Validation of the Simulated Ward Environment for Assessment of Ward-Based Surgical Care

被引:39
作者
Pucher, Philip H. [1 ]
Aggarwal, Rajesh [1 ]
Srisatkunam, Tharanny [2 ]
Darzi, Ara [1 ]
机构
[1] Univ London Imperial Coll Sci Technol & Med, Dept Surg & Canc, Div Surg, London, England
[2] Univ London Imperial Coll Sci Technol & Med, Fac Med, London, England
关键词
postoperative; simulation; surgery; training; ward round; NONTECHNICAL SKILLS; INPATIENT SURGERY; ADVERSE EVENTS; PATIENT SAFETY; MANAGEMENT; MORTALITY; TEAMWORK;
D O I
10.1097/SLA.0b013e318288e1d4
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). Background: Increasing evidence points to the importance of the postoperative or ward-based phase of surgical care in determining patient outcomes. Ward-based care is determined by the clinician ward round, with the simulated ward environment potentially providing a safe environment for training and assessment. Methods: A high-fidelity surgical ward environment was developed. Junior and senior trainees conducted ward rounds of 3 standardized surgical patients and were assessed using a checklist of assessment and management care processes, modified NOTECHS score, and fidelity questionnaire. Results: Nine senior and 9 junior trainees were observed. There was no significant difference in time taken to conduct the round (37.6 2.7 vs 32.6 +/- 1.9 minutes, P = 0.16). Senior trainees performed significantly more assessment processes (73% +/- 2.8% vs 63% +/- 2.5%, P = 0.016) and completed more management tasks (73% +/- 4.5% vs 59.4% +/- 5%, P = 0.058). Fifteen adverse events were committed by junior trainees versus 8 by seniors (P < 0.001). Seniors scored higher on nontechnical ability (NOTECHS score 21.8 +/- 0.61 vs 18.1 +/- 1.12, P = 0.017). All of subjects felt the ward, patients, and scenarios were realistic. Conclusions: A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.
引用
收藏
页码:215 / 221
页数:7
相关论文
共 28 条
[1]  
American College of Surgeons Division of Education, 2012, ACS APDS SURG SKILLS
[2]  
[Anonymous], 2012, SENT EV DAT ROOT CAU
[3]   Barriers and attitudes influencing non-engagement in a peer feedback model to inform evidence for GP appraisal [J].
Curnock, Esther ;
Bowie, Paul ;
Pope, Lindsey ;
McKay, John .
BMC MEDICAL EDUCATION, 2012, 12
[4]  
Fanning Ruth M, 2007, Simul Healthc, V2, P115, DOI 10.1097/SIH.0b013e3180315539
[5]   Complications, Failure to Rescue, and Mortality With Major Inpatient Surgery in Medicare Patients [J].
Ghaferi, Amir A. ;
Birkmeyer, John D. ;
Dimick, Justin B. .
ANNALS OF SURGERY, 2009, 250 (06) :1029-1034
[6]   Variation in Hospital Mortality Associated with Inpatient Surgery. [J].
Ghaferi, Amir A. ;
Birkmeyer, John D. ;
Dimick, Justin B. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 361 (14) :1368-1375
[7]  
Intercollegiate Committee for Basic Surgical Examinations, 2012, GUID INT MRCS EX
[8]   Early introduction to interprofessional learning: a simulated ward environment [J].
Ker, J ;
Mole, L ;
Bradley, P .
MEDICAL EDUCATION, 2003, 37 (03) :248-255
[9]   Training in surgical oncology - The role of VR simulation [J].
Lewis, T. M. ;
Aggarwal, R. ;
Rajaretnam, N. ;
Grantcharov, T. P. ;
Darzi, A. .
SURGICAL ONCOLOGY-OXFORD, 2011, 20 (03) :134-139
[10]   A comprehensive examination for senior surgical residents [J].
MacRae, H ;
Regehr, G ;
Leadbetter, W ;
Reznick, RK .
AMERICAN JOURNAL OF SURGERY, 2000, 179 (03) :190-193