Acad Med. 2024 Dec 1;99(12S Suppl 1):S48-S55. doi: 10.1097/ACM.0000000000005866. Epub 2024 Sep 6.
Incivility in the health care workplace is increasing and negatively impacts everyone in the environment, including health care team members and the patients and families they serve. This study examined the efficacy and impact of Civility Champions (CCs), a novel training program for a multidisciplinary cohort of faculty and graduate medical education (GME) trainees based in principles of trauma-informed care, nonviolent communication, and restorative practices.
Participants were 39 faculty and GME trainees representing 6 departments in a major academic medical center. The concurrent, mixed-methods study employed the Kirkpatrick New World Model as a framework for the creation of the evaluation tools as well as to analyze and report the results of the study. Quantitative and qualitative data analysis examined participants' reactions, perceived learning, workplace use of the skills following training, and initial indicators of whether the program is on track to meet its goals.
Participants found CCs training to be valuable (84.6% agree or strongly agree that training was relevant and would recommend it to others). Post-training, CCs felt an increased sense of confidence and commitment using the skills and knowledge learned as indicated by a positive average change score ( P < .05) on all measures. At the 6-month survey, 70% of CCs had employed the skills. Results on the implementation of the CCs program found that key success factors include improving program visibility, providing opportunities for skill refreshment, and fostering a supportive community.
This study expanded a novel training program to multidisciplinary departments and provided early evaluation of the efficacy of the training in the health care workplace. CCs training showed significant measurable benefit using both quantitative and qualitative measures. Future iterations will include training interdisciplinary cohorts and will attempt to assess the program's impact on institutional culture.
医疗工作场所的不文明行为日益增多,对环境中的每个人都产生了负面影响,包括医疗团队成员以及他们所服务的患者和家属。本研究调查了文明使者(Civility Champions,CCs)的效果和影响,这是一个针对多学科教员和住院医师规范化培训(graduate medical education,GME)学员的新型培训项目,其培训基础是创伤知情护理、非暴力沟通和修复性实践原则。
参与者为来自一家大型学术医疗中心 6 个部门的 39 名教员和 GME 学员。这项同期进行的混合方法研究采用了柯克帕特里克新世界模型(Kirkpatrick New World Model)作为创建评估工具的框架,并分析和报告研究结果。定量和定性数据分析检查了参与者的反应、感知学习、培训后在工作场所使用技能的情况,以及该计划是否有望实现其目标的初步指标。
参与者认为 CCs 培训很有价值(84.6%的人表示培训内容相关且会推荐给他人)。培训后,CCs 表示在使用所学技能和知识方面更有信心和承诺,所有措施的平均变化得分均为正(P<0.05)。在 6 个月的调查中,70%的 CCs 已经运用了这些技能。关于 CCs 项目实施的结果发现,关键的成功因素包括提高项目可见度、提供技能更新机会和培养支持性社区。
本研究将一项新型培训项目扩展到多学科部门,并对培训在医疗工作场所的效果进行了早期评估。CCs 培训在使用定量和定性措施方面均显示出显著的可衡量的益处。未来的迭代将包括培训跨学科群体,并尝试评估该计划对机构文化的影响。