Authors (including presenting author) :
LEUNG ASH, SO EHK, CHEUNG VKL, SO SS, NG GWY, CHIA NH
Affiliation :
Multi-Disciplinary Simulation and Skills Centre, Queen Elizabeth Hospital
Introduction :
“To err is human” is never a cliché in contemporary medical service where precision approach has been applying in education for health-care professionals with diverse clinical backgrounds. Crew Resources Management (CRM), which advocates non-technical skills for quality and safety assurance, was refined by organizing committee to tailor 3 specialty-based training curriculums, namely “Anaes&OTS”, “O&G” and “Paediatrics” for medical and nursing staff.
Objectives :
1)To evaluate overall post-training effect of participants’ attitudinal shift on human factors (e.g., communication, assertiveness, leadership and situational awareness);2)To identify such differences between doctor and nurse, and, between generic and specialty-based sessions for curriculum planning.
Methodology :
Twelve CRM Classroom training sessions were conducted between April 2017 and March 2018. Of 168 participants, the largest proportion was accounted for by 37% from “Paediatrics”, coming next to “Anaes&OTS” (25%) followed by “O&G” and “Generic” classes (19%, for both). The female-male and nurse-doctor ratio was approximately 8:2 (see Table 1, for demographics). Human Factor Analysis Survey (HFAS), a 22-item Likert scale with excellent content validity and inter-item reliability (Cronbach’s α = .89), was rated by participants before-and-after training. Independent t-test was used to compare HFAS between doctor and nurse, and Dunnett’s post-hoc test to compare each discipline to “Generic” (at α=.05, one-way).
Result & Outcome :
[RESULTS] Nurses showed no statistical difference in overall HFAS changes (M=.227, SD=.252) than did their doctor counterparts (M=.30, SD=.32), t(166)= -1.18, p=.24, two-tailed). However, nurses outweighed doctors by 46% in proportion of HFAS items reaching significant changes (see Table 2). [Compared with “Generic”]: “Paediatrics” strengthened their trust (diff_Item10=.35, p=.02) on how trained and experienced staff make good decision in operation; “O&G” (diff_Item13=.40, p=.03) on that leader should take into account member’s concerns for a decision; “Anaes&OTS” (diff_Item15=.30, p=.03) and “Paediatrics” (diff_Item15=.26, p=.04) on how essential instruction and feedback from supervisor is in teamwork skills attainment; and “Anaes&OTS” (diff_Item18=.34, p=.049) on empowering team member whenever necessary.[CONCLUSION] Consistent with HFAS findings in 2016, CRM classroom training was satisfactory to evoke positive attitudinal changes on human factors, particularly for nurses. Compared with generic classes, specialty-based designs resulted in additive impact on trainee’s attitudinal changes for “O&G” (22.7%), “Paediatrics” (27.3%) and “Anaes&OTS” (45.5%). Training effect of CRM appears optimized by replacing “one-size-fit-all” approach with department-specific modification and, in turns, enhances overall clinical safety, team morale, as well as communication with patients and stakeholders in the community.
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