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基于模拟的教育以提高沟通技巧:系统评价与当前最佳实践的识别

Simulation-based education to improve communication skills: a systematic review and identification of current best practice.

作者信息

Blackmore Andrew, Kasfiki Eirini Vasileiou, Purva Makani

机构信息

Hull Institute for Learning and Simulation, Hull, UK.

Hull and East Yorkshire Hospitals NHS Trust, Hull, UK.

出版信息

BMJ Simul Technol Enhanc Learn. 2018 Oct 4;4(4):159-164. doi: 10.1136/bmjstel-2017-000220. eCollection 2018.

Abstract

BACKGROUND

Good communication in healthcare between professionals and between professionals and patients is important in delivering high-quality care. Evidence of translation of technical skills taught through simulation into the clinical environment has been demonstrated, but the evidence for the impact of communication skills is less well known.

OBJECTIVES

To identify and critically appraise the evidence for the impact of communication taught through simulation-based education (SBE) and use this evidence to suggest a model for future SBE interventions for communication skills.

STUDY SELECTION

MEDLINE, CINAHL, EMBASE and PsycINFO were searched for articles pertaining to communication skills taught through simulation. A content expert was consulted to suggest additional studies. 1754 studies were initially screened for eligibility, with 274 abstracts screened further. 147 full-text articles were further assessed for eligibility, with 79 of these excluded. The remaining 68 studies were reviewed and 18 studies were included in the qualitative synthesis as studies designed to show benefits beyond the simulation centre.

FINDINGS

The 18 identified studies with an impact at a Kirkpatrick level of ≥3, are analysed; 4 looking specifically at communication between healthcare professionals and 14 looking at communication between health professionals and patients or relatives.

CONCLUSIONS

There is some evidence that the improvements in communication taught through simulation can be translated into benefits measurable beyond the simulation centre, but this evidence is limited due to the way that most of the studies are designed. We suggest a model for SBE aimed at teaching communication skills that is informed by the current evidence and takes into account the need to collect higher-level outcome data.

摘要

背景

在医疗保健领域,专业人员之间以及专业人员与患者之间的良好沟通对于提供高质量护理至关重要。通过模拟教学的技术技能转化到临床环境中的证据已得到证实,但沟通技能影响方面的证据却鲜为人知。

目的

识别并严格评估通过基于模拟的教育(SBE)教授沟通所产生影响的证据,并利用该证据为未来沟通技能的SBE干预措施提出一个模型。

研究选择

检索MEDLINE、CINAHL、EMBASE和PsycINFO数据库,查找与通过模拟教授沟通技能相关的文章。咨询了一位内容专家以推荐其他研究。最初筛选了1754项研究的资格,进一步筛选了274篇摘要。对147篇全文文章进行了资格进一步评估,其中79篇被排除。对其余68项研究进行了综述,18项研究被纳入定性综合分析,这些研究旨在证明在模拟中心之外的益处。

研究结果

对18项在柯克帕特里克水平≥3具有影响的已识别研究进行了分析;4项专门研究医疗保健专业人员之间的沟通,14项研究医疗保健专业人员与患者或亲属之间的沟通。

结论

有一些证据表明,通过模拟教授的沟通改善可以转化为在模拟中心之外可衡量的益处,但由于大多数研究的设计方式,这一证据有限。我们提出了一个旨在教授沟通技能的SBE模型,该模型以当前证据为依据,并考虑到收集更高层次结果数据的必要性。

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