Department of Emergency Medicine, Carolinas Medical Center, Carolinas Simulation Center, Atrium Health, 1000 Blythe Blvd., 3rd Floor MEB, Boston, Massachusetts, 28203, USA.
Department of Emergency Medicine, Carolinas Medical Center, Atrium Health, Boston, Massachusetts, USA.
BMC Med Educ. 2019 Jul 24;19(1):276. doi: 10.1186/s12909-019-1700-1.
Cooperative interdisciplinary patient care is a modern healthcare necessity. While various medical and surgical disciplines have independent educational requirements, a system-wide simulation-based curriculum composed of different disciplines provides a unique forum to observe the effect of interdisciplinary simulation-based education (IDSE). Our hypothesis: IDSE positively affects intern outlook and attitudes towards other medical disciplines.
Using an established interdisciplinary simulation curriculum designed for first year interns, we explored the relative effect of IDSE on between-discipline intern attitudes in a convergent, parallel, mixed-methods study. Data sources included novel pre-post anonymous survey measurements (10-point Likert scale), focus groups, direct observations, and reflective field notes. This quasi-experimental pilot study was conducted at an academic, tertiary care medical center with two cohorts of interns: one exposed to IDSE and one exposed to an independent within-discipline simulation curriculum.
IDSE exposed interns demonstrated statistically significant improvements when comparing mean pre-test and post-test score differences in five of seven areas: perceived interdisciplinary collegiality ([Formula: see text] = 0.855; p = 0.0002), respect (x̅ = 0.436; p = 0.0312), work interactions ([Formula: see text] = 0.691; p = 0.0069), perceived interdisciplinary attitudes (x̅ = 0.764; p = 0.0031), and comfort in interdisciplinary learning (x̅ = 1.164; p < 0.0001). There were no changes in interdisciplinary viewpoints observed among non-IDSE interns. IDSE interns were comfortable when learning with interns of different disciplines and believed others viewed their discipline positively compared to non-IDSE interns. Qualitative data uncovered the following themes related to the impact of IDSE including: 1) Relationship building, 2) Communication openness, 3) Attitude shifting, and 4) Enhanced learner experience.
IDSE positively influenced intern outlook on and attitudes towards other medical disciplines. This unique learning environment provided interns an opportunity to learn clinical case management while learning about, from, and with each other; subsequently breaking traditional discipline-specific stereotypes and improving interdisciplinary relations. Future explicit focus on IDSE offers opportunity to improve interdisciplinary interactions and patient care.
合作的跨学科患者护理是现代医疗保健的必要条件。虽然各个医学和外科学科都有独立的教育要求，但由不同学科组成的系统范围的基于模拟的课程提供了一个观察跨学科模拟教育 (IDSE) 效果的独特论坛。我们的假设：IDSE 积极影响实习医生对其他医学学科的看法和态度。
我们使用专为第一年实习医生设计的既定跨学科模拟课程，在一项收敛性、平行性、混合方法研究中探索 IDSE 对跨学科实习医生态度的相对影响。数据来源包括新颖的前后匿名调查测量（10 分李克特量表）、焦点小组、直接观察和反思性实地笔记。这项准实验性试点研究在一家学术性、三级保健医疗中心进行，有两批实习医生参加：一批接受 IDSE，一批接受独立的学科内模拟课程。
接受 IDSE 的实习医生在七个领域中的五个领域中，在比较前后测得分差异时表现出统计学上的显著改善：感知的跨学科同事关系 ([Formula: see text] = 0.855;p = 0.0002)、尊重 ([Formula: see text] = 0.436;p = 0.0312)、工作互动 ([Formula: see text] = 0.691;p = 0.0069)、感知的跨学科态度 ([Formula: see text] = 0.764;p = 0.0031) 和跨学科学习的舒适度 ([Formula: see text] = 1.164;p < 0.0001)。在非 IDSE 实习医生中没有观察到跨学科观点的变化。与非 IDSE 实习医生相比，IDSE 实习医生在与不同学科的实习医生一起学习时感到舒适，并认为其他人对他们的学科持积极态度。定性数据揭示了与 IDSE 影响相关的以下主题：1）建立关系，2）沟通开放，3）态度转变，4）增强学习体验。
IDSE 积极影响实习医生对其他医学学科的看法和态度。这种独特的学习环境为实习医生提供了一个机会，让他们在学习临床病例管理的同时，了解彼此、相互学习，从而打破传统的学科特定刻板印象，改善跨学科关系。未来明确关注 IDSE 为改善跨学科互动和患者护理提供了机会。
