies, and interactive teamworking exercises. The afternoon divided the group into multiprofessional teams to rotate around simulated scenarios. During the scenarios, teams were encouraged to focus on NTS, including communication strategies, situational awareness, and prompts such as checklists. A thorough debrief with experienced clinician observers followed. Data was collected through self-assessments, immediate and 6-month feedback to assess whether skills continued to be used and their effect on safety.
In total, 68 health care professionals have completed the course thus far. All participants felt the course had a clear structure and that learning objectives were explicit. Overall, 95% felt the scenarios had good or excellent relevance to clinical practice. Self-assessments revealed a 55% increase in confidence for "speaking up" in difficult situations. Long-term data revealed 97% of the participants continued to use the skills, with 88% feeling the course had prevented them from making errors. Moreover, 94% felt the course had directly improved patient safety.
There is a real demand and enthusiasm for developing NTS within the modern theater team. The simple and easily reproducible format of S-TEAMS is sustainable and inclusive, and crucially, the skills taught continue to be used in long term to improve patient safety and teamworking.
手术室中具备足够的非技术技能(NTS)越来越受到医疗保健专业人员的关注,但这些技能很少得到正式传授。尽管拥有专业技术和知识,团队仍会出现人为错误,从而危及患者安全。我们设计了一个为期一天的多专业、多学科课程,通过模拟来教授、练习和应用这些技能。
“S-TEAMS”课程包括上午的讲座、案例研究和互动式团队合作练习。下午将小组分成多专业团队,围绕模拟场景进行轮转。在场景中,鼓励团队专注于非技术技能,包括沟通策略、态势感知以及诸如检查表等提示。随后会与经验丰富的临床医生观察员进行全面的总结汇报。通过自我评估、即时反馈和6个月后的反馈来收集数据,以评估技能是否持续被使用及其对安全性的影响。
到目前为止,共有68名医疗保健专业人员完成了该课程。所有参与者都认为课程结构清晰,学习目标明确。总体而言,95%的人认为这些场景与临床实践具有良好或极佳的相关性。自我评估显示,在困难情况下“大声说出来”的信心提高了55%。长期数据显示,97%的参与者继续使用这些技能,88%的人认为该课程使他们避免了犯错。此外,94%的人认为该课程直接提高了患者安全。
现代手术室团队对培养非技术技能有着切实的需求和热情。“S-TEAMS”简单且易于复制的形式具有可持续性和包容性,至关重要的是,所教授的技能在长期内持续被使用,以提高患者安全和团队协作。