Improving the relational aspects of trauma care through translational simulation

Advances in Simulation

Victoria Brazil¹  Charlotte Alexander²  Eve Purdy³  Jack Matulich⁴ 

[1] 0000 0004 0405 3820, grid.1033.1, Faculty of Health Science and Medicine, Bond University, Robina, QLD, Australia;0000 0004 0625 9072, grid.413154.6, Gold Coast Hospital and Health Service, Southport, QLD, Australia;0000 0004 0625 9072, grid.413154.6, Emergency Department, Gold Coast Hospital and Health Service, Southport, QLD, Australia;0000 0004 0625 9072, grid.413154.6, Gold Coast Hospital and Health Service, Southport, QLD, Australia;0000 0004 1936 8331, grid.410356.5, Queen’s University, Kingston, ON, Canada;0000 0004 0625 9072, grid.413154.6, Simulation Service, Gold Coast Hospital and Health Service, Southport, QLD, Australia;

关键词: Teamwork;    Trauma care;    Simulation;    Ethnography;    Culture;   

DOI  :  10.1186/s41077-019-0100-2

来源: publisher

【 摘 要 】

BackgroundMajor trauma care is complex and requires individuals and teams to perform together in time critical, high-stakes situations. Scenario-based simulation is well established as a strategy for trauma teamwork improvement, but its role in the relational and cultural aspects of trauma care is less well understood. Relational coordination theory offers a framework through which we aimed to understand the impact of an established trauma simulation programme.MethodsWe studied simulation activities using a narrative survey of trauma providers from anaesthesia, emergency medicine, medical imaging, surgery, trauma service, intensive care, and pre-hospital providers at Gold Coast University Hospital, in conjunction with data from an ethnography. Data analysis was performed using a recursive approach—a simultaneous deductive approach using the relational coordination framework and an inductive analysis.ResultsNinety-five of 480 (19.8%) staff completed free-text survey questions on simulation. Deductive analysis of data from these narrative survey results using the RC framework domains identified examples of shared goals, shared knowledge, communication and mutual respect. Two major themes from the inductive analysis—“Behaviour, process and system change” and “Culture and relationships”—aligned closely with findings from the RC analysis, with additional themes of “Personal and team learning” and the “Impact of the simulation experience” identified.ConclusionsOur findings suggest that an established trauma simulation programme can have a profound impact on the relational aspects of care and the development of a collaborative culture, with perceived tangible impacts on teamwork behaviours and institutional systems and processes. The RC framework—shared knowledge, shared goals and mutual respect in the context of communication that is timely, accurate, frequent and problem-solving based—can provide a common language for simulation educators to design and debrief simulation exercises that aim to have a translational impact.

【 授权许可】

CC BY