University Hospital Coventry and Warwickshire, West Midlands Foundation Deanery, UK.
Oxford University Clinical Academic Graduate School, John Radcliffe Hospital, Oxford, UK.
Int J Surg. 2018 May;53:171-177. doi: 10.1016/j.ijsu.2018.03.044. Epub 2018 Mar 22.
The aviation industry pioneered formalised crew training in order to improve safety and reduce consequences of non-technical error. This formalised training has been successfully adapted and used to in the field of surgery to improve post-operative patient outcomes. The need to implement teamwork training as an integral part of a surgical programme is increasingly being recognised. We aim to systematically review the impact of surgical teamwork training on post-operative outcomes.
Two independent researchers systematically searched MEDLINE and Embase in accordance with PRISMA guidelines. Studies were screened and subjected to inclusion/exclusion criteria. Study characteristics and outcomes were reported and analysed.
Our initial search identified 2720 articles. Following duplicate removal, title and abstract screening, 107 full text articles were analysed. Eight articles met our inclusion criteria. Overall, three articles supported a positive effect of good teamwork on post-operative patient outcomes. We identified key areas in study methodology that can be improved upon, including small cohort size, lack of unified training programme, and short training duration, should future studies be designed and implemented in this field.
At present, there is insufficient evidence to support the hypothesis that teamwork training interventions improve patient outcomes. We believe that non-significant and conflicting results can be attributed to flaws in methodology and non-uniform training methods. With increasing amounts of evidence in this field, we predict a positive association between teamwork training and patient outcomes will come to light.
航空业开创了规范化的机组人员培训，以提高安全性并降低非技术性错误的后果。这种规范化的培训已成功地应用于外科领域，以改善术后患者的结局。越来越需要将团队合作培训作为外科计划的一个组成部分来实施。我们旨在系统地回顾外科手术团队合作培训对术后结果的影响。
两名独立的研究人员按照 PRISMA 指南系统地搜索了 MEDLINE 和 Embase。对研究进行筛选并进行纳入/排除标准。报告和分析研究特征和结果。
我们最初的搜索确定了 2720 篇文章。在删除重复项、标题和摘要筛选后，分析了 107 篇全文文章。符合纳入标准的有 8 篇文章。总的来说，有三篇文章支持良好的团队合作对术后患者结局的积极影响。我们确定了研究方法学中可以改进的关键领域，包括小样本量、缺乏统一的培训计划和培训时间短，如果未来在这一领域进行设计和实施研究。
目前，没有足够的证据支持团队合作培训干预措施改善患者结局的假设。我们认为，非显著和相互矛盾的结果可归因于方法学的缺陷和非统一的培训方法。随着这一领域证据的增加，我们预测团队合作培训与患者结局之间将存在积极的关联。
