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用于培训卫生专业住院医师保密及社交网络使用的临床模拟项目。

Clinical Simulation Program for the Training of Health Profession Residents in Confidentiality and the Use of Social Networks.

作者信息

Martínez-Arce Alejandro, Bermejo-Cantarero Alberto, Muñoz de Morales-Romero Laura, Baladrón-González Víctor, Bejarano-Ramírez Natalia, Verdugo-Moreno Gema, Montero-Gaspar María Antonia, Redondo-Calvo Francisco Javier

机构信息

Advanced Clinical Simulation Center, General University Hospital of Ciudad Real (HGUCR), 13005 Ciudad Real, Spain.

Faculty of Nursing, Universidad de Castilla-La Mancha, 13005 Ciudad Real, Spain.

出版信息

Nurs Rep. 2024 Oct 17;14(4):3040-3051. doi: 10.3390/nursrep14040221.

Abstract

In the transition to a professional learning environment, healthcare professionals in their first year of specialized postgraduate clinical training (known as residents in Spain) are suddenly required to handle confidential information with little or no prior training in the safe and appropriate use of digital media with respect to confidentiality issues. The aims of this study were: (1) to explore the usefulness of an advanced clinical simulation program for educating residents from different healthcare disciplines about confidentiality and the dissemination of clinical data or patient images; (2) to explore the use of social networks in healthcare settings; and (3) to explore participants' knowledge and attitudes on current regulations regarding confidentiality, image dissemination, and the use of social networks; Methods: This was a cross-sectional study. Data were collected from all 49 first-year residents of different health professions at a Spanish hospital between June and August 2022. High-fidelity clinical simulation sessions designed to address confidentiality and health information dissemination issues in hospital settings, including the use of social networks, were developed and implemented. Data were assessed using a 12-item ad hoc questionnaire on confidentiality and the use of social media in the healthcare setting. Descriptive of general data and chi-square test or Fisher's exact test were performed using the SPSS 25.0 software; Results: All the participants reported using the messaging application WhatsApp regularly during their working day. A total of 20.4% of the participants stated that they had taken photos of clinical data (radiographs, analyses, etc.) without permission, with 40.8% claiming that they were unaware of the legal consequences of improper access to clinical records. After the course, the participants reported intending to modify their behavior when sharing patient data without their consent and with respect to how patients are informed; Conclusions: The use of advanced simulation in the training of interprofessional teams of residents is as an effective tool for initiating attitudinal change and increasing knowledge related to patient privacy and confidentiality. Further follow-up studies are needed to see how these attitudes are incorporated into clinical practice.

摘要

在向专业学习环境过渡的过程中,处于专业研究生临床培训第一年的医疗保健专业人员(在西班牙称为住院医师)突然需要处理机密信息,但在数字媒体安全且恰当地用于保密问题方面几乎没有或根本没有接受过事先培训。本研究的目的是:(1)探索一个先进的临床模拟程序对于教育来自不同医疗保健学科的住院医师有关保密以及临床数据或患者图像传播的有用性;(2)探索社交网络在医疗环境中的使用;(3)探索参与者对当前有关保密、图像传播和社交网络使用的法规的知识和态度;方法:这是一项横断面研究。2022年6月至8月期间,从西班牙一家医院的所有49名不同健康专业的一年级住院医师那里收集了数据。开发并实施了旨在解决医院环境中保密和健康信息传播问题(包括社交网络的使用)的高保真临床模拟课程。使用一份关于医疗保健环境中保密和社交媒体使用的12项特设问卷对数据进行评估。使用SPSS 25.0软件进行一般数据的描述性统计以及卡方检验或费舍尔精确检验;结果:所有参与者都报告在工作日经常使用即时通讯应用程序WhatsApp。共有20.4%的参与者表示他们未经许可拍摄过临床数据(X光片、分析报告等),40.8%的人声称他们不知道不当获取临床记录的法律后果。课程结束后,参与者报告打算在未经患者同意分享患者数据以及告知患者方式方面改变自己的行为;结论:在住院医师跨专业团队培训中使用先进模拟是引发态度改变和增加与患者隐私和保密相关知识的有效工具。需要进一步的后续研究来观察这些态度如何融入临床实践。

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