Jitwiriyanont Sujinat, Rawan Rattanasuwan, Narajeenron Khuansiri
Department of Linguistics and Center of Excellence in Southeast Asian Linguistics, Faculty of Arts, Chulalongkorn University, Bangkok, Thailand.
Department of Foreign Languages, Faculty of Liberal Arts, Rajamangala University of Technology Krungthep, Bangkok, Thailand.
J Med Internet Res. 2025 Apr 21;27:e66988. doi: 10.2196/66988.
Effective interprofessional communication, including politeness, respect for coworkers, and self-control, is crucial in emergency care. These values are emphasized by both Thai and US cultures. Notably, nurses place greater significance on respect and self-control than physicians, underscoring the need for physicians to recognize and adopt these attributes, especially in interactions with nursing staff. To develop these competencies, interprofessional education (IPE) programs are essential, with simulation-based IPE, particularly virtual simulations, showing promise in enhancing teamwork and communication. However, research on the tone of voice in emergency communication is limited, especially in Thailand, where standardized IPE curricula are lacking.
This study aimed to assess the effectiveness of Team and Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) virtual simulation IPE, using a 3D computer-based or virtual reality (VR) approach, in enhancing interprofessional communication among health care students, focusing on politeness and assertiveness in the tone of voice.
An experimental design was used with 30 health care students from 5 disciplines, including medical, nursing, medical technology, radiological technology, and pharmacy students. Participants were recorded during pretraining and posttraining TeamSTEPPS sessions. Acoustic analysis focused on 3 cues: duration, intensity, and fundamental frequency (F0). Duration measured the length of utterances, whereas intensity (loudness) and F0 (pitch) were analyzed using parameters, such as maximum, minimum, mean, SD, and range. In total, 5663 utterances were analyzed, providing a dataset for identifying significant shifts in vocal delivery after training. Using the Wilcoxon signed-rank test, these 11 acoustic parameters were extracted and statistically analyzed to compare pre- and posttraining differences.
Significant improvements in the tone of voice were observed. Medical and nursing students exhibited changes in pitch (SD and mean of F0; P<.001) and loudness (mean of intensity, P<.001), suggesting more attentive communication. The increased utterance duration in core team members suggests that they engaged in more elaborate information sharing and verification, critical for patient safety. Medical technology and radiological technology students showed reduced pitch (mean of F0; P<.05 in medical technology students and P<.01 in radiological students) and intensity (mean of intensity; P<.01 in medical technology students), reflecting calmer, more controlled communication. Pharmacy students showed minor changes.
TeamSTEPPS virtual simulation IPE, using a 3D computer-based or VR approach, effectively enhances interprofessional nonverbal communication by improving key acoustic features related to politeness and assertiveness within the Thai culture context. Medical and nursing students showed the most notable gains, whereas quieter more controlled communication styles emerged among the other groups. The results demonstrate the ways in which vocal modulations can reflect role-specific responsibilities and interpersonal sensitivity in clinical interactions. These findings highlight the significance of tailored virtual simulation IPE programs for improving teamwork and patient outcomes across health care disciplines.
有效的跨专业沟通，包括礼貌、尊重同事和自我控制，在急诊护理中至关重要。泰国和美国文化都强调这些价值观。值得注意的是，护士比医生更重视尊重和自我控制，这凸显了医生认识并采纳这些特质的必要性，尤其是在与护理人员的互动中。为培养这些能力，跨专业教育（IPE）项目必不可少，基于模拟的IPE，特别是虚拟模拟，在增强团队合作和沟通方面显示出前景。然而，关于急诊沟通中语气的研究有限，尤其是在泰国，那里缺乏标准化的IPE课程。
本研究旨在评估团队与策略以提高绩效和患者安全（TeamSTEPPS）虚拟模拟IPE（采用基于3D计算机或虚拟现实（VR）的方法）在增强医护学生跨专业沟通方面的有效性，重点关注语气中的礼貌和坚定性。
采用实验设计，招募了来自医学、护理、医学技术、放射技术和药学5个学科的30名医护学生。在TeamSTEPPS培训前和培训后的课程中对参与者进行录音。声学分析聚焦于3个线索：时长、强度和基频（F0）。时长测量话语的长度，而强度（响度）和F0（音高）则使用最大值、最小值、均值、标准差和范围等参数进行分析。总共分析了5663条话语，为识别培训后语音表达的显著变化提供了数据集。使用Wilcoxon符号秩检验提取这11个声学参数并进行统计分析，以比较培训前后的差异。
观察到语气有显著改善。医学和护理专业学生在音高（F0的标准差和均值；P<.001）和响度（强度均值，P<.001）方面表现出变化，表明沟通更加专注。核心团队成员话语时长增加，表明他们进行了更详尽的信息共享和核实，这对患者安全至关重要。医学技术和放射技术专业学生的音高降低（医学技术专业学生的F0均值；P<.05，放射专业学生P<.01），强度降低（医学技术专业学生的强度均值；P<.01），这反映出沟通更平静、更可控。药学专业学生变化较小。
采用基于3D计算机或VR方法的TeamSTEPPS虚拟模拟IPE，在泰国文化背景下，通过改善与礼貌和坚定性相关的关键声学特征，有效增强了跨专业非语言沟通。医学和护理专业学生收获最为显著，而其他组则呈现出更安静、更可控的沟通风格。结果表明了语音调制在临床互动中反映特定角色责任和人际敏感性的方式。这些发现凸显了量身定制的虚拟模拟IPE项目对于改善各医疗学科的团队合作和患者结局的重要性。
