Körner Mirjam, Dinius Julia, Ernstmann Nicole, Heier Lina, Bergelt Corinna, Hammer Antje, Pfisterer-Heise Stefanie, Kriston Levente
Medical Faculty, Institute of Medical Psychology and Medical Sociology, University of Freiburg, Freiburg, Germany.
Department of Health Professions, Competence Centre Interprofessionalism, Bern University of Applied Sciences, Bern, Switzerland.
Front Psychol. 2023 Nov 7;14:1186303. doi: 10.3389/fpsyg.2023.1186303. eCollection 2023.
Interprofessional healthcare teams are important actors in improving patient safety. To train these teams, an interprofessional training program (IPTP) with two interventions (eLearning and blended learning) was developed to cover key areas of patient safety using innovative adult learning methods. The aims of this study were to pilot test IPTP regarding its effectiveness and feasibility. The trial was registered with DRKS-ID: DRKS00012818.
The design of our study included both a pilot investigation of the effectiveness of the two interventions (eLearning and blended learning) and testing their feasibility (effectiveness-implementation hybrid design). For testing the effectiveness, a multi-center cluster-randomized controlled study with a three-arm design [intervention group 1 (IG1): eLearning vs. intervention group 2 (IG2)]: blended learning (eLearning plus interprofessional in-person training) vs. waiting control group (WCG) and three data collection periods (pre-intervention, 12 weeks post-intervention, and 24 weeks follow-up) was conducted in 39 hospital wards. Linear mixed models were used for the data analysis. The feasibility of IPTP was examined in 10 hospital wards (IG1) and in nine hospital wards (IG2) using questionnaires (formative evaluation) and problem-focused interviews with 10% of the participants in the two intervention groups. The collected data were analyzed in a descriptive exploratory manner.
Pilot testing of the effectiveness of the two interventions (eLearning and blended learning) showed no consistent differences between groups or a clear pattern in the different outcomes (safety-related behaviors in the fields of teamwork, error management, patient involvement, and subjectively perceived patient safety). Feasibility checks of the interventions showed that participants used eLearning for knowledge activation and self-reflection. However, there were many barriers to participating in eLearning, for example, lack of time or access to computers at the ward. With regard to in-person training, participants stated that the training content sensitized them to patient-safety-related issues in their everyday work, and that awareness of patient safety increased.
Although the interventions were judged to be feasible, no consistent effects were observed. A possible explanation is that the duration of training and the recurrence rate may have been insufficient. Another conceivable explanation would be that participants became more sensitive to patient safety-critical situations due to their knowledge acquired through the IPTP; therefore, their assessment post-intervention was more critical than before. In addition, the participants reported high pre-measurement outcomes. Future studies should examine the evidence of the intervention within a confirmatory study after adapting it based on the results obtained.
跨专业医疗团队是提高患者安全的重要力量。为培训这些团队，开发了一个包含两种干预措施（电子学习和混合式学习）的跨专业培训项目（IPTP），以采用创新的成人学习方法覆盖患者安全的关键领域。本研究的目的是对IPTP的有效性和可行性进行试点测试。该试验已在德国临床试验注册中心（DRKS）注册，注册号为：DRKS00012818。
我们的研究设计包括对两种干预措施（电子学习和混合式学习）有效性的试点调查以及对其可行性的测试（有效性-实施混合设计）。为测试有效性，在39个医院病房开展了一项多中心整群随机对照研究，采用三臂设计[干预组1（IG1）：电子学习；干预组2（IG2）：混合式学习（电子学习加跨专业面对面培训）；等待对照组（WCG）]以及三个数据收集阶段（干预前、干预后12周和随访24周）。数据分析采用线性混合模型。通过问卷调查（形成性评价）以及对两个干预组10%的参与者进行聚焦问题访谈，在10个医院病房（IG1）和9个医院病房（IG2）中考察IPTP的可行性。对收集到的数据进行描述性探索性分析。
对两种干预措施（电子学习和混合式学习）有效性的试点测试表明，各组之间没有一致的差异，不同结果（团队合作、差错管理、患者参与和主观感知的患者安全领域的安全相关行为）也没有明显的模式。对干预措施的可行性检查表明，参与者利用电子学习进行知识激活和自我反思。然而，参与电子学习存在许多障碍，例如，病房缺乏时间或电脑设备。关于面对面培训，参与者表示培训内容使他们在日常工作中对患者安全相关问题更加敏感，并且对患者安全的认识有所提高。
尽管干预措施被认为是可行的，但未观察到一致的效果。一个可能的解释是培训时长和重复率可能不足。另一个可以想象的解释是，参与者由于通过IPTP获得的知识，对患者安全关键情况变得更加敏感；因此，他们干预后的评估比以前更严格。此外，参与者报告干预前测量结果较高。未来的研究应在根据获得的结果进行调整后，在验证性研究中检验该干预措施的证据。
