OhioHealth Learning, Riverside Methodist Hospital, Columbus, Ohio.
Department of Medical Education, Riverside Methodist Hospital, Columbus, Ohio.
J Surg Educ. 2019 May-Jun;76(3):856-863. doi: 10.1016/j.jsurg.2018.10.014. Epub 2019 Feb 28.
There is a critical relationship between team communication and patient safety in the operating room (OR), but limited opportunities are available to help OR trainees develop the communication skills needed to be good team players. The purpose of this study was to evaluate the effectiveness of a simulation-based communication-training program developed for general surgery and obstetrics and gynecology residents.
Following a group lecture on diagnostic laparoscopy, 34 residents independently completed a laparoscopy case on a patient simulator followed by a structured debrief that targeted team-based communication skills. Integrated into the case were 2 events (bradycardia and OR fire) that provided additional opportunities for the resident to communicate with his/her team. The mean Likert scale score for 11 post-training survey questions were calculated to determine residents' reaction to the training. Additionally, mean scores of observer ratings of communication performance after the simulation were calculated and analyzed using separate Wilcoxon Sign-Rank tests and kappa statistics.
Of the 41 GS and ObGyn residents, 34 (83%) participated in the training. 18 (53%) residents completed the simulation once and 16 (47%) completed it twice. Overall, residents had a positive reaction to the training program (average survey score = 4.56 of 5) and participation in the program improved their ability to use effective communication techniques during the bradycardia and OR fire events (p < 0.05, κ = 0.61).
Residents had a positive reaction to the training program and participation in the program improved their ability to use effective communication techniques throughout the procedure.
手术室(OR)中的团队沟通与患者安全之间存在着至关重要的关系,但提供给 OR 受训者的机会有限,无法帮助他们发展成为优秀团队成员所需的沟通技巧。本研究旨在评估为普通外科和妇产科住院医师开发的基于模拟的沟通培训计划的有效性。
在进行关于诊断腹腔镜检查的小组讲座后,34 名住院医师各自在患者模拟器上独立完成腹腔镜检查案例,然后进行有针对性的团队沟通技巧的结构化讨论。案例中还包含了 2 个事件(心动过缓和 OR 火灾),为住院医师与他/她的团队进行沟通提供了额外的机会。通过计算 11 个培训后调查问题的平均李克特量表得分,确定住院医师对培训的反应。此外,还使用单独的 Wilcoxon 符号秩检验和 Kappa 统计分析了模拟后观察评分的沟通表现的平均得分。
在 41 名 GS 和 ObGyn 住院医师中,有 34 名(83%)参加了培训。18 名(53%)住院医师完成了一次模拟,16 名(47%)完成了两次。总体而言,住院医师对培训计划的反应积极(平均调查评分=5 分制的 4.56 分),并且参与该计划提高了他们在心动过缓和 OR 火灾事件中使用有效沟通技巧的能力(p<0.05,κ=0.61)。
住院医师对培训计划的反应积极,参与该计划提高了他们在整个手术过程中使用有效沟通技巧的能力。