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改善重症监护团队协作:基于模拟的跨专业培训以加强沟通与安全

Improving Critical Care Teamwork: Simulation-Based Interprofessional Training for Enhanced Communication and Safety.

作者信息

Sung Tzu-Ching, Hsu Hsiang-Chin

机构信息

School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.

School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Multidiscip Healthc. 2025 Jan 22;18:355-367. doi: 10.2147/JMDH.S500890. eCollection 2025.

Abstract

BACKGROUND

This study evaluates a simulation-based interprofessional education (IPE) program implemented at the National Cheng Kung University Hospital between 2018 and 2023. The program aimed to improve teamwork, communication, and collaboration among healthcare professionals in high-acuity environments such as emergency departments and intensive care units (ICUs).

METHODS

A prospective, mixed-methods approach was used to assess the program's effectiveness. The study enrolled 237 participants, including postgraduate medical trainees, nurses, respiratory therapists, and administrative staff. Two high-fidelity clinical scenarios-multiple trauma and respiratory distress with shock-were designed to simulate real-world emergencies. Participants' teamwork performance was evaluated using the Team Emergency Assessment Measure (TEAM), while qualitative feedback was collected via structured questionnaires and thematically analyzed.

RESULTS

Quantitative analysis revealed significant improvement in leadership communication (p = 0.0328) and positive trends in teamwork dimensions such as completion and effective communication. However, global team performance showed only modest numerical gains. (p=0.5201) Qualitative feedback highlighted recurring themes such as unclear task delegation, delayed recognition of patient condition changes, and inconsistent use of communication techniques like call-outs and check-backs.

CONCLUSION

The simulation-based IPE program significantly enhanced interprofessional collaboration and clinical competencies among participants. However, specific areas, particularly communication, leadership, and situational awareness, require further attention in future training sessions. These findings underscore the importance of continuous refinement of simulation programs to prepare healthcare teams for high-stakes clinical scenarios effectively.

摘要

背景

本研究评估了2018年至2023年在国立成功大学医院实施的基于模拟的跨专业教育(IPE)项目。该项目旨在改善急诊科和重症监护病房(ICU)等高急症环境中医疗专业人员之间的团队合作、沟通与协作。

方法

采用前瞻性混合方法评估该项目的有效性。该研究招募了237名参与者,包括医学研究生学员、护士、呼吸治疗师和行政人员。设计了两个高保真临床场景——多发伤和伴有休克的呼吸窘迫——以模拟现实世界中的紧急情况。使用团队紧急评估量表(TEAM)评估参与者的团队合作表现,同时通过结构化问卷收集定性反馈并进行主题分析。

结果

定量分析显示领导沟通有显著改善(p = 0.0328),并且在团队合作维度如完成情况和有效沟通方面有积极趋势。然而,整体团队表现仅显示出适度的数值提升(p = 0.5201)。定性反馈突出了反复出现的主题,如任务分配不明确、对患者病情变化的识别延迟以及呼叫和确认等沟通技巧的使用不一致。

结论

基于模拟的IPE项目显著增强了参与者之间的跨专业协作和临床能力。然而,在未来的培训课程中,特定领域,特别是沟通、领导和情境意识,需要进一步关注。这些发现强调了持续完善模拟项目以有效让医疗团队为高风险临床场景做好准备的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e549/11769723/8e3abb9be8cf/JMDH-18-355-g0001.jpg

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