Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Centre for Medical Education, University of Dundee, Dundee, UK.
Paediatr Anaesth. 2020 May;30(5):614-623. doi: 10.1111/pan.13846. Epub 2020 May 6.
Anesthetic induction and other procedures performed by anesthetists are potentially stressful for children. Pediatric anesthetists use communication to rapidly establish rapport and engagement with children and reduce anxiety and discomfort. Communication in pediatric anesthesia is increasingly topical, but there is limited discussion regarding which specific techniques should be taught to trainees.
The aim of this research was to identify which communication techniques used locally by pediatric anesthetic specialists, trainees, and nurses are viewed as the most effective and valuable to teach trainees.
Qualitative semi-structured focus groups (7) and in-depth interviews (7) were used to gather data from 30 specialist pediatric anesthetists, trainees, and assistants from a major tertiary pediatric anesthetic department. Inductive and deductive thematic data analysis explored communication techniques used locally.
The research identified the range of communication techniques being utilized to establish rapport and engage with children, including methods for distraction and focusing attention such as storytelling, guided imagery, and positive suggestions. Thematic analysis revealed a series of core overarching principles for successful application, using social skills within an adaptable, competent, child-centered approach. Drawing on the experiences of specialist practitioners and trainees, teaching these communication techniques would ideally employ an interactive approach involving both modeling and specific communication education with focus on developing communication skills via experiential learning using self-reflection and feedback.
Within the range of communication techniques being utilized by pediatric anesthetists exist a series of core principles that are essential to engaging and building rapport with children. Focusing on the importance of these common core elements in trainee education, in addition to the range of techniques available, may provide a pragmatic framework for centers providing pediatric anesthesia to consider when designing their trainee curriculum.
麻醉师进行的麻醉诱导和其他程序可能会对儿童造成压力。儿科麻醉师使用沟通技巧迅速与儿童建立融洽关系并参与其中，从而减轻焦虑和不适。儿科麻醉中的沟通越来越受到关注，但对于应该向学员传授哪些具体的沟通技巧，讨论却很有限。
本研究旨在确定儿科麻醉专家、学员和护士在当地使用的哪些沟通技巧被认为是最有效和最有价值的，可以教授给学员。
采用定性半结构式焦点小组（7 个）和深入访谈（7 个），从一家主要的儿科麻醉部门的 30 名专科儿科麻醉师、学员和助理那里收集数据。采用归纳和演绎主题数据分析方法，探索当地使用的沟通技巧。
研究确定了用于建立融洽关系和与儿童建立联系的沟通技巧范围，包括讲故事、引导想象和积极建议等分散注意力和集中注意力的方法。主题分析揭示了一系列成功应用的核心原则，即在灵活、有能力、以儿童为中心的方法中运用社交技能。借鉴专科医生和学员的经验，理想情况下，教授这些沟通技巧将采用互动式方法，包括示范和特定的沟通教育，重点通过体验式学习发展沟通技能，并进行自我反思和反馈。
在儿科麻醉师使用的沟通技巧范围内，存在一系列与儿童建立融洽关系和建立融洽关系的核心原则。在学员教育中关注这些共同核心要素的重要性，除了可用的一系列技术外，可能为提供儿科麻醉的中心在设计学员课程时提供一个实用的框架。
