Escher Cecilia, Rystedt Hans, Creutzfeldt Johan, Meurling Lisbet, Hedman Leif, Felländer-Tsai Li, Kjellin Ann
Center for Advanced Medical Simulation and Training (CAMST), Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Adv Simul (Lond). 2023 Jul 17;8(1):18. doi: 10.1186/s41077-023-00257-0.
Operating rooms have become more technically complex due to new advanced procedures, which has increased demands on teamwork in the operating room. In response, team training has been proposed to improve team performance, workplace culture, and patient safety. We developed and delivered a simulation-based team training course for entire professional surgical teams. This type of intervention has been proposed by researchers but has not been widely published. The aims of this intervention study were to examine participants' reactions to the course in terms of their motivation for the training and their self-efficacy in relation to their performance, as well as their views on transferring the lessons learned in the course to their workplace.
In a prospective mixed-methods intervention study, operating room professionals participated in a full-day simulation-based teamwork training course. Learning objectives were nontechnical skills, specifically communication and collaboration across the team. Seventy-one staff members representing 5 operating room professions were included, and the average work experience of participants was 6 years. Quantitative data on self-efficacy and situational motivation were collected by questionnaires before and after training. Qualitative data were collected through 5 focus group interviews that took place in direct relation to the courses and included a total of 31 participants. Transcripts were coded and analyzed using thematic analysis.
All occupations showed a similar pattern in terms of increases in self-efficacy and intrinsic motivation after the training. Analysis of the qualitative data showed that training in one's profession and in authentic multiprofessional teams was important factors for motivation. Participating staff described an awareness of undesirable communication barriers in surgical teams that can lead to risks for patients. Systematic training was definitely perceived as a means to reduce barriers and improve communication and collaboration.
Simulation-based training was equally well received by all professional groups. Our results confirm the feasibility of this type of training for professional teams and promising opportunities for improving teamwork skills. The qualitative data reveal both opportunities and limitations for transferring the learning experiences to the workplace.
由于新的先进手术程序，手术室的技术复杂性日益增加，这对手术室团队协作提出了更高要求。作为回应，团队培训被提出来以提高团队绩效、工作场所文化和患者安全。我们为整个专业手术团队开发并提供了一个基于模拟的团队培训课程。研究人员已提出这种干预方式，但尚未广泛发表。这项干预研究的目的是从参与者对培训的动机、与绩效相关的自我效能感以及他们对将课程中学到的经验应用到工作场所的看法等方面，考察他们对该课程的反应。
在一项前瞻性混合方法干预研究中，手术室专业人员参加了为期一天的基于模拟的团队协作培训课程。学习目标是非技术技能，特别是团队内部的沟通与协作。纳入了代表5个手术室专业的71名工作人员，参与者的平均工作经验为6年。通过培训前后的问卷调查收集关于自我效能感和情境动机的定量数据。通过与课程直接相关的5次焦点小组访谈收集定性数据，共有31名参与者。对访谈记录进行编码并使用主题分析法进行分析。
所有职业在培训后自我效能感和内在动机的提升方面都呈现出相似的模式。定性数据分析表明，在自己的专业领域以及真实的多专业团队中进行培训是激发动机的重要因素。参与培训的工作人员描述了意识到手术团队中存在不良沟通障碍，这些障碍可能给患者带来风险。系统培训无疑被视为减少障碍、改善沟通与协作的一种手段。
基于模拟的培训受到了所有专业群体的同等好评。我们的结果证实了这种培训方式对专业团队的可行性以及提升团队协作技能的良好前景。定性数据揭示了将学习经验应用到工作场所的机会和局限性。
