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COVID-19 大流行期间的多学科气管切开术质量改进:建立全球学习社区。

Multidisciplinary Tracheostomy Quality Improvement in the COVID-19 Pandemic: Building a Global Learning Community.

机构信息

Department of Otolaryngology - Head & Neck Surgery, West Suffolk Hospital, Bury St Edmunds, UK.

University of Uppsala, Uppsala, SE, Sweden.

出版信息

Ann Otol Rhinol Laryngol. 2021 Mar;130(3):262-272. doi: 10.1177/0003489420941542. Epub 2020 Jul 17.

Abstract

OBJECTIVES

To report experience with a global multidisciplinary tracheostomy e-learning initiative.

METHODS

An international multidisciplinary panel of experts convened to build a virtual learning community for tracheostomy care, comprising a web-based platform, five distance learning (interactive webinar) sessions, and professional discourse over 12 months. Structured pre- and post-webinar surveys were disseminated to global participants including otolaryngologists, intensivists, nurses, allied health professionals, and patients/caregivers. Data were collected on audio-visual fidelity, demographics, and pre- and post-tutorial assessments regarding experience and skill acquisition. Participants reported confidence levels for NICU, pediatric, adult, and family care, as well as technical skills, communication, learning, assessment, and subdomains.

RESULTS

Participants from 197 institutions in 22 countries engaged in the virtual education platform, including otolaryngologists, speech pathologists, respiratory therapists, specialist nurses, patients, and caregivers. Significant improvements were reported in communication ( < .0001), clinical assessments ( < .0001), and clinical governance ( < .0001), with positive impact on pediatric decannulation ( = .0008), adult decannulation ( = .04), and quality improvement ( < .0001). Respondents reported enhanced readiness to integrate knowledge into practice. Barriers included time zones, internet bandwidth, and perceived difficulty of direct clinical translation of highly technical skills. Participants rated the implementation highly in terms of length, ability for discussion, satisfaction, applicability to professional practice, and expertise of discussants (median scores: 4, 4, 4, 4 and 5 out of 5).

CONCLUSIONS

Virtual learning has dominated the education landscape during COVID-19 pandemic, but few data are available on its effectiveness. This study demonstrated feasibility of virtual learning for disseminating best practices in tracheostomy, engaging a diverse, multidisciplinary audience. Learning of complex technical skills proved a hurdle, however, suggesting need for hands-on experience for technical mastery. While interactive videoconferencing via webinar affords an engaging and scalable strategy for sharing knowledge, further investigation is needed on clinical outcomes to define effective strategies for experiential online learning and virtual in-service simulations.

摘要

目的

报告全球多学科气管切开术电子学习计划的经验。

方法

召集了一个由国际多学科专家组成的小组,建立了一个气管切开护理的虚拟学习社区,包括一个基于网络的平台、五次远程学习(互动网络研讨会)课程以及在 12 个月内的专业讨论。向耳鼻喉科医生、重症监护医生、护士、辅助医疗专业人员和患者/护理人员等全球参与者分发了结构合理的课前和课后网络研讨会调查。收集了关于视听保真度、人口统计学以及关于经验和技能获取的课前和课后教程评估的数据。参与者报告了在新生儿重症监护病房、儿科、成人和家庭护理方面的信心水平,以及技术技能、沟通、学习、评估和子领域。

结果

来自 22 个国家 197 个机构的参与者参与了虚拟教育平台,包括耳鼻喉科医生、言语病理学家、呼吸治疗师、专科护士、患者和护理人员。沟通( < .0001)、临床评估( < .0001)和临床治理( < .0001)方面有显著改善,对儿科拔管( = .0008)、成人拔管( = .04)和质量改进( < .0001)有积极影响。受访者报告说,他们更有准备将知识融入实践。障碍包括时区、互联网带宽以及将高度技术技能直接转化为临床实践的感知难度。参与者在长度、讨论能力、满意度、对专业实践的适用性和讨论者的专业知识方面对实施情况给予了高度评价(中位数评分:4、4、4、4 和 5 分中的 5 分)。

结论

虚拟学习在 COVID-19 大流行期间主导了教育格局,但关于其有效性的数据很少。本研究证明了虚拟学习在传播气管切开术最佳实践方面的可行性,吸引了来自不同学科的多元化观众。复杂技术技能的学习被证明是一个障碍,这表明需要通过实践经验来掌握技术。虽然通过网络研讨会进行交互式视频会议为分享知识提供了一种引人入胜且可扩展的策略,但需要进一步研究临床结果,以确定有效的经验在线学习和虚拟在职模拟策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d6f/7883002/6946ca3c8cae/10.1177_0003489420941542-fig1.jpg

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