مقاله انگلیسی رایگان در مورد توسعه مهارتهای مدیریت بحران – الزویر 2017

The use of crisis resource management principles (CRM), including problem solving, situational awareness, resource utilization, communication, and leadership, have been thought to reduce adverse patient outcomes and lead to greater teamwork in healthcare settings. Education programs using high-fidelity simulation (HFS) has become an increasingly popular strategy to teach these skills. There is little evidence however demonstrating the effectiveness of this type of education on actual performance of these skills. In order to explore the effectiveness of HFS education on development of CRM skills, a literature review was undertaken to identify evidence available in the healthcare literature. Thirty-one articles were identified that met criteria for this review. Articles were highly variable in methods, population used, educational intervention, evaluative method, and results. The following paper outlines a summary of these results, including synthesis of findings and recommendations for research in this area.

Although numbers and percentages vary, a vast number of patients die from what are perceived as preventable errors (Rudy, Polomano, Murray, Henry, & Marine, 2007). To avoid these errors, health care professionals must have knowledge of threats to patient safety and experience in caring for patients when extraordinary clinical problems arise. Recently, a focus in application of crisis resource management (CRM) principles has been thought to reduce adverse patient outcomes and lead to greater teamwork in crisis events (Messmer, 2008). CRM is a set of principles that encompass a range of cognitive and interpersonal skills aimed at creating an environment of improved efficiency, teamwork, and safety (Gaba, 2010; White, 2012). Key CRM skills include (a) problem solving, (b) situational awareness, (c) resource utilization, (d) communication, and (e) leadership. Education programs that focus on these CRM skills have been shown to have a positive impact on learner competence in handling crisis events (Kim, Neilipovitz, Cardinal, Chiu, & Clinch, 2006). By teaching health care providers CRM foundational skills, the cognitive and interpersonal skills that allow them to critically analyze and respond in crisis situations will be developed as well (Andersen, Jensen, Lippert, & Ostergaard, 2010; Bearman et al., 2012; Gordon, Mendenhall, & Blair O’Connor, 2013; Pearson & McLafferty, 2011; White, 2012). So, how can experience with CRM skills be created? How can professionals practice responses with deteriorating patients without jeopardizing safety? In recent years, growing numbers of health care professions have turned to simulation as a way to answer these questions. High-fidelity simulation (HFS) has become a popular method of teaching CRM skills. One form of HFS uses advanced humanepatient simulators, which are computerized manikins that ‘‘can mimic diverse parameters of human physiology, such as changes in cardiovascular, pulmonary, metabolic, and neurological systems’’ (Lapkin, LevettJones, Bellchambers, & Fernandez, 2010, p. e 209). Gaba (2010) identified that ‘‘the most frequent question now asked about CRM and teamwork training in health care, and especially for that using simulation, is ‘where is the evidence’?’’ (p. 4). A literature review was undertaken to identify available evidence on the effectiveness of HFS education interventions on development of CRM skills, meaning, have learners translated behaviours learned in the simulation environment into performance of CRM skills? This was addressed via the following question: what evidence is there to demonstrate the effectiveness of HFS learning programs on health care professionals’ acquisition and performance of CRM skills? A summary of this evidence, including synthesis of findings and recommendations for research in this area, will be outlined.