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提高创伤术中的沟通:联合 DSTC™-DATC™ 课程的教育效果。

Improving Intraoperative Communication in Trauma: The Educational Effect of the Joint DSTC™-DATC™ Courses.

机构信息

Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-548, Coimbra, Portugal.

Department of Surgery, Coimbra University Hospital Center, Praceta Mota Pinto, 3000-075, Coimbra, Portugal.

出版信息

World J Surg. 2020 Jun;44(6):1856-1862. doi: 10.1007/s00268-020-05421-5.

Abstract

BACKGROUND

Operative management of severe trauma requires excellent communication among team members. The surgeon and anesthesiologist need to interact efficiently, exchanging vital information. The Definitive Surgical Trauma Care (DSTC) and Definitive Anesthesia Trauma Care (DATC) courses provide an excellent opportunity for teamwork training. Our goal was to study the impact of the joint DSTC-DATC courses in candidates' self-reported assessment in communication skills and techniques in a simulated intraoperative trauma scenario.

METHODS

Study population consists of 93 candidates (67 surgeons and 26 anesthesiologists) participating in four consecutive joint DSTC-DATC courses in May and June 2019 in Brazil (3) and in Portugal (1). Median age was 30 years; 53 (60%) of subjects were male (46 senior residents and 47 specialists). All participants attended joint lectures, case discussions and surgical skills session, emphasizing intraoperative communication. Post-course survey on several aspects of perioperative communication (responses on a Likert scale) was conducted with participants being asked which aspects of intraoperative communication they valued the most.

RESULTS

All participants responded to the survey. Results displayed an increase in the self-assessed importance of team briefing and intraoperative communication, particularly routine periodic communication, rather than only at critical moments. Postoperative team debriefing was also valued as highly relevant. Closed-loop and direct, by-name communication were highly rated. Self-reported communication skills improved significantly during the course.

CONCLUSIONS

Joint training in the DSTC-DATC courses improved candidates' perception and skills on proficient intraoperative communication. Further studies should address both the durability of these changes and the potential impact on patient care.

摘要

背景

严重创伤的手术管理需要团队成员之间的出色沟通。外科医生和麻醉师需要高效互动,交流重要信息。确定性外科创伤护理 (DSTC) 和确定性麻醉创伤护理 (DATC) 课程为团队合作培训提供了绝佳机会。我们的目标是研究联合 DSTC-DATC 课程对候选人在模拟术中创伤场景中沟通技巧自我评估的影响。

方法

研究人群由 93 名候选人(67 名外科医生和 26 名麻醉师)组成,他们参加了 2019 年 5 月和 6 月在巴西(3 个地点)和葡萄牙(1 个地点)连续举办的四届联合 DSTC-DATC 课程。中位数年龄为 30 岁;53 名(60%)参与者为男性(46 名住院医师和 47 名专家)。所有参与者都参加了联合讲座、病例讨论和手术技能课程,强调术中沟通。课程结束后,对围手术期沟通的几个方面(通过李克特量表回答)进行了调查,要求参与者回答他们认为术中沟通的哪些方面最重要。

结果

所有参与者都对调查做出了回应。结果显示,他们对团队简报和术中沟通的重要性的自我评估有所增加,特别是常规定期沟通,而不仅仅是在关键时刻。术后团队汇报也被认为非常重要。闭环和直接、指名道姓的沟通受到高度评价。自我报告的沟通技巧在课程中显著提高。

结论

联合 DSTC-DATC 课程培训提高了候选人对熟练术中沟通的认知和技能。进一步的研究应该解决这些变化的持久性以及对患者护理的潜在影响。

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