混合方法在外科手术死亡率和发病率会议期间评估无礼
Egide Abahuje1, Shae Yang1, Yue-Yung Hu1,2
1Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Annals of surgery
|August 28, 2023
概括
死亡和发病率 (M&M) 会议的非文明性源于非结构化的,以责备为中心的讨论. 组织M&M会议以关注护理改进可以促进心理安全和更富有成效的对话.
科学领域:
- 医学教育 医学教育
- 手术会议 手术会议
- 患者安全 患者安全
背景情况:
- 心理安全对于有效的死亡率和发病率 (M&M) 会议至关重要,以改善患者护理.
- 不礼貌和排斥,经常表现为"羞耻和责怪",阻碍了M&M环境中的产生性讨论.
研究的目的:
- 在死亡和发病率 (M&M) 会议期间评估不文明的流行和性质.
- 确定导致外科M&M会议中的不文明和排斥的因素.
主要方法:
- 采用了融合混合方法设计,将M&M会议的非参与者观察与标准化调查的定量数据相结合.
- 参与者包括外科医生,研究员,住院医生,医学学生,高级实践提供者和管理人员.
- 调查包括正面和负面影响表简短形式 (PANAS) 和临床护理教育中的不文明行为 (UBCNE) 工具.
主要成果:
- 非结构化,自由形式的讨论,特别是从记录的参与外科医生的有限投入和缺乏系统方法,经常导致责备和随后的不文明.
- 与副教授和常任教授相比,助理教授报告的负面影响,排斥行为和UBCNE分数显著更高.
- 女性参与者报告的负面影响得分高于男性参与者.
结论:
- 传统的M&M会议的非结构化性质有助于不文明.
- 实施以改善护理为重点的结构化讨论可以增强包容性,促进更具创造性的对话,最终改善患者护理.
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