Assistant Professor, Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston.
Third-Year Resident, Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston.
MedEdPORTAL. 2023 Aug 16;19:11335. doi: 10.15766/mep_2374-8265.11335. eCollection 2023.
Biases in communication can be harmful to patient perceptions of care and the medical team's decision-making. Optimal communication must be taught and practiced similarly to the optimal management of the complex medical conditions associated with sickle cell disease (SCD). This simulation is designed to teach about biases, optimizing communication to and about a patient with SCD, and appropriately diagnosing and managing pediatric osteomyelitis as a complication of SCD.
We designed and implemented a simulation case targeting emergency medicine residents and fellows to raise awareness about biases associated with SCD care and the complication of osteomyelitis in children with SCD. The case was delivered as a scheduled educational activity. Guided debriefing about optimizing care and communication for this patient population followed the simulation. We measured outcomes based on facilitator field notes and participant evaluations (Likert-scale and open-response questions).
Forty learners of varying medical practice proficiencies, societal experiences, and demographics participated, with 30 completing the postsimulation feedback survey. A majority (97%) of participants indicated that the experience was useful and would improve their clinical performance. Participants learned from each other's language and communication styles and reflected on their own communication.
Overall, participants found the simulation very useful as a review of the medical diagnosis and management of osteomyelitis in pediatric SCD. Moreover, they were very engaged and interested in the opportunity to learn about communication biases, particularly as these relate to SCD, to optimize their patient care.
沟通中的偏见可能会影响患者对医护的看法，并影响医疗团队的决策。最佳的沟通方式必须像管理与镰状细胞病（SCD）相关的复杂医疗情况一样进行教授和实践。本模拟旨在教授有关偏见、优化针对 SCD 患者的沟通，以及适当诊断和管理 SCD 并发症儿童骨髓炎的知识。
我们设计并实施了一项针对急诊住院医师和研究员的模拟案例，以提高他们对 SCD 护理相关偏见的认识，以及儿童 SCD 并发骨髓炎的认识。该案例作为一项预定的教育活动进行。模拟后，对针对该患者群体的优化护理和沟通进行引导式讨论。我们根据主持人的现场记录和参与者的评估（李克特量表和开放性问题）来衡量结果。
有 40 名具有不同医疗实践能力、社会经验和人口统计学特征的学习者参加了此次模拟，其中 30 人完成了模拟后的反馈调查。大多数（97%）参与者表示，该体验很有用，会提高他们的临床表现。参与者从彼此的语言和沟通方式中学习，并反思自己的沟通方式。
总体而言，参与者认为该模拟非常有用，可用于复习儿童 SCD 骨髓炎的医学诊断和管理。此外，他们非常投入且有兴趣了解沟通偏见的机会，特别是与 SCD 相关的偏见，以优化他们的患者护理。
