From the Department of Pediatrics, Emory University School of Medicine (V.M.); Department of Anesthesiology and Pain Management (R.B., A.A.), University of Texas Southwestern Medical Center; Department of Population and Data Sciences (J.R.); Ford Audio Video, LLC (M.K.), Irving; and Simulation Center (D.H.), University of Texas Southwestern Medical School, Dallas, TX.
Simul Healthc. 2021 Dec 1;16(6):e181-e187. doi: 10.1097/SIH.0000000000000539.
Teamwork failures are a major source of preventable error in medicine. Acquisition of skills early in training seems beneficial for impacting system-level change. Simulation-based curricula provide a psychologically safe and formative environment to learn and practice team skills. This project aims to assess teamwork and communication skill acquisition in preclerkship medical students during a longitudinal simulation-based curriculum.
This is a prospective, observational study of medical students participating in a high-technology simulation curriculum on team principles. Students, in groups of 5 to 7, participated in 6 mannequin-based simulation sessions over 10 months coordinated with an organ system-based preclerkship course. Each scenario was executed by a simulation technologist and guided by a simulation educator who functioned as a bedside nurse and led a postsimulation debrief. Likert-based, self- and global assessments completed by students and facilitators, respectively, were used to evaluate the teams. Descriptive statistics and Mann-Whitney U test were used to analyze data using a P value of less than 0.05 for statistical significance and a null hypothesis stating that there would be no change in behavior. The primary outcome measure was improvement in the teamwork and communication domains of both assessments.
Students (N = 231) were divided into the same 32 groups during every session. At the end of every session, each student completed a self-assessment and each educator completed the team's global assessment for teamwork. Median scores for teamwork and communication domains increased between the first and sixth sessions on both assessments. Mann-Whitney U analysis of self-assessment scores showed Z values between -5.30 and -8.83 and P values of less than 0.00001. Mann-Whitney U analysis of global assessment scores showed Z values ranging from -3.43 to -5.24 and P values between 0.0031 and less than 0.00001.
There was meaningful improvement in scores in the domains of teamwork and communication over the 10-month, simulation-based curriculum designed to teach and hone teamwork skills.
团队合作失败是医学中可预防错误的主要来源。在培训早期获得技能似乎有利于影响系统层面的改变。基于模拟的课程为学习和实践团队技能提供了一个心理安全和形成性的环境。本项目旨在评估医学生在预临床阶段通过基于模拟的课程获得团队合作和沟通技能。
这是一项针对参与基于团队原则的高科技模拟课程的医学生的前瞻性观察研究。学生以 5 到 7 人的小组形式参加了 10 个月内的 6 次基于人体模型的模拟课程，与基于器官系统的预临床课程相协调。每个场景都由一名模拟技术员执行，并由一名模拟教育者指导，该教育者充当床边护士并领导场景后的讨论。学生和指导者分别完成基于李克特量表的自我评估和全球评估，以评估团队。使用描述性统计和曼-惠特尼 U 检验分析数据，使用 P 值小于 0.05 表示具有统计学意义，零假设表示行为不会发生变化。主要的结果衡量标准是两个评估中团队合作和沟通领域的改善。
学生（N=231）在每次课程中都被分为相同的 32 个小组。在每次课程结束时，每个学生都完成了自我评估，每个教育者都完成了团队的团队合作全球评估。在两个评估中，团队合作和沟通领域的中位数分数在第一和第六次课程之间都有所提高。自我评估分数的曼-惠特尼 U 分析显示 Z 值在-5.30 到-8.83 之间，P 值小于 0.00001。全球评估分数的曼-惠特尼 U 分析显示 Z 值范围从-3.43 到-5.24，P 值在 0.0031 到小于 0.00001 之间。
在设计用于教授和磨练团队合作技能的为期 10 个月的基于模拟的课程中，团队合作和沟通领域的分数有了显著提高。
