培训是医疗保健环境中使用的关键实施策略。这项研究旨在确定一系列促进指南实施的临床医生培训技术,促进临床医生行为改变,优化临床结果,并解决内隐偏见,以促进高质量的妇幼保健(MCH)护理。在PubMed内部进行了范围审查,CINAHL,PsycInfo,和Cochrane数据库使用与(提供者或临床医生)和(教育或培训)相关的迭代搜索。共有152篇文章符合纳入/排除标准。培训涉及多种临床医生类型(例如,医师,护士),主要在医院实施(63%)。主题集中在产妇/胎儿发病率/死亡率(26%),团队合作和沟通(14%),和筛选,评估,和测试(12%)。常见的技术包括说教(65%),模拟(39%),动手(例如,场景,角色扮演)(28%),讨论(27%)。报告的培训中有不到一半(42%)是基于指南或循证实践。少数文章报告评估了临床医生知识的变化(39%),信心(37%),或临床结果(31%)。二级审查确定了22篇与内隐偏见训练相关的文章,它使用了其他反射方法(例如,隐式偏差测试,角色扮演,和患者观察)。尽管确定了许多培训技术,未来的研究需要确定最有效的培训技术,最终改善以患者为中心的护理和结果。
Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping
review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary
review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.