Purdy Eve, Borchert Laura, El-Bitar Anthony, Isaacson Warwick, Bills Lucy, Brazil Victoria
Gold Coast University Hospital Emergency Department, Southport, Queensland, Australia.
Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia.
Adv Simul (Lond). 2022 Feb 5;7(1):5. doi: 10.1186/s41077-022-00201-8.
Simulation facilitators strive to ensure the psychological safety of participants during simulation events; however, we have limited understanding of how antecedent levels of psychological safety impact the simulation experience or how the simulation experience impacts real-world psychological safety.
We explored the experience of participants in an embedded, interprofessional simulation program at a large tertiary emergency department (ED) in Australia. We engaged in theoretical thematic analysis of sequential narrative surveys and semi-structured interviews using a previously derived framework of enablers of psychological safety in healthcare. We sought to understand (1) how real-world psychological safety impacts the simulation experience and (2) how the simulation experience influences real-world psychological safety.
We received 74 narrative responses and conducted 19 interviews. Simulation experience was both influenced by and impacted psychological safety experienced at the individual, team, and organizational levels of ED practice. Most strikingly, simulation seemed to be an incubator of team familiarity with direct impact on real-world practice. We present a model of the bidirectional impact of psychological safety and simulation within healthcare environments.
Our model represents both opportunity and risk for facilitators and organizations engaging in simulation. It should inform objectives, design, delivery, debriefing, and faculty development and firmly support the situation of simulation programs within the broader cultural ethos and goals of the departments and organizations.
模拟培训引导者努力在模拟活动期间确保参与者的心理安全；然而，我们对心理安全的前期水平如何影响模拟体验，或者模拟体验如何影响现实世界中的心理安全了解有限。
我们探究了澳大利亚一家大型三级急诊科中一个嵌入式跨专业模拟项目参与者的体验。我们使用先前得出的医疗保健领域心理安全促进因素框架，对连续叙事调查和半结构化访谈进行了理论主题分析。我们试图了解：（1）现实世界中的心理安全如何影响模拟体验；（2）模拟体验如何影响现实世界中的心理安全。
我们收到了74份叙事回复并进行了19次访谈。模拟体验受到急诊科实践中个人、团队和组织层面心理安全的影响，同时也对其产生影响。最引人注目的是，模拟似乎是团队熟悉度的孵化器，对现实世界的实践有直接影响。我们提出了一个医疗保健环境中心理安全与模拟双向影响的模型。
我们的模型对参与模拟的引导者和组织而言既代表机遇也意味着风险。它应为目标设定、设计、实施、总结汇报及教员发展提供指导，并坚定支持模拟项目在各科室和组织更广泛的文化精神及目标中的地位。
