Using a situational awareness global assessment technique for interprofessional obstetrical team training with high fidelity simulation

Although a core component of many current health-care directions, interprofessional collaboration continues to challenge educators and health professionals. This paper aims to inform the development of collaborative practice by illuminating the experiences of collaborating within rehabilitation teams. The researchers focused on experiences that transcended team members' professional role categorizations in order to bring individuals and their lived experiences to the forefront. An inclusive view of “teams” and “collaboration” was adopted and the complexity and multifaceted nature of collaborating were explored through a hermeneutic phenomenological approach. Semi-structured interviews were used to gather data about experiences of collaborating in nine rehabilitation teams. Sixty-six team members across nine teams were interviewed. Eight interdependent dimensions, core to the experience of collaborating, emerged from the analysis of the data. Five dimensions expressed interpersonal dimensions of endeavor: engaging positively with other peoples' diversity; entering into the form and feel of the team; establishing ways of communicating and working together; envisioning together frameworks for patients' rehabilitation and effecting changes in people and situations. Three reviewing dimensions, reflexivity, reciprocity and responsiveness, operated across the endeavor dimensions. By identifying meaning structures of the experience of collaborating, this study highlights the importance of seeing beyond team members' professional affiliations and being aware of their contextualized interpersonal and activity-related collaborating capabilities.     

Postgraduate training in global health: ensuring UK doctors can contribute to health in resource-poor countries

The UK has recognised the important role its health professionals play in achieving the Millennium Development Goals. For doctors to contribute to these efforts without detracting from domestic service and training commitments presents a challenge. Moreover, doctors need suitable education in order to make appropriate and effective contributions in resource-poor settings. In this article it is argued that, while mechanisms exist within current UK postgraduate training that permit a degree of flexibility to training pathways, they are not structured in a way that facilitates work in low and middle income countries. Furthermore, the knowledge and skills required to make contributions to global health are not sufficiently served by existing training. A model for a national curriculum and tiered qualifications in global health is proposed, based on rigorous appraisal and mentoring to complement the training pathways for UK specialisation, allowing doctors to add global health skills at a level appropriate for their career plans.     

Interprofessional simulation training for community mental health teams: Findings from a mixed methods study

ABSTRACT

Community mental health teams (CMHTs) in England face mounting service pressures due to an increased focus on out-of-hospital care. Interprofessional working is essential to providing good mental healthcare in community settings. Simulation training is underused in mental health, despite strong support for its improvement of clinical skills, confidence, teamwork, and interprofessional collaboration in other healthcare settings. This study aims to evaluate the impact of simulation training on community mental health professionals. An interprofessional simulation training course on assessment and team working skills for community mental health professionals was developed and delivered at a time of service reorganisation in South London services, including changes to job roles and responsibilities. In total, 57 course participants completed a survey that measured perceptions of knowledge and confidence, as well as a general view of the course. Eight participants took part in further semi-structured interviews 2–3 months after the course to provide perceptions about this experience’s subsequent impact. There were statistically significant increases in knowledge and confidence scores with large effect sizes. Thematic analyses of open-text survey and interview data identified emergent themes of interprofessional understanding; attitudes in clinical practice; staff well-being; the value of reflection; opportunity for feedback; and fidelity to clinical practice. Simulation training can improve confidence and knowledge in core skills and team working for CMHTs. Participants reported benefits to key areas of community mental healthcare, such as interprofessional collaboration, reflective practice, and staff well-being. Findings represented individual and team learning, as well as subsequent changes to clinical practice, and were related back to the interactive and reflective nature of the simulation. Implications are highlighted concerning the use of interprofessional simulation training in mental health, particularly relating to staff well-being, attitudes, and interprofessional working.     

急救模拟训练在心内科轮转护士培训中的应用

目的:探讨应用急救模拟训练对提高心血管内科轮转护士急救能力的效果。方法:选择2011年7月~2013年7月新毕业轮转我科的护士120名,随机等分为试验组和对照组,对照组采用常规教学法,试验组在采用常规教学方法的基础上增设急救模拟训练,比较两组医师对护士抢救配合的满意度、出科前急救模拟训练考核成绩及采用自设问卷调查护士急救能力。结果:采用急救模拟训练的轮转护士急救能力明显高于常规教学法训练的护士,差异有统计学意义,P0.05。结论:急救模拟训练能提高新毕业轮科护士的急救能力,是一种理想的低年资护士在职培训方法,值得临床推广应用。     

Improving patient safety by using interprofessional simulation training in health professional education

Modern medicine is complex. Reports and surveys demonstrate that patient safety is a major problem. Health educators focus on professional knowledge and less on how to improve patient care and safety. The ability to act as part of a team, fostering communication, co-operation and leadership is seldom found in health education. This paper reports the findings from pilot testing a simulated training program in interprofessional student teams. Four teams each comprising one medical, nursing, and intensive nursing student (n = 12), were exposed to two simulation scenarios twice. Focus groups were used to evaluate the program. The findings suggest that the students were satisfied with the program, but some of the videos and simulation exercises could be more realistic and more in accordance with each other. Generally they wanted more interprofessional team training, and had learned a lot about their own team performance, personal reactions and lack of certain competencies. Involving students in interprofessional team training seem to be more likely to enhance their learning process. The students' struggles with roles, competence and team skills underline the need for more focus on combining professional knowledge learning with team training.     

Improving patient safety by using interprofessional simulation training in health professional education

Modern medicine is complex. Reports and surveys demonstrate that patient safety is a major problem. Health educators focus on professional knowledge and less on how to improve patient care and safety. The ability to act as part of a team, fostering communication, co-operation and leadership is seldom found in health education. This paper reports the findings from pilot testing a simulated training program in interprofessional student teams. Four teams each comprising one medical, nursing, and intensive nursing student (n = 12), were exposed to two simulation scenarios twice. Focus groups were used to evaluate the program. The findings suggest that the students were satisfied with the program, but some of the videos and simulation exercises could be more realistic and more in accordance with each other. Generally they wanted more interprofessional team training, and had learned a lot about their own team performance, personal reactions and lack of certain competencies. Involving students in interprofessional team training seem to be more likely to enhance their learning process. The students' struggles with roles, competence and team skills underline the need for more focus on combining professional knowledge learning with team training.     

脑血管病后完全性失语的治疗

完全性失语(球性失语)是脑损伤后最严重的失语症,是治疗的难题。本文着重探讨了我康复中心3年来所收治的110例脑血管病后失语症中观察到的10例完全性失语患者,在药物治疗的同时进行了语言治疗,其方法包括听理解、阅读理解和口语表达、书写能力的恢复训练。结果:8例听理解力、呼名、复述、自动言语与书写能力有进步,7例阅读功能有改进,2例呼名、复述和阅读能力有明显进步。     

Preparing nurse leaders for global health reforms

One of the International Council of Nurses' main remits, on behalf of its member organisations, is to prepare nurses for management and leadership roles. Its Leadership for Change (LFC) programme aims to complement a country's own educational and development schemes, to give nurses confidence in facing the challenges of health reforms in response to demand for services. This article describes the structure of LFC and illustrates how it helps nurses to emerge as effective leaders.