基于CBL的TeamSTEPPS管理课程提升麻醉医师危机事件中临床胜任力的探索研究  

Exploratory study on the enhancement of clinical competence among anesthesiologists in crisis events through TeamSTEPPS management course in combination with problem-based learning

作　　者：夏迪 权翔[1] 阮侠[1] 李旭[1] 王境一 张羽冠[1] 谭刚[1] Xia Di;Quan Xiang;Ruan Xia;Li Xu;Wang Jingyi;Zhang Yuguan;Tan Gang(Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院麻醉科,北京100730

出　　处：《中华医学教育探索杂志》2024年第12期1591-1595,共5页Chinese Journal of Medical Education Research

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-RW320-003)。

摘　　要：目的探索基于临床实际案例的多模式TeamSTEPPS课程应用于以麻醉科医师为主导的手术团队的教学效果,旨在提升团队应对突发事件时的团队合作表现,以增强临床安全保障。方法中国医学科学院北京协和医院麻醉科将TeamSTEPPS课程与以案例为基础的学习(case-based learning,CBL)相结合,基于8个实际临床真实案例,开展了针对麻醉科医师、外科医师及手术室护士等跨专业人员的模拟案例培训。本研究以培训学员为研究对象,进行了前后对照研究。共纳入研究对象80人,对培训前后学员的理论知识及团队合作情况两方面进行了评估与反馈。采用SPSS 27.0软件对数据进行统计学处理。量表评分前后的差值,若经检验符合正态分布,则以(均数±标准差)表示,并进行配对t检验;学员构成资料则采用百分比表示。结果培训后的理论考核成绩高于培训前(76.45±8.34 vs.60.21±5.90),差异有统计学意义(t=13.55,P<0.001)。学员在TeamSTEPPS团队合作认知调查问卷(TeamSTEPPS teamwork perception questionnaire,T-TPQ)和TeamSTEPPS团队合作态度调查问卷(TeamSTEPPS teamwork attitudes questionnaire,T-TAQ)量表上的评分,培训后均高于培训前[TPQ:(156.08±15.20)vs.(149.32±15.58);TAQ:(134.59±10.71)vs.(128.47±10.89)],差异具有统计学意义(P<0.001)。结论基于CBL的TeamSTEPPS管理课程可以增强麻醉科医师的临床理论水平,并提升他们的团队认知和合作能力,从而为提高麻醉科医师面对危机事件的临床胜任力提供帮助。ObjectiveTo explore the effectiveness of a multimodal TeamSTEPPS course based on clinical cases in training surgical teams led by anesthesiologists,improve team cooperation in crisis management,and enhance clinical safety.MethodsThe Department of Anesthesiology at Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,combined the TeamSTEPPS course with problem-based learning.Based on eight clinical cases,simulation-based training was conducted for interdisciplinary personnel,including anesthesiologists,surgeons,and operating room nurses.Pre-and post-training evaluations were conducted for 80 participants on theoretical knowledge and teamwork.Statistical analysis was performed using SPSS 27.0 software.The differences in scale scores before and after training were tested for normality.If normally distributed,results were expressed as mean±standard deviation and analyzed using paired t-tests.Participant demographic data were represented using percentages.ResultsThe theoretical assessment scores after training were significantly higher than those before training[(76.45±8.34)vs.(60.21±5.90),t=13.55,P<0.001].TeamSTEPPS Teamwork Perception Questionnaire and TeamSTEPPS Teamwork Attitudes Questionnaire scores were significantly higher after training than before training[(156.08±15.20)vs.(149.32±15.58)and(134.59±10.71)vs.(128.47±10.89)],with statistically significant differences(P<0.001).ConclusionsThe TeamSTEPPS management course in combination with problem-based learning can enhance the clinical theoretical knowledge of anesthesiologists and improve their team awareness and collaboration,thus improving their clinical competence in managing crisis events.

关 键 词：TeamSTEPPS 模拟培训 问题驱动式学习 团队合作 

分 类 号：R-05[医药卫生] R614