A national pilot study on simulation-based upstander training for emergency medicine clinicians

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES AEM Education and Training Pub Date : 2024-05-24 DOI:10.1002/aet2.10990
William Mundo MD, MPH, Jordan Vaughn MD, Adetoriola Odetunde MD, Tai Donovan, Al'ai Alvarez MD, Kristyn Smith DO, Cortlyn Brown MD, MCSO, Italo Brown MD, Suchismita Datta MD, Samreen Vora MD, Jacqueline Ward-Gaines MD
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Abstract

Objective

This study assesses the effectiveness of clinical simulation-based training in boosting self-perceived confidence for using upstander communication skills to confront racism, discrimination, and microaggressions (RDM).

Methods

We conducted an observational cohort study with emergency medicine professionals at the 2023 Scientific Assembly of the American Academy of Emergency Medicine in New Orleans, Louisiana. The study featured a clinical simulation-based training on upstander communications skills session followed by small- and large-group debriefs. Participants completed pre- and post-training questionnaires assessing demographics and confidence in health equity competencies. This survey was used in a previous study with emergency medicine residents. Data were analyzed using an independent Student's t-test, with a significance threshold of 0.05.

Results

Thirty-two individuals participated in the simulation-based training, and 24 completed surveys, with a 75% response rate. Most participants were non-Hispanic (24, 85.7%) and women (18, 64%), with racial demographics mostly White (8, 28.6%), Black or African American (8, 28.6%), and Asian (6, 21.4%). After the workshop, there was a notable increase in self-perceived ability and confidence in identifying RDM (from 7 ± 3.2 to 8.6 ± 1.6, p < 0.003), using upstander communication tools (from 6.1 ± 3.5 to 8.5 ± 1, p < 0.0001), and the likelihood of intervening in RDM situations (from 7.1 ± 3.3 to 8.8 ± 1.1, p < 0.0002).

Conclusions

The clinical simulation-based training significantly improved participants' confidence and self-perceived ability to address RDM in simulated clinical environments. This training method is a promising tool for teaching health equity topics in clinical medicine.

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针对急诊科临床医生的模拟 "挺身而出 "培训全国试点研究
目的 本研究评估了基于临床模拟的培训在增强使用旁观者沟通技巧应对种族主义、歧视和微诽谤 (RDM) 的自我认知信心方面的有效性。 方法 我们在路易斯安那州新奥尔良市举行的美国急诊医学学会 2023 年科学大会上对急诊医学专业人员进行了一项观察性队列研究。该研究以临床模拟为基础,对旁观者沟通技巧进行了培训,随后进行了小组和大组汇报。参与者填写了培训前和培训后的问卷,评估人口统计学和对健康公平能力的信心。这项调查曾在之前一项针对急诊科住院医生的研究中使用过。数据分析采用独立的学生 t 检验,显著性阈值为 0.05。 结果 32 人参加了模拟培训,24 人完成了调查,回复率为 75%。大多数参与者为非西班牙裔(24 人,占 85.7%)和女性(18 人,占 64%),种族构成主要为白人(8 人,占 28.6%)、黑人或非裔美国人(8 人,占 28.6%)和亚裔(6 人,占 21.4%)。培训结束后,学员在识别 RDM(从 7 ± 3.2 到 8.6 ± 1.6,p < 0.003)、使用旁观者沟通工具(从 6.1 ± 3.5 到 8.5 ± 1,p < 0.0001)以及干预 RDM 情况的可能性(从 7.1 ± 3.3 到 8.8 ± 1.1,p < 0.0002)方面的自我认知能力和信心都有显著提高。 结论 基于临床模拟的培训极大地提高了参与者在模拟临床环境中处理 RDM 的信心和自我认知能力。这种培训方法是在临床医学中教授健康公平主题的一种很有前途的工具。
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来源期刊
AEM Education and Training
AEM Education and Training Nursing-Emergency Nursing
CiteScore
2.60
自引率
22.20%
发文量
89
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