A35模拟本科跨专业培训病房-在过渡到临床实践之前,提高对跨专业工作的自信和态度

Steve McLaren, Alexandra Muston, Sophie Page
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摘要

研究表明,跨专业培训病房(ITW)提高了学生的学习和患者满意度[1],但从管理和教师培训的角度来看,这是资源密集型的。考虑到NHS的压力,我们开发了一个模拟ITW,以满足医疗保健本科生的培训需求,并改善在获得资格之前对跨专业工作的态度和信心。会议模拟了一个典型的病房日,包括护理交接、病房查房、董事会查房、交流场景,以及一位病情急剧恶化的病人。最后一年,医学、护理和理疗专业的学生参加了会议,并组成了跨专业的团队。在每个场景之后都进行了一次跨专业的汇报。学生在前后完成了跨专业学习准备量表(RIPLS)[2],并使用李克特量表和定性评论提供反馈。35名学生参与,全部完成RIPLS, 32名完成Likert和定性反馈。尽管数据集较小,但我们在9个RIPLS陈述中发现了显著变化(p<0.05),表明对跨专业学习的态度发生了积极变化。所有学生都认为这节课符合他们的学习要求。各行业的李克特反馈表明,人们对多学科团队(MDT)的理解和重视程度有所提高(97%);认识到多学科工作与培训的相关性(91%);相信这将改变他们对MDT工作的态度(84%);在过渡到工作角色之前增加了信心(81%)。专业细分显示了物理治疗师的最高信心和更高的理解,但他们(以及护士)发现内容更具挑战性。专题分析强调了几个关键主题:跨专业团队合作、以患者为中心的护理、沟通、专业准备、技术技能以及对会议格式和交付的满意度。跨专业团队合作、以患者为中心的护理和沟通架起了“有价值方面”和“关键信息”的桥梁,展示了对关键学习点的吸收,并加强了RIPLS数据的变化。虽然关于“建议改进”类别的反馈重申了满足所有学习者的挑战,但这一类别的评论绝大多数是积极的,对这一学习活动的赞赏和重要性频繁出现。一位网友写道:“能有机会参加,我感到非常幸运……我坚信,每一位医疗保健专业的学生都应该有机会参加类似的会议。”我们的试点项目表明,使用模拟itw为学生提供了多种好处。模拟ITW环境提高了临床实践中跨专业角色的信心和理解;对于那些对跨专业学习态度有所改善的早期学习者来说,这是有价值的和相关的。需要进行全面的研究,以充分评估模拟ITW环境的学习效益和成本效益。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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A35 Simulated Undergraduate Interprofessional Training Ward – improving self-confidence and attitudes to interprofessional working prior to transition to clinical practice
Research suggests that interprofessional training wards (ITW) enhance student learning and patient satisfaction [1] but are resource intensive from governance and faculty training points of view. Given NHS pressures, we developed a simulated ITW to meet training needs of healthcare undergraduates and improve attitudes and confidence regarding interprofessional working prior to qualification. The session simulated a typical ward day, with nursing handover, ward-round, board-round, communication scenarios, and an acutely deteriorating patient. Final year medical, nursing and physiotherapy students attended, and formed interprofessional teams. After each scenario an interprofessional debrief took place. Students completed the readiness for interprofessional learning scale (RIPLS) [2] pre and post, also providing feedback using Likert scales and qualitative comments. 35 students participated, all completing RIPLS, and 32 completing Likert and qualitative feedback. Despite the small dataset, we demonstrated significant change (p<0.05) in 9 of the RIPLS statements, indicating a positive change in attitudes toward interprofessional learning. All students felt the session met their learning requirements. Likert feedback across professions demonstrated increased understanding and valuing of multi-disciplinary teams (MDT) (97%); appreciation of the relevance of multi-disciplinary working to their training (91%); belief that it would change their approach to MDT work (84%); and increased confidence prior to transitioning to a working role (81%). Profession-specific breakdown demonstrated highest confidence and increased understanding for physiotherapists, however they (alongside nurses) found the content more challenging. Summary of infographic for SUIT ward Thematic analysis highlighted several key themes: Interprofessional teamworking, patient-centred care, communication, professional readiness, technical skills, and satisfaction with session format and delivery. Interprofessional teamworking, patient-centred care, and communication bridged the categories of ‘valued aspects’ and ‘take-home messages’, demonstrating uptake of key learning points, and reinforcing the changes in the RIPLS data. While the feedback regarding the ‘suggested improvements’ category reiterated the challenges of catering to all learners, this category’s comments were overwhelmingly positive, with appreciation and importance of this learning event appearing frequently. One wrote, ‘I feel incredibly lucky to have had the opportunity to take part… and strongly believe every single healthcare student should have the chance to attend a similar session’. Our pilot program suggests that using simulated ITWs offers multiple benefits to students. The simulated ITW environment improved confidence and understanding of interprofessional roles in clinical practice; and was valuable and relevant to learners with early signs of improving attitudes towards interprofessional learning. A full study is needed to fully assess the learning benefits and cost-effectiveness of simulated ITW environments. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
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