TeamSTEPPS联合案例复盘在麻醉危机处理情景模拟教学中的应用

Application of TeamSTEPPS combined with debriefing in simulation teaching of anesthesia crisis management

目的探讨提高医疗质量和患者安全的团队策略与工具包(team strategies and tools to enhance performance and patient safety,TeamSTEPPS)联合案例复盘在麻醉危机处理情景模拟教学中的应用效果。方法2022年1至12月,选取中国科学技术大学附属第一医院麻醉科40名住院医师为研究对象,采用随机数字表法将其平均分为试验组和对照组,试验组20名住院医师采用TeamSTEPPS联合案例复盘教学,对照组20名住院医师采用常规情景模拟教学。教学结束后,对两组住院医师的麻醉危机处理表现分别进行评分;并使用TeamSTEPPS团队合作认知问卷(TeamSTEPPS teamwork perception questionnaire,T-TPQ)和TeamSTEPPS团队合作态度问卷(TeamSTEPPS teamwork attitudes questionnaire,T-TAQ)对两组住院医师评分,同时进行教学满意度调查。采用Wilcoxon秩和检验、t检验和Fisher确切概率法对相关数据进行统计学分析。结果试验组住院医师麻醉危机处理模拟教学测评总分[(80.80±4.79)分]高于对照组住院医师[(72.65±5.54)分],其差异具有统计学意义(t=-4.98,P<0.001)。试验组住院医师T-TPQ评分和T-TAQ评分分别为162.00(9.50)分和138.00(15.00)分,高于对照组住院医师的150.00(20.25)分和125.50(19.75)分;试验组住院医师对团队合作和学习兴趣感到满意的人数为19人和20人,高于对照组住院医师的13人和15人。其差异均具有统计学意义(均P<0.05)。结论TeamSTEPPS联合案例复盘能够提高住院医师在情景模拟教学中的团队合作力和学习兴趣,改善麻醉危机处理的教学效果。

Objective To evaluate the application of team strategies and tools to enhance performance and patient safety(TeamSTEPPS)combined with debriefing in simulation teaching of anesthesia crisis management.Methods Forty residents in the department of anesthesiology from the First Affiliated Hospital of University of Science and Technology of China were randomly divided into experimental group and control group using a random number table.TeamSTEPPS training combined with debriefing for simulation teaching were adopted for the 20 residents in the experimental group,while regular simulation teaching were adopted for the 20 residents in the control group.The performance of residents of the two groups in anesthesia crisis management was scored after the teaching.Then TeamSTEPPS teamwork perception questionnaire(T-TPQ)and TeamSTEPPS teamwork attitudes questionnaire(T-TAQ)were used to rate their perceptions and attitudes towards teamwork of residents,and a teaching satisfaction survey was conducted.Wilcoxon rank sum test,student t test and Fisher's exact probability method were performed to analysis relevant data.Results In the experimental group,the total scores of the residents in the evaluation of anesthesia crisis management simulation teaching were higher than those of the control group[(80.80±4.79)points vs.(72.65±5.54)points],and the difference was statistically significant(t=-4.98,P<0.001).The T-TPQ scores and T-TAQ scores of residents in the experimental group[162.00(9.50),138.00(15.00)]were higher than those in the control group[150.00(20.25),125.50(19.75)],and the differences were statistically significant(all P<0.05).In the experimental group,the number of residents who are satisfied with teamwork and interest in learning(19 and 20 persons)were higher than those in control group(13 and 15 persons),and the difference were statistically significant(all P<0.05).Conclusions TeamSTEPPS combined with debriefing can improve the teamwork and learning interest of residents during simulation teaching and therefore enhance the teaching effect of anesthesia crisis management.