Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
MedLed Ltd, Slough, UK.
BJS Open. 2022 Mar 8;6(2). doi: 10.1093/bjsopen/zrac011.
Human factors (HF) integration can improve patient safety in the operating room (OR), but the depth of current knowledge remains unknown. This study aimed to explore the content of HF training for the operative environment.
We searched six bibliographic databases for studies describing HF interventions for the OR. Skills taught were classified using the Chartered Institute of Ergonomics and Human Factors (CIEHF) framework, consisting of 67 knowledge areas belonging to five categories: psychology; people and systems; methods and tools; anatomy and physiology; and work environment.
Of 1851 results, 28 studies were included, representing 27 unique interventions. HF training was mostly delivered to interdisciplinary groups (n = 19; 70 per cent) of surgeons (n = 16; 59 per cent), nurses (n = 15; 56 per cent), and postgraduate surgical trainees (n = 11; 41 per cent). Interactive methods (multimedia, simulation) were used for teaching in all studies. Of the CIEHF knowledge areas, all 27 interventions taught 'behaviours and attitudes' (psychology) and 'team work' (people and systems). Other skills included 'communication' (n = 25; 93 per cent), 'situation awareness' (n = 23; 85 per cent), and 'leadership' (n = 20; 74 per cent). Anatomy and physiology were taught by one intervention, while none taught knowledge areas under work environment.
Expanding HF education requires a broader inclusion of the entirety of sociotechnical factors such as contributions of the work environment, technology, and broader organizational culture on OR safety to a wider range of stakeholders.
人为因素(HF)的整合可以提高手术室(OR)的患者安全性,但目前的知识深度尚不清楚。本研究旨在探讨操作性环境中 HF 培训的内容。
我们在六个文献数据库中搜索了描述 OR 中 HF 干预措施的研究。使用英国人机工程学和人类因素学会(CIEHF)框架对教授的技能进行分类,该框架由 67 个属于五个类别的知识领域组成:心理学;人和系统;方法和工具;解剖学和生理学;和工作环境。
在 1851 项结果中,纳入了 28 项研究,代表了 27 项独特的干预措施。HF 培训主要针对跨学科团队(n = 19;70%)的外科医生(n = 16;59%)、护士(n = 15;56%)和研究生外科受训者(n = 11;41%)。所有研究都使用了互动方法(多媒体、模拟)进行教学。在 CIEHF 的知识领域中,所有 27 项干预措施都教授了“行为和态度”(心理学)和“团队合作”(人和系统)。其他技能包括“沟通”(n = 25;93%)、“情境意识”(n = 23;85%)和“领导力”(n = 20;74%)。一项干预措施教授了解剖学和生理学,而没有一项干预措施教授工作环境下的知识领域。
扩大 HF 教育需要更广泛地纳入工作环境、技术以及更广泛的组织文化等社会技术因素,以更广泛的利益相关者为对象,提高 OR 安全性。