在紧急部门打破坏消息
Susan Siraco1, Cindy Bitter2, Tina Chen2
1Saint Louis University School of Medicine, Saint Louis, MO.
Journal of education & teaching in emergency medicine
|July 19, 2023
概括
紧急医疗人员使用模拟课程提高了对打破坏消息的信心. 这次培训提供了一个安全的空间来练习困难的对话,并建立护理目标.
科学领域:
- 医学教育 医学教育
- 紧急医疗模拟模拟器
- 沟通技巧培训 培训 沟通技巧培训
背景情况:
- 打破坏消息和讨论护理目标是紧急医疗 (EM) 医生关键但具有挑战性的技能.
- 急诊室 (ED) 的环境为这些讨论带来了独特的复杂性,原因是重症患者和缺乏先前报告.
- 现有的结构化方法如GRIEV_ING和SPIKES可用,但EM医生经常报告对其应用的信心较低.
研究的目的:
- 开发和评估一个模拟课程,让EM实习生练习打破坏消息.
- 为了提高学员的信心和沟通技巧,照顾讨论的目标和家庭通知.
- 为练习这些具有挑战性的场景提供心理安全的环境.
主要方法:
- 一个两个案例,高保真模拟课程被实施为EM居民和医学学生.
- 学习者接受了关于GRIEV_ING方法的预读.
- 模拟后的调查评估了对沟通技能的信心,分析使用了Wilcoxon签名的等级测试.
主要成果:
- 学习者在实施一致的坏消息传递方法时,表现出有统计学意义的信心提升.
- 质量反强调了在模拟环境中练习困难对话的价值.
- 与老年居民相比,第一年和第二年居民的好处更大.
结论:
- 模拟为EM实习生提供了一个有价值的,安全的环境,以练习打破坏消息和关怀讨论的目标.
- 该课程有效地提高了学员对基本沟通技能的信心.
- 简报强调了常见的挑战,例如在通知家庭之前进行激进的复苏.
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