Acute Care Management Skills: An Assessment Program for Graduate Physicians

急性护理管理技能：研究生医师评估计划

• 批准号: 7236325
• 负责人: David J Murray
• 金额: $ 21.41万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7236325
• 关键词: acute disease /disorder; behavioral /social science research tag; clinical research; communication behavior; computer simulation; cooperative study; health care personnel performance; human subject; interdisciplinary collaboration; medical education; nurses; patient care management; physicians

DESCRIPTION (provided by the applicant): In the proposed project, we will utilize simulation technology to assess a physicians' competence in acute care incidents and their abilities to communicate effectively with fellow team members. In the first specific aim, 150 medical students and interns will be evaluated as they manage 15 different acute care events, using a full-scale electro-mechanical mannequin in a range of simulated medical settings. An expert panel will define a competence standard for each scenario by reviewing a representative sample of participants' performances. These competency-based decisions will then be compared to the raters' analytic scores. Our goal in these procedures is to provide an unambiguous performance standard that can be readily measured and effectively attained by physicians. The competence standard will provide an objective method to identify physicians who do not meet the requisite skill level. In the second specific aim, we will implement a simulation-based methodology to objectively and subjectively measure 50 physicians' communication behaviors as they interact with a nurse in an acute care management setting. In a first analysis, ethnographic measures will include time spent in communication breakdown and the effectiveness of the physician in repairing these breakdowns. In a second analysis, a panel of nurses and physicians will rate the communication skills of each physician and the overall communication effectiveness that occurs during the physician-nurse interaction. By conducting two analyses and including both physician and nurse judges, we can relate the two types of measures and also compare and contrast the impressions of physicians and nurses. Importantly, our assessment will control for a variety of extraneous variables that sometimes plague observational reports. During the course of completing these two specific aims, we will call upon the expertise of a multi-disciplinary team that includes physicians, nurses, and experts in both aural rehabilitation and psychometrics. By the completion of .the project, we will have developed procedures to assess the two primary components of managing acute care events, clinical skills and communication effectiveness, and procedures that will serve as a model for other applications of simulation technology in the field of assessment. In addition, our findings about the performance of a large number of physicians will provide specific directions for future medical training, and will ultimately result in improved patient safety.

描述（由申请人提供）：在拟议的项目中，我们将利用模拟技术来评估医生在急性护理事件中的能力，以及他们与其他团队成员有效沟通的能力。在第一个具体目标中，150名医学生和实习生将在一系列模拟医疗环境中使用全尺寸机电人体模型管理15种不同的急性护理事件时进行评估。一个专家小组将通过审查参与者表现的代表性样本，为每一种情况确定能力标准。这些基于能力的决定将与评分员的分析分数进行比较。我们在这些程序中的目标是提供一个明确的性能标准，可以很容易地测量和有效地实现医生。能力标准将提供一个客观的方法，以确定谁不符合所需的技能水平的医生。在第二个具体目标，我们将实施一个基于模拟的方法，客观和主观地衡量50名医生的沟通行为，因为他们与护士在急性护理管理设置。在第一次分析中，人种学测量将包括沟通中断所花费的时间和医生修复这些故障的有效性。在第二次分析中，一组护士和医生将对每位医生的沟通技巧以及在医生-护士互动期间发生的整体沟通有效性进行评分。通过进行两个分析，包括医生和护士的法官，我们可以将这两种类型的措施，也比较和对比医生和护士的印象。重要的是，我们的评估将控制有时困扰观察报告的各种无关变量。在完成这两个具体目标的过程中，我们将呼吁一个多学科团队的专业知识，包括医生，护士和专家在听力康复和心理测量。通过该项目的完成，我们将制定程序来评估管理急性护理事件的两个主要组成部分，临床技能和沟通效果，以及将作为模拟技术在评估领域的其他应用模型的程序。此外，我们对大量医生表现的研究结果将为未来的医疗培训提供具体的方向，并最终提高患者的安全性。