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医学生非技术技能(Medi-StuNTS):开发急性护理中医学生非技术技能行为标记系统的初步工作。

Medical Students' Non-Technical Skills (Medi-StuNTS): preliminary work developing a behavioural marker system for the non-technical skills of medical students in acute care.

作者信息

Hamilton Ailsa L, Kerins Joanne, MacCrossan Marc A, Tallentire Victoria R

机构信息

NHS Lothian, Edinburgh, UK.

NHS Grampian, Aberdeen, UK.

出版信息

BMJ Simul Technol Enhanc Learn. 2018 Jun 1;5(3):130-139. doi: 10.1136/bmjstel-2018-000310. eCollection 2019.

Abstract

INTRODUCTION

Good non-technical skills (NTS) are critical to the delivery of high-quality patient care. It is increasingly recognised that training in such skills should be incorporated into primary medical training curricula. This study aimed to develop an NTS behavioural marker system (BMS), specifically applicable to medical students, for use within simulated acute care scenarios.

METHODS

The methodology used to develop other BMS was adopted and modified. Following ethical approval, 16 final year medical students participated in acute care simulated scenarios. Semistructured interviews were performed to gauge the understanding of NTS. A panel meeting of subject matter experts was convened to translate key NTS into skill elements and observable behaviours. A second expert panel was consulted to refine aspects of the BMS. Further refinement and initial face validity was undertaken by a third panel of experts using the prototype BMS to observe prerecorded simulation scenarios.

RESULTS

Five categories of NTS were identified: situation awareness, teamwork and communication, decision-making and prioritisation, self-awareness, and escalating care. Observable behaviours in each category describe good and poor performance. Escalating care was identified as a unique component that incorporated behaviours related to each of the other four skill categories. A 5-point rating scale was developed to enable both peer-to-peer and tutor-to-student feedback.

CONCLUSION

The Medi-StuNTS (Medical Students' Non-Technical Skills) system is the first BMS for the NTS of medical students. It reinforces the importance of escalating care effectively. It provides an exciting opportunity to provide feedback to medical students and may ultimately aid their preparedness for professional practice.

摘要

引言

良好的非技术技能(NTS)对于提供高质量的患者护理至关重要。人们越来越认识到,此类技能的培训应纳入初级医学培训课程。本研究旨在开发一种专门适用于医学生的NTS行为标记系统(BMS),用于模拟急性护理场景。

方法

采用并修改了用于开发其他BMS的方法。在获得伦理批准后,16名医学专业最后一年的学生参与了急性护理模拟场景。进行了半结构化访谈以评估对NTS的理解。召开了主题专家小组会议,将关键的NTS转化为技能要素和可观察到的行为。咨询了第二个专家小组以完善BMS的各个方面。第三个专家小组使用原型BMS观察预先录制的模拟场景,进行了进一步的完善和初步的表面效度评估。

结果

确定了五类NTS:态势感知、团队合作与沟通、决策与优先级排序、自我意识以及护理升级。每个类别中的可观察行为描述了良好和不佳的表现。护理升级被确定为一个独特的组成部分,它包含了与其他四个技能类别相关的行为。开发了一个5分制评分量表,以实现同伴之间和导师对学生的反馈。

结论

Medi-StuNTS(医学生非技术技能)系统是首个针对医学生NTS的BMS。它强化了有效进行护理升级的重要性。它为向医学生提供反馈提供了一个令人兴奋的机会,并最终可能有助于他们为专业实践做好准备。

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