Development and implementation of an oral sign-out skills curriculum
Development and implementation of an oral sign-out skills curriculum
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DOI：
10.1007/s11606-007-0331-0
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发表时间：
2007-10-01
影响因子：
5.7
通讯作者：
Green, Michael L.
中科院分区：
文献类型：
--
作者：
Horwitz, Leora I.;Moin, Tannaz;Green, Michael L.
简介：提供者之间患者信息的不完善签出已被证明会导致医疗错误，但没有标准化的课程来教授签出技能。在我们的机构，我们确定了几个不足之处，在技能和缺乏任何现有的training.AIM：制定一个签出课程的医务人员。设定：内科住院医师项目。描述：我们开发了一个1小时的课程，并于2006年8月在三家医院实施。教学策略包括促进讨论，建模，并观察个人实践与反馈。我们强调交互式沟通，一个结构化的签出格式总结了一个易于记忆的助记符（“SIGNOUT”），一致包括关键内容项目，如预期的指导，并使用具体的语言。在1-5级量表上，该课程的平均得分为4.44 +/- 0.61。结构化口头交流形式的感知有用性为4.46 +/- 0.78。参与者在会议结束后对提供口头签出的舒适度的评价显著高于之前（3.27 +/- 1.0之前与3.94 +/- 0.90之后; p <0.001）。讨论：我们开发了一个简短，结构化的口头签出课程，并受到参与者的好评。需要进一步研究，以确定课程的长期影响。
INTRODUCTION: Imperfect sign-out of patient information between providers has been shown to contribute to medical error, but there are no standardized curricula to teach sign-out skills. At our institution, we identified several deficiencies in skills and a lack of any existing training.AIM: To develop a sign-out curriculum for medical house staff. Setting: Internal medicine residency program.PROGRAM DESCRIPTION: We developed a 1-h curriculum and implemented it in August of 2006 at three hospital sites. Teaching strategies included facilitated discussion, modeling, and observed individual practice with feedback. We emphasized interactive communication, a structured sign-out format summarized by an easy-to-remember mnemonic ("SIGNOUT"), consistent inclusion of key content items such as anticipatory guidance, and use of concrete language.PROGRAM EVALUATION: We received 34 evaluations. The mean score for the course was 4.44 +/- 0.61 on a 1-5 scale. Perceived usefulness of the structured oral communication format was 4.46 +/- 0.78. Participants rated their comfort with providing oral sign-out significantly higher after the session than before (3.27 +/- 1.0 before vs. 3.94 +/- 0.90 after; p < .001).DISCUSSION: We developed an oral sign-out curriculum that was brief, structured, and well received by participants. Further study is necessary to determine the long-term impact of the curriculum.