从 11 个泛欧国家医疗保健实习生导师的角度看临床实习期间的心理安全能力培训:混合方法观察研究。

IF 3.2 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Irene Carrillo, Ivana Skoumalová, Ireen Bruus, Victoria Klemm, Sofia Guerra-Paiva, Bojana Knežević, Augustina Jankauskiene, Dragana Jocic, Susanna Tella, Sandra C Buttigieg, Einav Srulovici, Andrea Madarasová Gecková, Kaja Põlluste, Reinhard Strametz, Paulo Sousa, Marina Odalovic, José Joaquín Mira
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引用次数: 0

摘要

背景:在研究领域,心理安全已被广泛认为是提高护理质量和患者安全的一个促进因素。然而,在住院医师和医护学生的课程和实习途径中很少考虑到这一点:本研究旨在确定医护受训人员在临床实习期间获得心理安全能力的程度,并确定可以采取哪些措施来促进他们的学习:方法: 我们在泛欧医疗机构的医疗实习生导师样本中开展了一项基于共识会议和开放式调查的混合方法观察研究。首先,我们发放了一份特别问卷,以评估心理安全方面的能力(知识、态度和技能)和机构干预措施的获得或实施程度及重要性。其次,我们要求辅导员提出措施,以培养学员在第一阶段研究中获得平均成果分的能力:共有来自 11 个泛欧洲国家的 173 名导师填写了第一份问卷(回复率:173/256,67.6%),其中 63 人(36.4%)参加了第二次咨询。掌握程度最低的能力涉及警告专业人员其行为对患者构成风险、处理他们可能出现的不良反应,以及为成为第二受害者的同事提供支持。导师们为改善这一能力差距而提出的建议包括:沟通技巧和患者安全方面的培训、安全文化、工作氛围、个人态度、受训者的参照人、正式纳入医疗学位和专业路径的课程、让受训者发表意见的具体制度和机制、机构风险管理、法规、指导方针和标准、监督以及支持受训者的资源。在教学方法方面,导师们推荐了一些创新策略,其中许多是基于技术工具或解决方案,包括视频、研讨会、讲座、讲习班、模拟学习或有专业演员或无专业演员的角色扮演、案例研究、带有实际演示或示范情况的视频、小组讨论、共同分析患者安全事件的临床会议,以及总结和讨论经验教训的汇报会:这项研究旨在促进心理安全能力,将其作为未来医疗保健专业人员培训的正式组成部分,从而推动将国际准则转化为泛欧洲范围内的实践和临床环境。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Psychological Safety Competency Training During the Clinical Internship From the Perspective of Health Care Trainee Mentors in 11 Pan-European Countries: Mixed Methods Observational Study.

Background: In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce.

Objective: This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning.

Methods: A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined.

Results: In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned.

Conclusions: This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.

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来源期刊
JMIR Medical Education
JMIR Medical Education Social Sciences-Education
CiteScore
6.90
自引率
5.60%
发文量
54
审稿时长
8 weeks
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