AIM: To enhance non-technical skills and to analyse participant's experience of a course tailored for orth-opaedic surgeons.METHODS: A Delphi technique was used to develop a course in human factors specific to ort...AIM: To enhance non-technical skills and to analyse participant's experience of a course tailored for orth-opaedic surgeons.METHODS: A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents(six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire(strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself.RESULTS: Twenty-six orthopaedic residents participated(24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showedthat while the majority of candidates recognised the importance of non-technical(NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course(Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training(4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program.CONCLUSION: Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.展开更多
Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that struct...Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that structured framework can improve the clinical performance and reduce errors to improve patients’ safety. Methodology: A total of 24 teams composed of cardiac residents, attending surgeons and ICU nurses performed simulated emergency incident tasks in cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) scenarios. Framework education was introduced to the assigned groups in two separate semesters. All the scenarios were recorded by video for further evaluation by cardiologist and emergency medicine specialist. Clinical performance, time consumption in simulated scenarios, correlation between framework training and nontechnical skills performance were assessed. Results: The average percentages of CPR completed in the Group 1 (G1) with framework education and the Group 2 (G2) were 85% (SEM: 6.20%) and 53% (SEM: 5.77%) respectively (P < 0.001). And the average percentages of TI completed in G2 with framework education was 87% (SEM: 3.96%), higher than G1 (50%, SEM: 5.64%) (P < 0.001). As for time consumption, the mean time to complete CPR in groups with framework education was shorter than in groups without framework education (P o complete TI in groups with framework education was shorter than in groups without framework education (P < 0.005). Further, there was a significant correlation between framework training and communication in simulated scenarios. Conclusion: The framework provides the whole procedure of the task to every participant. Structured framework education can improve nontechnical skills as well as technical skills of doctors and nurses. Further, researches should be conducted to evaluate the clinical performance and correlation between technical skills and nontechnical skills in cardiothoracic training.展开更多
文摘AIM: To enhance non-technical skills and to analyse participant's experience of a course tailored for orth-opaedic surgeons.METHODS: A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents(six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire(strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself.RESULTS: Twenty-six orthopaedic residents participated(24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showedthat while the majority of candidates recognised the importance of non-technical(NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course(Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the course achieved its intended aims with realistic simulation scenarios. Participants believed patient care, patient safety and team working would all improve with further human factors training(4.4-4.6). and felt that NT skills learnt through simulation-based training should become an integral component of their training program.CONCLUSION: Participants demonstrated improved understanding of non-technical performance, recognised its relevance to patient safety and expressed a desire for its integration in training.
文摘Background: Both technical and nontechnical skills are important factors in cardiac emergency incident. The effects of structured framework on these skills have not been thoroughly studied. We hypothesized that structured framework can improve the clinical performance and reduce errors to improve patients’ safety. Methodology: A total of 24 teams composed of cardiac residents, attending surgeons and ICU nurses performed simulated emergency incident tasks in cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) scenarios. Framework education was introduced to the assigned groups in two separate semesters. All the scenarios were recorded by video for further evaluation by cardiologist and emergency medicine specialist. Clinical performance, time consumption in simulated scenarios, correlation between framework training and nontechnical skills performance were assessed. Results: The average percentages of CPR completed in the Group 1 (G1) with framework education and the Group 2 (G2) were 85% (SEM: 6.20%) and 53% (SEM: 5.77%) respectively (P < 0.001). And the average percentages of TI completed in G2 with framework education was 87% (SEM: 3.96%), higher than G1 (50%, SEM: 5.64%) (P < 0.001). As for time consumption, the mean time to complete CPR in groups with framework education was shorter than in groups without framework education (P o complete TI in groups with framework education was shorter than in groups without framework education (P < 0.005). Further, there was a significant correlation between framework training and communication in simulated scenarios. Conclusion: The framework provides the whole procedure of the task to every participant. Structured framework education can improve nontechnical skills as well as technical skills of doctors and nurses. Further, researches should be conducted to evaluate the clinical performance and correlation between technical skills and nontechnical skills in cardiothoracic training.
