A46 SPEED:不影响病人等待时间的急诊科模拟训练模型

Sebastian Chong, Michael Phillips, Salwa Malik
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引用次数: 0

摘要

在英国,初级医生(JDs)的临床服务提供和学习活动的参与之间存在着公认的紧张关系[1]。jd经常报告说,由于部门的临床压力,他们无法参加常规教学,这意味着他们失去了培训和发展的机会。因此,有必要开发培训方法,以尽量减少对临床服务提供的影响。为急诊科专科医生发展模拟训练模式,以达致a)根据参加者的训练水平提供量身订定的学习目标,以及b)尽量减少对急诊科服务的影响。开发了“急诊室模拟和个性化教育”(SPEED)模型。在速成日,当日在急诊科执行临床工作的jd和高级临床医生(acp)被个别邀请参加一个20分钟的临床模拟。完成后,参与者进行了10分钟的汇报,以加强预定的学习目标,并向模拟导师提供反馈,然后返回他们在急诊科的临床职责。进行了课前和课后问卷调查,以评估学习目标的获得情况。培训日在联合王国重大创伤中心(MTC)和附属小型教学医院(TH)的急诊科进行。回顾性收集急诊科临床医生在SPEED日和可比较的非SPEED日的部门数据,并区分专业和紧急护理(UC) MTC子部门。在2022年9月至2023年3月的6个月内,共进行了7天的SPEED测试,其中5天在MTC ED, 2天在TH ED。在7天内,65名jd和acp参与了测试。当被问及SPEED会议对日常实践的有用性时,41名参与者回答“非常同意”,18名参与者回答“同意”。与测试前问卷相比,7天中的6天在测试后问卷得分上表现出正的平均差异。在MTC专业(1h11m vs. 48m)、MTC UC (2h41m vs. 2h25m)或TH (1h15m vs. 1h8m)中,SPEED天数与非SPEED天数在见临床医生的时间上没有统计学上的显著差异(kruskl - wallis检验)。SPEED模型表明与日常实践相关的学习目标的习得。没有证据表明这种模式的实施会显著影响小型或大型急诊科的等待时间。采用这种培训策略可能会改善其他急诊科临床医生的培训机会。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A46 SPEED: an emergency department simulation training model which does not affect patient waiting times
There is a well-recognized tension between clinical service provision and participation in learning events for junior doctors (JDs) in the UK [1]. JDs frequently report that they are unable to attend regular teaching due to departmental clinical pressures, representing lost opportunities for their training and development. Therefore, there is need for development of training methods which minimize impact on clinical service delivery. To develop a simulation training model for Emergency Department (ED) JDs which would a) deliver tailored learning objectives according to the participants’ level of training and b) have minimal impact upon ED service provision. The ‘Simulation and Personalised Education in the Emergency Department’ (SPEED) model was developed. On SPEED days, JDs and advanced clinical practitioners (ACPs) who were undertaking clinical duties in ED on that day were invited on an individual basis to participate in a twenty-minute clinical simulation. Upon completion, the participant underwent a ten-minute debrief to reinforce predetermined learning objectives and supply feedback to simulation tutors before returning to their clinical duties in ED. Pre- and post-session questionnaires were conducted to assess acquisition of learning objectives. Training days were conducted in EDs of a UK Major Trauma Centre (MTC) and an associated small teaching hospital (TH). Departmental data on time to be seen by an ED clinician were collected retrospectively for SPEED days and comparable non-SPEED days, with differentiation between the majors and urgent care (UC) MTC sub-departments. A total of 7 SPEED days were conducted over 6 months between September 2022 and March 2023 – 5 in the MTC ED and 2 in the TH ED. 65 JDs and ACPs participated across the seven days. On asking about the usefulness of the SPEED session for day-to-day practice, 41 participants responded ‘strongly agree’ and 18 participants responded ‘agree’. 6 of the 7 SPEED days demonstrated a positive mean difference in post-session questionnaire score when compared to pre-test questionnaire. There was no statistically significant difference in time to see clinician between SPEED days and comparable non-SPEED days in MTC majors (1h11m vs. 48m), MTC UC (2h41m vs. 2h25m), or TH (1h15m vs. 1h8m) (Kruskal-Wallis test, The SPEED model demonstrates acquisition of learning objectives which are relevant to day-to-day practice. There is no evidence that delivery of this model significantly affects waiting times in either a small or large ED. Adoption of this training strategy may improve training opportunities for other ED clinicians. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
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