Spence Heather, Somasundram Khevan, Biyani Chandra Shekhar, Jain Sunjay
St. James' University Hospital, Leeds, United Kingdom.
St. James' University Hospital, Leeds, United Kingdom.
J Surg Educ. 2020 Jul-Aug;77(4):921-930. doi: 10.1016/j.jsurg.2020.02.012. Epub 2020 Mar 16.
To assess the utility of simulated ward rounds to train healthcare professionals in nontechnical skills using a qualitative analysis of participant feedback.
We developed simulated scenarios to train members of the surgical healthcare team in nontechnical skills, derived from observations of real ward rounds. Participants performed the simulated ward rounds as a team, led by a Urology trainee. Scenarios were carried out using actors as patients, and a simulated "switchboard" for phone conversations. Throughout the scenarios, distractions were introduced and directed at different members of the participating team. Following each scenario, a whole group debrief took place to discuss and provide feedback on performances. All participants completed a 2-part feedback form comprising of questions answered on a Likert scale, as well as free-text responses.
All simulations took place in a high-fidelity simulated ward bay. Observers were in a separate room, where the scenarios were projected on a screen in real-time.
Thirty-five healthcare professionals in the department of Urology attended this session. There was no restriction on professional background or seniority for attendees.
The qualitative thematic analysis revealed that participants commented positively on the type of scenarios, but would have preferred if more participants could partake in scenarios. The attendees also commended the use of debriefs between scenarios. Suggestions were also given regarding types of scenarios; and involved ensuring that participants are well briefed before each scenario.
This simulated ward round exercise was positively received by participants. The approach to derive scenarios from real ward round observations permitted a variety of the main themes of nontechnical skills to be tested, and improved the fidelity of the simulation. The reflections expressed by participants demonstrate a need for this training, and drives our initiative to raise awareness and develop nontechnical skills in a controlled environment, supported with transparent discussion and feedback.
通过对参与者反馈的定性分析，评估模拟查房在培训医疗保健专业人员非技术技能方面的效用。
我们根据对实际查房的观察，开发了模拟场景，以培训外科医疗团队成员的非技术技能。参与者以团队形式进行模拟查房，由一名泌尿外科实习医生带领。场景使用演员扮演患者，并设有模拟“总机”用于电话交谈。在整个场景中，会引入干扰因素并针对参与团队的不同成员。每个场景结束后，进行全体讨论，以讨论并提供关于表现的反馈。所有参与者都完成了一份两部分的反馈表，包括按李克特量表回答的问题以及自由文本回复。
所有模拟均在高保真模拟病房进行。观察员在一个单独的房间里，场景实时投影在屏幕上。
泌尿外科的35名医疗保健专业人员参加了此次培训。对参与者的专业背景或资历没有限制。
定性主题分析显示，参与者对场景类型给予了积极评价，但希望有更多参与者能够参与场景。参与者还称赞了场景之间讨论环节的使用。还就场景类型提出了建议，包括确保在每个场景之前让参与者得到充分的简报。
参与者对这次模拟查房练习给予了积极评价。从实际查房观察中得出场景的方法能够测试非技术技能的各种主要主题，并提高了模拟的逼真度。参与者表达的看法表明有进行这种培训的必要，并推动我们在可控环境中提高认识并培养非技术技能的主动性，同时辅以透明的讨论和反馈。
