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团队STEPPS在线模拟:扩大医学生团队合作培训的获取途径。

TeamSTEPPS online simulation: expanding access to teamwork training for medical students.

作者信息

Burns Rebekah, Gray Megan, Peralta Dana, Scheets Andrew, Umoren Rachel

机构信息

Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.

Division of Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA.

出版信息

BMJ Simul Technol Enhanc Learn. 2021 Jan 7;7(5):372-378. doi: 10.1136/bmjstel-2020-000649. eCollection 2021.

Abstract

BACKGROUND

The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) programme is an evidence-based approach to teamwork training. In-person education is not always feasible for medical student education. The aim of this study was to evaluate the impact of online, interactive TeamSTEPPS simulation versus an in-person simulation on medical students' TeamSTEPPS knowledge and attitudes.

METHODS

Fourth-year medical students self-selected into an in-person or online training designed to teach and evaluate teamwork skills. In-person participants received didactic sessions, team-based medical simulations and facilitated debriefing sessions. The online group received an equivalent online didactic session and participated in an interactive software-based simulation with immediate, personalised performance-based feedback and scripted debriefing. Both trainings used three iterations of a case of septic shock, each with increasing medical complexity. Participants completed a demographic survey, a preintervention/postintervention TeamSTEPPS Benchmarks test and a retrospective preintervention/postintervention TeamSTEPPS teamwork attitudes questionnaire. Data were analysed using descriptive statistics and repeated measures analysis of variance.

RESULTS

Thirty-one students (18 in-person, 13 online) completed preintervention/postintervention surveys, tests and questionnaires. Gender, age and exposure to interprofessional education, teamwork training and games were similar between groups. There were no statistical differences in preintervention knowledge or teamwork attitude scores between in-person and online groups. Postintervention knowledge scores increased significantly from baseline (+2.0% p=0.047), and these gains did not differ significantly based on whether participants received in-person versus online training (+1.5% vs +2.9%; p=0.49). Teamwork attitudes scores also showed a statistically significant increase with training (+0.9, p<0.01) with no difference in the effect of training by group (+0.8 vs +1.0; p=0.64).

CONCLUSIONS

Graduating medical students who received in-person and online teamwork training showed similar increases in TeamSTEPPS knowledge and attitudes. Online simulations may be used to teach and reinforce team communication skills when in-person, interprofessional simulations are not feasible.

摘要

背景

团队策略与工具提升绩效和患者安全(TeamSTEPPS)项目是一种基于证据的团队合作培训方法。对于医学生教育而言,面对面教育并不总是可行的。本研究的目的是评估在线交互式TeamSTEPPS模拟与面对面模拟对医学生的TeamSTEPPS知识和态度的影响。

方法

四年级医学生自行选择参加旨在教授和评估团队合作技能的面对面或在线培训。面对面参与的学生接受理论课程、基于团队的医学模拟以及有指导的汇报环节。在线组接受同等的在线理论课程,并参与基于软件的交互式模拟,该模拟提供即时、个性化的基于表现的反馈以及脚本化的汇报。两种培训都使用了三次感染性休克病例模拟,每次模拟的医学复杂性都逐步增加。参与者完成了一份人口统计学调查问卷、干预前/干预后TeamSTEPPS基准测试以及一份回顾性的干预前/干预后TeamSTEPPS团队合作态度问卷。使用描述性统计和重复测量方差分析对数据进行分析。

结果

31名学生(18名面对面,13名在线)完成了干预前/干预后调查、测试和问卷。两组在性别、年龄以及接受跨专业教育、团队合作培训和游戏的经历方面相似。面对面组和在线组在干预前的知识或团队合作态度得分上没有统计学差异。干预后的知识得分从基线显著提高(+2.0%,p = 0.047),并且基于参与者接受的是面对面培训还是在线培训,这些提高没有显著差异(+1.5%对+2.9%;p = 0.49)。团队合作态度得分在培训后也显示出统计学上的显著提高(+0.9,p < 0.01),且两组培训效果没有差异(+0.8对+1.0;p = 0.64)。

结论

接受面对面和在线团队合作培训的即将毕业的医学生在TeamSTEPPS知识和态度方面的提高相似。当面对面的跨专业模拟不可行时,在线模拟可用于教授和强化团队沟通技能。

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本文引用的文献

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Moving the Needle: Simulation's Impact on Patient Outcomes.推动变革:模拟对患者结局的影响。
Surg Clin North Am. 2015 Aug;95(4):827-38. doi: 10.1016/j.suc.2015.03.005. Epub 2015 Apr 22.

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