Identifying Stress-Associated Factors to Develop Advanced Emergency Medicine Simulation

识别压力相关因素以开发先进的急诊医学模拟

• 批准号: 9329364
• 负责人: Kathryn M Kellogg
• 金额: $ 4.75万
• 依托单位: MEDSTAR HEALTH RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9329364
• 关键词: Identifying; Stress; Associated; Factors; Develop

Project Summary/Abstract Surrounded by a cacophony of sounds, severely ill patients, frustrated family members, and frequent interruptions, emergency physicians provide care in an incredibly complex environment and report significant amounts of job-related stress. Stress has been shown to negatively affect decision-making, technical skills, and team interactions, and therefore has the potential to negatively affect patient care and patient outcomes. Prolonged occupational stress also contributes to burnout, and emergency physicians leaving the specialty, thereby limiting available providers to care for patients. While emergency physicians have long reported work-related stress, little is known about the true stress- inducing factors of the emergency department work environment. Additionally, simulation is an important component of education for physicians-in-training, however simulation as it is used in healthcare usually features low psychological fidelity, or the ability of the simulation to evoke the same psychological response as the true environment. Psychological fidelity has been linked to improved transference of skills learned in simulation to practice in real-world environments. In Specific Aim 1 we will begin the work of elucidating the stress-associated factors of the emergency department environment by using an innovative method, developed from strategies used in other high-risk industries such as aviation, of using unobtrusive physiologic response monitoring of physicians at work to evaluate stress-inducing factors. The factors discovered here will be further evaluated and validated using semi-structured interviews and qualitative methods in Specific Aim 2, with a resulting robust taxonomy of stress- associated factors in the emergency department work environment. This taxonomy will be used in Specific Aim 3 to develop preliminary simulation scenarios with improved psychological fidelity as the final outcome of this project. These scenarios will serve as the foundation for a follow-on proposal in which we will develop stress-management techniques and evaluate these in a randomized, controlled fashion in the setting of the improved simulation scenarios.

项目摘要/摘要 被声音刺耳的人包围，严重患者，沮丧的家庭成员和频繁 中断，急诊医师在令人难以置信的复杂环境中提供护理和报告 大量与工作相关的压力。压力已被证明对决策产生负面影响， 技术技能和团队互动，因此有可能对患者护理产生负面影响 和患者的结果。长时间的职业压力也会导致倦怠和紧急 医生离开专业，从而限制了可用的提供者来照顾患者。尽管 急诊医师长期以来一直报告与工作相关的压力，对真正的压力知之甚少 引起急诊部工作环境的因素。另外，模拟是重要的 培训医师教育的组成部分，但是通常在医疗保健中使用的模拟 具有低心理忠诚度或模拟唤起相同心理的能力 响应是真正的环境。心理保真度与改善的转移有关 在模拟中学到的技能在现实世界环境中练习。在特定目标1中，我们将开始 通过使用 创新方法，从其他高风险行业（例如航空， 使用对工作中医生的不受欢迎的生理反应监测来评估诱导压力 因素。此处发现的因素将通过半结构化进一步评估和验证 特定目标2中的访谈和定性方法，由此产生了强大的压力分类法 - 急诊部工作环境中的相关因素。该分类法将用于 具体目标3以发展心理忠诚度的初步模拟方案 该项目的最终结果。这些场景将作为后续提案的基础 我们将开发压力管理技术，并在随机，控制的 在改进的模拟方案的环境中的时尚。