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首页> 外文期刊>Journal of Nursing Education and Practice >Assessing human factors during simulation: The development and preliminary validation of the rescue assessment tool
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Assessing human factors during simulation: The development and preliminary validation of the rescue assessment tool

机译：在仿真过程中评估人为因素：救援评估工具的开发和初步验证

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Background: Failure to rescue the deteriorating patient is a concern for all healthcare providers. In response to this problem providers have introduced a range of interventions to promote timely rescue. Human factors and non-technical skills play a part in both the recognition of ill patients and in the delivery of interventions associated with their successful rescue. Given the risks to patient safety which failure to rescue raises, simulation provides a vehicle for staff training and development in terms of both technical and non-technical skills. This paper describes the development and preliminary validation of a human factors rating tool specifically designed to assess the non-technical skills associated with the recognition and rescue of the deteriorating patient. Methods: Using high fidelity simulation scenarios related to patient deterioration Faculty independently rated student performance. Scoring took place using video footage of the students’ performance. Data were analyzed to establish the validity of the tool, internal consistency between categories and elements and inter-rater reliability. Results: Content validity was established through a process of review and by checking for duplicate or redundant items. The internal consistency of the tool was acceptable with a Cronbach’s alpha of 0.84. Factor analysis suggested that the tool assessed only two components rather than the three hypothesized during tool development. The components were labelled as recognizing and responding and leading and reassuring. Inter-rater reliability was initially poor at 0.21 but following training of raters this rose to above 0.8 for two videos related to the same scenario one which had been used during training. However, when the scenario changed the reliability dropped to 0.5. Conclusions: Rescue appears to be a well-structured tool with good levels of inter-rater reliability following intensive training related to the specific scenario being scored. Further work is required to establish all aspects of construct validity and to ensure test-retest reliability.
机译：背景：无法挽救恶化的患者是所有医疗保健提供者关注的问题。针对此问题，提供者已采取了一系列干预措施以促进及时营救。人为因素和非技术技能在识别患病患者以及提供与成功救助相关的干预措施中都发挥着作用。鉴于无法挽救会给患者带来安全隐患，模拟技术为员工的技术和非技术技能培训和发展提供了一种手段。本文介绍了人为因素评估工具的开发和初步验证，该工具专门用于评估与恶化患者的识别和抢救相关的非技术技能。方法：使用与患者恶化相关的高保真模拟方案，学院对学生的表现进行独立评估。使用学生表现的录像进行评分。分析数据以确定工具的有效性，类别和元素之间的内部一致性以及评估者之间的可靠性。结果：内容有效性是通过审查过程以及检查重复项或冗余项来确定的。该工具的内部一致性在Cronbach的alpha为0.84时是可以接受的。因子分析表明，该工具仅评估了两个组成部分，而不评估工具开发过程中假设的三个组成部分。这些组件被标记为识别和响应以及领导和保证。评估者间的可靠性最初很差，为0.21，但是在评估者进行培训后，对于与在培训期间使用的同一场景相关的两个视频，该值上升到0.8以上。但是，当方案更改时，可靠性下降到0.5。结论：救援似乎是一种结构良好的工具，在与特定评分情况相关的强化训练后，评估者之间的信度水平较高。需要进一步的工作来确定构建有效性的所有方面并确保重测的可靠性。

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