Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Health Education England Kent, Surrey and Sussex, Crawley, UK.
BMJ Open. 2019 Jul 23;9(7):e028572. doi: 10.1136/bmjopen-2018-028572.
Acutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants' reported experiences.
Three research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.
The intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.
The in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.
This study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.
在初级保健环境中，病情突然恶化的患者并不常见，但成功管理需要临床和非临床工作人员作为一个有凝聚力的团队共同参与。尽管跨专业教育的优势有充分的记录，但在初级保健中，几乎没有研究证据证明这一点。加强跨专业合作最终可以改善对急性疾病患者的护理。本概念验证研究旨在开发一种用于初级保健的现场模拟医疗紧急情况，并通过参与者报告的经验评估其可接受性和实用性。
英格兰东南部的三个研究活跃的全科医生诊所。每家诊所的 9 名员工同意参与，代表临床和非临床专业。
研究团队开发了现场模拟心脏骤停的情景干预措施。在评估中，员工在现场模拟后参与了个体定性半结构化访谈：重点关注他们的参与经验，特别关注跨学科培训和现场模拟的潜在未来发展。
现场模拟适合在参与的全科医生诊所使用。对访谈的定性主题分析确定了四个主题：（1）担忧和（不）愿意参与，（2）对模拟设计的反思，（3）情景体验，（4）培训。
本研究表明，现场模拟可以成为初级保健中跨专业团队培训的一种可接受方法，受到实践和员工的欢迎。这有助于更全面地了解现场模拟如何使劳动力和患者受益。需要进一步的研究来进一步完善现场模拟培训课程。
