Royce Celeste S, Atkins Katharyn Meredith, Mendiola Monica, Ricciotti Hope
Instructor, Department of Obstetrics, Gynecology and Reproductive Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School.
Assistant Professor, Department of Obstetrics, Gynecology and Reproductive Gynecology, Beth Israel Deaconess Medical Center and Harvard Medical School.
MedEdPORTAL. 2016 Oct 2;12:10479. doi: 10.15766/mep_2374-8265.10479.
Patient handoffs, the communications required for the safe transfer of patient care, are known to be a common source of medical errors. Simulation exercises are effective techniques for teaching the procedures and patient interaction skills involved in a handoff. We developed a teaching tool that allows students to individually interact with a simulated patient, develop a treatment plan, and practice a handoff to another provider.
The curriculum is a flexible instructional tool to teach patient handoffs in the context of a simulated obstetric emergency for learners at the clerkship through first-year obstetrics and gynecology resident levels. The curriculum secondarily teaches management of first-trimester bleeding with acute blood loss and can be adapted to allow advanced learners to practice obtaining informed consent. To evaluate this simulation for educational effectiveness, we developed a faculty observation assessment tool.
The simulation assessments for history taking, fund of knowledge, and interpersonal skills were predictive of subsequent clerkship clinical grades. Eighty percent of students agreed the exercise was realistic, 95% agreed it was relevant to the clinical curriculum, 90% agreed the simulation taught handoff skills, and 73% agreed the simulation increased confidence in handoff skills. Students uniformly found the curriculum to be relevant, realistic, and effective at teaching handoff skills.
Use of this curriculum has the potential to improve students' communication skills, handoff performance, and confidence during an obstetrics and gynecology clerkship. The assessment tool may allow early identification of students in need of improvement in communication skills.
患者交接,即安全移交患者护理所需的沟通,是已知的医疗差错常见来源。模拟练习是教授交接过程中所涉及程序和患者互动技能的有效方法。我们开发了一种教学工具,使学生能够与模拟患者单独互动、制定治疗计划并练习向另一位医护人员进行交接。
该课程是一种灵活的教学工具,用于在模拟产科急诊的情境中,向见习医学生至妇产科一年级住院医师阶段的学习者教授患者交接。该课程还教授早孕出血伴急性失血的管理,并且可以进行调整,以便让高年级学习者练习获取知情同意。为了评估该模拟教学的教育效果,我们开发了一种教师观察评估工具。
对病史采集、知识储备和人际技能的模拟评估可预测随后见习期间的临床成绩。80%的学生认为该练习逼真,95%的学生认为它与临床课程相关,90%的学生认为该模拟教授了交接技能,73%的学生认为该模拟增强了他们在交接技能方面的信心。学生们一致认为该课程与实际相关、逼真且在教授交接技能方面有效。
使用该课程有可能提高学生在妇产科见习期间的沟通技能、交接表现和信心。该评估工具可能有助于早期识别需要提高沟通技能的学生。