The teaching of non-technical skills through medical simulation

• Autor(a) principal: Silva, Juliana Andreia da Costa e
• Data de Publicação: 2011
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/1051
• topic: Educação médica; Prática médica - Competências técnicas; Prática médica - Simulação - Mais-valia; Prática médica - Competências não-técnicas

Introduction: To meet society‘s expectations that physicians ―can and will attend equally to all aspects of health care,‖ the Association of American Medical Colleges‘ Medical School Objectives Project Report I has stated that physicians must be altruistic, knowledgeable, skillful, and dutiful. Considering that skills may be defined as actions and reactions performed by an individual in a competent way in order to achieve a goal, there is no doubt that this goal will be better managed the greater the expertise and practical skills of its performer. Based on this statement, the recreation of real situations to improve practical skills, allows the benefits of learning through simulation to become increasingly effective and reliable. It is obvious that clinical procedures require technical skills. Skills‘ training using simulation has, for the most part, focused on technical expertise, ignoring other key competencies such as professionalism and communication skills. Despite studies on non-technical skills (NTS) claiming the emerging need of their valuation and implementation in medical education alongside technical skills (TS), in most instances and institutions such education is lacking. Objective: The main purpose of this study is better understand the importance attributed to teaching of NTS alongside TS, and the implementation of such skills teaching through medical simulation in medical simulation centres around the world. Methods: This was an exploratory study. The research model used was descriptive and correlational (i.e. centred on the description and characterization of variables involved); 1090 Simulation Centres worldwide were randomly mapped by manual search via Internet. Of these, 39 answered an online questionnaire. Results: 1090 Simulation Centres worldwide were mapped and a contact list was created. Of the 39 centres that responded, most were from the United States of America (n=22). About half of the total participating centres were founded after 2004 and about a quarter after 2007. The surveyed institutions teach on average around 193 courses per year to an average number of 1532 students. Of all participants in the study, 64.7% of them (n=22) said they had a course with special focus on NTS, and twelve declined (36.1%). Results also show that centre‘s antiquity appear to relate with the amount of courses supplied by these centres (p=0.038 and p=0.011<0.05, respectively). Besides, it is also possible to conclude that there is a differentiated focus on the teaching of NTS according to the Simulation Centres‘ antiquity (p<0.05), which proves that in older simulation centres there is a greater differentiated focus on the teaching of NTS.Conclusion: Nowadays, being the teaching of NTS a recent but growing phenomenon, the level of implementation of NTS is still far from meeting expectations, and the importance attributed. It may also be noted, by distribution found, that many simulation centers exist worldwide especially in the United States, but increasingly in Europe and Asian nations. Moreover, one may conclude that there is a strong relationship between the antiquity of the institutions, the training supply of the centres and the existence of a differentiated focus on the teaching of NTS. The oldest institutions, with greater volume of courses to be taught, are usually also the ones who contemplate courses geared specifically to teaching non-technical skills.