Authors (including presenting author) :
So EHK(1)(2), Cheung VKL(1), Chan LH(2), Yip JWH(1), Wong PK (1), Cheung SHK (1), Chia NH(1)(3), Ng GWY(1)(4)
Affiliation :
(1) Multi-Disciplinary Simulation and Skills Centre (MDSSC), Queen Elizabeth Hospital (2) Department of Anaesthesiology & Operating Theatre Services, Queen Elizabeth Hospital (3) Department of Surgery, Queen Elizabeth Hospital (4) Intensive Care Unit, Queen Elizabeth Hospital
Introduction :
Under manpower shortage, HA has been launching the “Greater Bay Area (GBA) Healthcare Talents Exchange Programme” for capacity enhancement since September 2022. Despite lacking in academic literatures and comparable local programme, our training centre put great emphasis on “healthcare acculturation” throughout the service integration journey.
Objectives :
As partial advancement from roll-out of “深化醫療團隊協作計劃” programme (Phase I), this project (Phase II) aims to: i) elicit perceived training needs regarding elements of Crew Resource Management (CRM) and medical education, ii) understand/ further explore common barriers (and specific themes) in acculturation process from perspective of non-locally trained professionals in local healthcare setting, iii) and address perceived learning effect 3-month after Phase I.
Methodology :
This was a mixed-method study applying i) structural interview with open-ended questions to elicit qualitative responses for common themes of healthcare acculturation barrier and ii) questionnaire to quantify preference on CRM elements, experience in integrating innovative approach into healthcare education, and perceived level of knowledge acquisition at 3 time points. All sessions, including interviewing materials design and validation, were carried out by our team which consisted of medical/ surgical consultants, nurse, administrators, and research psychologist at the Multi-Disciplinary Simulation and Skills Centre in Queen Elizabeth Hospital. Through non-random purposive sampling method, all non-locally trained doctors and nurses from KCC who have accomplished Phase I (Interactive CRM Session) were invited to participate in Phase II (Innovative Education and Research Exposure) 3-month post Phase I (Acceptance Rate = 91%). Through full review, research team was enabled to identify common themes related to CRM, service gap of innovative medical education, and barriers in healthcare acculturation process. In retrieving matched scale data in Phase I, same items regarding contextual knowledge acquisition (in overall service and CRM elements) were re-evaluated using 5-point Likert scales (1=Strongly Disagree; 5=Strongly Agree), enabling research team to analyse learning effect among 3 time points with repeated measures ANOVA.
Result & Outcome :
Participants (N=31) considered healthcare simulation training effective in enhancing quality and safety of healthcare service (M=9.71, SD=.63). Despite perceived enhancement of training quality with innovative technologies (M=9.34/10, SD=1.00), almost all participants had prior experiences in traditional training modalities (Standardised Patient=97%; Part-task Trainer=94%) but not in their advanced technology counterparts (VR/AR=26%; 3D-printed Simulator=29%). Major challenges participants encountered in the acculturation process were themes related to “Communication barrier”(45%) and “Service Culture”(35%). With significant main effect of time, F(2,60)=35.82, p<.001, post-hoc tests using Bonferroni correction revealed that contextual knowledge in service overview and CRM elements increased by 1.07 unit scores after Phase I (p<.001), and then dropped by 0.36 unit scores after wash-out period in 3 months (p<.05). [Discussion] The findings confirmed high acceptance and perceived needs of non-locally trained professionals from GBA in enhancing quality and safety of healthcare service with innovative simulation training modalities. Observed learning retention pattern (peak at completion of Phase I but dropped by over 30% in 3 months) reminded simulation educator the importance of memory consolidation with post-learning materials plus scenario-based practice in CRM elements. Further studies could research into specific healthcare acculturation behaviours in communication with practical recommendation on incorporating invaluable findings into existing programme of CRM (e.g., communication barrier in clinical handover).
