教住院医生如何传达坏消息:试点一个由住院医生主导的课程和反馈工作组,作为概念验证研究

IF 1.1 Q2 Social Sciences
Joseph Sleiman, D. J. Savage, Benjamin Switzer, Colleen Y. Colbert, Cory Chevalier, K. Neuendorf, David Harris
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引用次数: 2

摘要

突发坏消息(BBN)对居民来说是一项至关重要的技能。有限的正式监督和不可预测的坏消息发布时间阻碍了有意义反馈的交流。这项教育创新的目的是提高内科住院医师在遇到具有挑战性的BBN时的沟通技巧。正式的BBN培训方案和创新的按需工作队是这个两阶段项目的一部分。研究设计一个大型学术医疗中心的内科住院医师参加了一个以BBN为重点的互动研讨会。讲习班调查结果作为发展一个新的居民领导的BBN工作队的需求评估。该工作组的成立是为了提供床边观察和BBN遭遇后的反馈。对工作队成员的培训包括视频触发器和反馈清单。在现场测试之前,对内部可靠性进行了分析,提供了实际实施挑战的数据。结果共培训148名住院医师。根据调查结果,73%(148人中的108人)的居民表示参与后对BBN的信心增强。工作队在医院病房的现场测试揭示了要求观察的住院医生可能存在的工作流程障碍,并提示了故障排除。根据现场测试结果实施了解决方案。结论以学员为主导的BBN工作小组和沟通技巧工作坊是提高BBN居民人际关系和沟通技巧的创新模式。我们相信这种模式是可持续的,也是可复制的。提供了经验教训,以帮助在其他情况下实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Teaching residents how to break bad news: piloting a resident-led curriculum and feedback task force as a proof-of-concept study
Background Breaking bad news (BBN) is a critically important skill set for residents. Limited formal supervision and unpredictable timing of bad news delivery serve as barriers to the exchange of meaningful feedback. Purpose of study The goal of this educational innovation was to improve internal medicine residents’ communication skills during challenging BBN encounters. A formal BBN training programme and innovative on-demand task force were part of this two-phase project. Study design Internal medicine residents at a large academic medical centre participated in an interactive workshop focused on BBN. Workshop survey results served as a needs assessment for the development of a novel resident-led BBN task force. The task force was created to provide observations at the bedside and feedback after BBN encounters. Training of task force members incorporated video triggers and a feedback checklist. Inter-rater reliability was analysed prior to field testing, which provided data on real-world implementation challenges. Results 148 residents were trained during the 2-hour communications skills workshop. Based on survey results, 73% (108 of 148) of the residents indicated enhanced confidence in BBN after participation. Field testing of the task force on a hospital ward revealed potential workflow barriers for residents requesting observations and prompted troubleshooting. Solutions were implemented based on field testing results. Conclusions A trainee-led BBN task force and communication skills workshop is offered as an innovative model for improving residents’ interpersonal and communication skills in BBN. We believe the model is both sustainable and reproducible. Lessons learnt are offered to aid in implementation in other settings.
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来源期刊
BMJ Simulation & Technology Enhanced Learning
BMJ Simulation & Technology Enhanced Learning HEALTH CARE SCIENCES & SERVICES-
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