CRITICAL CARE SKILLS: SIMULATION TO ASSESS DECISION-MAKING SKILLS

描述(由申请人提供)：重症患者在重症监护病房(ICU)专科医生的护理下更有可能存活下来，但受过重症监护培训的专业人员的短缺危及向这些患者提供ICU专科护理的目标。护士从业者、医生助理和其他医院医生越来越多地被要求为ICU中的患者提供护理，但这些卫生专业人员中的许多人没有接受过安全管理这些患者的教育或经验。该项目将检验模拟可用于评估卫生保健专业人员是否具有必要的知识和技能来为ICU中的患者提供护理的假设。我们的研究团队包括重症监护医生和护理教育者，他们指导医生和高级执业护士的教育计划，以及在设计和实施基于模拟的评估策略方面具有经验的模拟专家。这个多学科调查小组将构建和验证模拟需要在ICU迅速诊断和处理的条件的情景。专家医生和护士将被用来评判表现，他们关于能力的决定将被用来建立照顾危重病人的最低表现标准。这一研究战略将提供一个通用的评估工具， 可用于定义来自目前管理ICU患者的不同专业和专业培训背景的卫生保健专业人员的能力。利用模拟想定性能的专家共识来确定性能标准的方法可以广泛适用于其他实践领域。我们的长期目标是开发使用模拟来定义实践标准的方法，这些标准可以应用于提高实践标准并使患者护理更安全。

DESCRIPTION (provided by applicant): Patients with critical illnesses are more likely to survive when cared for by Intensive care unit (ICU) specialists, but a shortage of critical care-trained professionals jeopardizes the goal of providing ICU specialty care to these patients. Nurse practitioners, physician assistants and other hospital-based physicians are increasingly called upon to provide care for patients in the ICU, but many of these health professionals do not have the education or experience to safely manage these patients. This project will test the hypothesis that simulation can be used to assess whether health care professionals have the requisite knowledge and skill to provide care for patients in the ICU. Our research team includes critical care physician and nursing educators, who direct educational programs for physicians and advanced practice nurses and simulation experts who have experience in designing and implementing simulation-based assessment strategies. This multidisciplinary investigative team will construct and validate scenarios simulating conditions that require prompt diagnosis and management in the ICU. Expert physicians and nurses will be used to judge performances and their decisions about competence will be used to establish minimum performance standards to care for critically ill patients. This research strategy will provide a common assessment tool that can be used to define competence of health care professionals from the diverse professional and specialty training backgrounds that currently manage ICU patients. The methodology using expert consensus of simulation scenario performance to define a performance standard could be broadly adapted to other domains of practice. Our long-term goal is to develop methodology that uses simulation to define practice standards that could be applied to elevate practice standards and make patient care safer.