Henker Richard Alynn, Henker Hiroko, Eng Hor, O'Donnell John, Jirativanont Tachawan
Department of Nurse Anesthesia, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States.
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States.
Front Public Health. 2017 Jul 5;5:154. doi: 10.3389/fpubh.2017.00154. eCollection 2017.
A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers. The purpose of this project was to evaluate the impact of a CTM simulation course at AHC on attitudes and perceptions of participants on concepts related to team performance.
Each of the CTM courses consisted of three lectures, including team performance concepts, communication, and debriefing followed by rotation through four simulation scenarios. The evaluation instrument used to evaluate the AHC CTM course was developed for Cambodian staff at AHC based on TeamSTEPPs© instruments evaluating attitude and perceptions of team performance (5). CTM team performance concepts included in lectures, debriefing sessions, and the evaluation instrument were: team structure, leadership, situation monitoring, mutual support, and communication. The Wilcoxon signed-rank test was used to analyze pre- and post-test paired data from participants in the course.
Of the 54 participants completing the three CTM courses at AHC, 27 were nurses, 6 were anesthetists, and 21 were physicians. Attitude and perception scores were found to significantly improve ( < 0.05) for team structure, leadership, situation monitoring, and communication. Team performance areas that improved the most were: discussion of team performance, communication, and exchange of information.
Teaching of non-technical skills can be effective in a setting with scarce resources in a Southeastern Asian country.
海外健康志愿者组织的志愿者为柬埔寨暹粒吴哥儿童医院（AHC）的医生和护士开发了一门危机团队管理（CTM）模拟课程。该课程框架改编自危机资源管理（1, 2）、危机团队培训（3）和团队STEPPS©模型（4）。CTM课程专注于教授医生和护士团队绩效知识、技能和态度的培养。在AHC提供该课程面临的挑战包括模拟设备的可用性、学习中的文化差异以及语言障碍。本项目的目的是评估AHC的CTM模拟课程对参与者关于团队绩效相关概念的态度和认知的影响。
每门CTM课程包括三场讲座，内容涵盖团队绩效概念、沟通和汇报，随后进行四个模拟场景的轮转。用于评估AHC CTM课程的评估工具是基于评估团队绩效态度和认知的团队STEPPS©工具为AHC的柬埔寨员工开发的（5）。讲座、汇报环节以及评估工具中包含的CTM团队绩效概念有：团队结构、领导力、情况监测相互支持和沟通。采用Wilcoxon符号秩检验分析课程参与者的测试前和测试后配对数据。
在AHC完成三门CTM课程的54名参与者中，27名是护士，6名是麻醉师，21名是医生。发现团队结构、领导力、情况监测和沟通方面的态度和认知得分显著提高（<0.05）。团队绩效提升最大的领域是：团队绩效讨论、沟通和信息交流。
在东南亚国家资源匮乏的环境中，非技术技能的教学可能是有效的。
