Evaluation of a computer-based educational intervention to improve medical teamwork and performance during simulated patient resuscitations.
Evaluation of a computer-based educational intervention to improve medical teamwork and performance during simulated patient resuscitations.
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评估基于计算机的教育干预，以改善模拟患者复苏期间的医疗团队合作和表现。
DOI：
10.1097/ccm.0b013e31829828f7
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发表时间：
2013
影响因子：
8.8
通讯作者：
Kozlowski,SteveWJ
中科院分区：
文献类型：
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作者：
Fernandez,Rosemarie;Pearce,Marina;Grand,JamesA;Rench,TaraA;Jones,KerinA;Chao,GeorgiaT;Kozlowski,SteveWJ
目的：确定低资源需求、易传播的基于计算机的团队工作过程训练干预对代码团队中团队行为和患者护理表现的影响。设计：从2010年8月至2011年3月，进行了一项基于计算机的团队协作训练与安慰剂训练的随机对照试验。地点：本研究在韦恩州立大学医学院Kado家庭临床技能中心内的模拟实验室进行。参与者：231名来自韦恩州立大学的四年级医学生和一、二、三年级急诊住院医师。每个参与者被分配到一个四到六人的团队(n个团队=45个)。干预：团队被随机分配到接受针对适当复苏团队合作行为的25分钟基于计算机的培训模块或安慰剂培训模块。测量：团队合作行为和患者护理行为在高保真模拟患者复苏过程中被视频记录，并由训练有素的评分员编码，对条件分配和研究假设视而不见。团队合作行为项目(例如，“与团队沟通的胸部X光检查结果”和“团队成员协助准备插管”)在合并之前被标准化，以创建整体团队合作得分。同样，患者护理项目(“胸片正确解释”；“开始按压的时间”)在合并之前被标准化，以产生总体患者护理评分。主要结果：当控制团队成员的医疗相关经验时，训练条件下的团队表现出更好的团队合作(F[1，42]=4.81，p<；0.05；η2 p=10%)和患者护理(F[1，42]=4.66，p<；0.05；η2 p=10%)。结论：在模拟患者复苏过程中，基于计算机的团队培训对团队合作和患者护理有积极影响。这种低资源的团队培训干预可能有助于解决与更大、更昂贵的团队培训计划相关的传播和可持续性问题。
Objectives:To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams.Design:A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011.Setting:This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine.Participants:Participants (n= 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (n teams= 45).Interventions:Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module.Measurements:Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (eg,“chest radiograph findings communicated to team” and “team member assists with intubation preparation”) were standardized before combining to create overall teamwork scores. Similarly, patient care items (“chest radiograph correctly interpreted”;“time to start of compressions”) were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity.Main Results:When controlling for team members’ medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42]= 4.81, p< 0.05; η 2 p= 10%) and patient care (F [1, 42]= 4.66, p< 0.05; η 2 p= 10%) than did teams in the placebo condition.Conclusions:Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.