Ashcroft James, Wilkinson Aimee, Khan Mansoor
Imperial College London, London, United Kingdom; Department of Surgery & Cancer, St. Mary's Hospital, London, United Kingdom.
Imperial College London, London, United Kingdom.
J Surg Educ. 2021 Jan-Feb;78(1):245-264. doi: 10.1016/j.jsurg.2020.07.001. Epub 2020 Jul 21.
Crew Resource Management (CRM) training incorporates methods such as simulation, debrief, and teamwork training to emphasize human factors skills. This systematic review aimed to assess differences in CRM between UK and USA trauma personnel.
A structured search of the databases MEDLINE and Embase in addition to unstructured reference review and Google Scholar search was undertaken without time restraint to identify articles describing CRM training courses of trauma personnel. Predetermined criteria for inclusion included comprehensive reports of CRM training in trauma personnel with participant assessment. Articles were analyzed for course details and descriptions, Kirkpatrick domains and levels utilized, and measure items and outcomes.
Twenty-nine full-text articles (24 USA, 5 UK) met predetermined criteria. UK-based CRM had a heavy emphasis on doctors while USA-based CRM reached a range of multidisciplinary civilian and military professionals. UK-based CRM focused on skills outcomes using pre- and post-training questionnaires, whereas USA-based training focused on behavior and nontechnical skills utilizing validated standardized measures. CRM-based training, and particularly courses incorporating simulation and multidisciplinary methods, resulted in significantly improved preparedness for trauma, emergency skills, and clinical behavioral change.
CRM training has the potential to give significant benefits to participant learning, teamwork behaviors, and clinical care outcomes. The USA appears to utilize a focused multidisciplinary and human factors approach to trauma training, which could be adopted by UK institutions to improve cohesive team performance and patient care.
机组资源管理（CRM）培训采用模拟、汇报和团队合作培训等方法来强调人为因素技能。本系统评价旨在评估英国和美国创伤急救人员在CRM方面的差异。
除了无时间限制地对数据库MEDLINE和Embase进行结构化检索外，还进行了非结构化参考文献审查和谷歌学术搜索，以识别描述创伤急救人员CRM培训课程的文章。纳入的预定标准包括对创伤急救人员CRM培训的全面报告及参与者评估。对文章的课程细节和描述、所采用的柯克帕特里克领域和层次以及测量项目和结果进行了分析。
29篇全文文章（24篇来自美国，5篇来自英国）符合预定标准。英国的CRM非常重视医生，而美国的CRM涵盖了一系列多学科的 civilian 和 military 专业人员。英国的CRM使用培训前和培训后的问卷来关注技能成果，而美国的培训则使用经过验证的标准化测量方法来关注行为和非技术技能。基于CRM的培训，尤其是包含模拟和多学科方法的课程，显著提高了创伤急救准备、应急技能和临床行为改变。
CRM培训有可能为参与者的学习、团队合作行为和临床护理结果带来显著益处。美国似乎采用了一种针对创伤培训的多学科和人为因素方法，英国机构可以采用这种方法来提高团队凝聚力和患者护理水平。
