课程创新:提高神经病学住院医生的严重疾病沟通技能使用模拟:试点研究
Marcey Osgood1, Brian Silver1, Jennifer Reidy1
1From the Department of Neurology (M.O.), Lahey Health and Medical Center, Burlington, MA; and Department of Neurology (B.S.), and Department of Palliative Care (J.R.,V.N.), University of Massachusetts Chan Medical School, Worcester.
在基于模拟的课程后,神经病房住院医生对治疗目标 (GOC) 对话的信心有所提高. 这次培训提高了他们讨论急性缺血性中风患者的预后和终身护理方面的技能.
科学领域:
- 医学教育 医学教育
- 神经学 神经学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 急性缺血性中风患者面临的预后不确定性和早期死亡率.
- 神经科医生往往缺乏足够的训练在息护理和目标的护理 (GOC) 讨论.
- 需要提高住户在与患者和家人进行敏感对话方面的技能.
研究的目的:
- 评估和增强神经病学住院人员在进行晚期治疗目标 (GOC) 对话时的信心和舒适度.
- 为居民提供一个结构化的框架来进行中国政府的讨论,包括预后和宿舍护理.
- 为练习沟通技能的安全环境提供实时反和重复的机会.
主要方法:
- 一个基于模拟的3小时课程,结合教学课程和交互式角色扮演.
- 在模拟患者接触期间,教师观察和实时反.
- 居民和教师的解读会议讨论表现,情绪和自我照顾.
主要成果:
- 超过90%的居民认为培训是相关的,有帮助的,有组织的和清晰的.
- 培训后的调查表明,在提供预后,讨论宿舍和启动中国政府早期讨论方面,居民的舒适性得到了改善.
- 教师注意到居民在解决预后,评估目标,治疗计划和表现出同情心方面的困难.
结论:
- 基于模拟的培训有效地提高神经病学住院医生的信心和技能,以进行医疗目标 (GOC) 对话.
- 该课程成功地解决了神经病学家在息和终身护理沟通方面的结构化培训需求.
- 未来的努力应集中在加强这些沟通技巧和重新评估它们的长期影响上.
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