Department of Pediatrics and Child Health, and Department of Educational Development, The Aga Khan University, Karachi, Pakistan.
Family Medicine Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt.
BMC Med Educ. 2024 Jun 11;24(1):649. doi: 10.1186/s12909-024-05459-2.
BACKGROUND: The healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment. METHODS: This study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick's Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training. RESULTS: Thirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants' pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing. CONCLUSIONS: The study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.
背景:医疗体系非常复杂,不良事件通常是人为因素和系统故障共同导致的,尤其是在危机情况下。危机资源管理技能对于优化此类情况下的团队表现和患者结局至关重要。基于模拟的培训为在可控和真实的环境中发展此类技能提供了一种有前景的方法。
方法:本研究采用混合方法(定量-定性)设计,旨在评估在一家三级保健医院的儿科跨专业团队中,基于模拟的培训课程对危机资源管理技能的发展效果。采用柯克帕特里克模型(Kirkpatrick's Model)评估干预的效果,重点关注反应和学习水平,使用协作和护理决策满意度量表、临床团队合作量表和渥太华全球评定量表进行干预前后评估。对参与者进行焦点小组讨论,以探讨他们对培训的体验和看法。
结果:共有 39 名参与者,包括医学生、护士和住院医师,参与了这项研究。与参与者的培训前表现相比,在培训后,所有测量的团队合作和表现组成部分都有显著改善,包括团队沟通(3.16±1.20 至 7.61±1.0,p<0.001)、决策制定(3.50±1.54 至 7.16±1.42,p<0.001)、领导技能(2.50±1.04 至 5.44±0.6,p<0.001)和态势感知(2.61±1.13 至 5.22±0.80,p<0.001)方面的得分均有提高。干预后不同团队之间没有显著差异。此外,参与者报告满意度高,认为培训在提高他们的危机资源管理技能方面非常有价值,并强调了角色分配和讨论的重要性。
结论:本研究强调了基于模拟的培训在发展儿科跨专业团队的危机资源管理技能方面的有效性。研究结果表明,此类培训可以影响学习向工作场所的转移,最终改善患者结局。我们研究中的发现为持续完善基于模拟的培训计划提供了额外的有价值的考虑因素。需要开发更全面的临床技能评估方法,以更好地评估这些技能在现实环境中的可转移性。我们研究中揭示的潜在挑战,例如培训期间的身体疲劳,在完善和设计此类干预措施时必须加以考虑。
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