PDF(Pubmed)
Abstract：
UNASSIGNED: The advance of digital health technologies has created new forms of potential pathology which are not captured in current clinical guidelines. Through simulation-based research, we have identified the challenges to clinical care that emerge when patients suffer from illnesses stemming from failures in digital health technologies.
UNASSIGNED: Clinical simulation sessions were designed based on patient case reports relating to (a) medical device hardware errors, (b) medical device software errors, (c) complications of consumer technology and (d) technology-facilitated abuse. Clinicians were recruited to participate in simulations at three UK hospitals; audiovisual suites were used to facilitate group observation of simulation experience and focused debrief discussions. Invigilators scored clinicians on performance, clinicians provided individual qualitative and quantitative feedback, and extensive notes were taken throughout.
UNASSIGNED: Paired t-tests of pre and post-simulation feedback demonstrated significant improvements in clinician\'s diagnostic awareness, technical knowledge and confidence in clinical management following simulation exposure (p < 0.01). Barriers to care included: (a) low suspicion of digital agents, (b) attribution to psychopathology, (c) lack of education in technical mechanisms and (d) little utility of available tests. Suggested interventions for improving future practice included: (a) education initiatives, (b) technical support platforms, (c) digitally oriented assessments in hospital workflows, (d) cross-disciplinary staff and (e) protocols for digital cases.
UNASSIGNED: We provide an effective framework for simulation training focused on digital health pathologies and uncover barriers that impede effective care for patients dependent on technology. Our recommendations are relevant to educators, practising clinicians and professionals working in regulation, policy and industry.
UNASSIGNED: Clinical simulation sessions were designed based on patient case reports relating to (a) medical device hardware errors, (b) medical device software errors, (c) complications of consumer technology and (d) technology-facilitated abuse. Clinicians were recruited to participate in simulations at three UK hospitals; audiovisual suites were used to facilitate group observation of simulation experience and focused debrief discussions. Invigilators scored clinicians on performance, clinicians provided individual qualitative and quantitative feedback, and extensive notes were taken throughout.
UNASSIGNED: Paired t-tests of pre and post-simulation feedback demonstrated significant improvements in clinician\'s diagnostic awareness, technical knowledge and confidence in clinical management following simulation exposure (p < 0.01). Barriers to care included: (a) low suspicion of digital agents, (b) attribution to psychopathology, (c) lack of education in technical mechanisms and (d) little utility of available tests. Suggested interventions for improving future practice included: (a) education initiatives, (b) technical support platforms, (c) digitally oriented assessments in hospital workflows, (d) cross-disciplinary staff and (e) protocols for digital cases.
UNASSIGNED: We provide an effective framework for simulation training focused on digital health pathologies and uncover barriers that impede effective care for patients dependent on technology. Our recommendations are relevant to educators, practising clinicians and professionals working in regulation, policy and industry.
摘要：
■数字健康技术的进步创造了新形式的潜在病理，目前的临床指南中没有捕捉到。通过基于仿真的研究，我们已经确定了当患者因数字健康技术失败而患病时，临床护理面临的挑战。
■临床模拟会议是根据与（a）医疗设备硬件错误，(b)医疗器械软件错误，（c）消费者技术的复杂性和（d）技术促进的滥用。招募临床医生参加英国三家医院的模拟；视听套件用于促进模拟经验的小组观察和重点汇报讨论。监考人员对临床医生的表现进行评分，临床医生提供个人定性和定量反馈，并进行了广泛的笔记。
■模拟前和模拟后反馈的配对t检验表明，临床医生的诊断意识显着提高，模拟暴露后对临床管理的技术知识和信心(p<0.01)。护理障碍包括：(a)对数字代理人的怀疑低，(b)精神病理学的归属，(c)缺乏技术机制方面的教育，(d)现有测试的效用很小。改进未来做法的建议干预措施包括：(a)教育举措，(b)技术支持平台，(C)医院工作流程中的数字化评估，(d)跨学科工作人员和(e)数字案件的协议。
■我们提供了一个有效的模拟训练框架，专注于数字健康病理，并发现阻碍对依赖技术的患者进行有效护理的障碍。我们的建议与教育工作者有关，执业的临床医生和专业人员在监管工作，政策和产业。
■临床模拟会议是根据与（a）医疗设备硬件错误，(b)医疗器械软件错误，（c）消费者技术的复杂性和（d）技术促进的滥用。招募临床医生参加英国三家医院的模拟；视听套件用于促进模拟经验的小组观察和重点汇报讨论。监考人员对临床医生的表现进行评分，临床医生提供个人定性和定量反馈，并进行了广泛的笔记。
■模拟前和模拟后反馈的配对t检验表明，临床医生的诊断意识显着提高，模拟暴露后对临床管理的技术知识和信心(p<0.01)。护理障碍包括：(a)对数字代理人的怀疑低，(b)精神病理学的归属，(c)缺乏技术机制方面的教育，(d)现有测试的效用很小。改进未来做法的建议干预措施包括：(a)教育举措，(b)技术支持平台，(C)医院工作流程中的数字化评估，(d)跨学科工作人员和(e)数字案件的协议。
■我们提供了一个有效的模拟训练框架，专注于数字健康病理，并发现阻碍对依赖技术的患者进行有效护理的障碍。我们的建议与教育工作者有关，执业的临床医生和专业人员在监管工作，政策和产业。
