背景:工作场所暴力不成比例地影响医护人员,并且经常发生患者的言语攻击。虽然口头降级是化解愤怒的第一线方法,在本科医学教育中,缺乏一致的课程或强有力的评估。
目的:制定医学院课程,重点关注成人患者的降级技能,并通过调查和客观结构化临床检查(OSCE)评估有效性。
方法:我们在2023年一家大型学术机构的“准备好居留训练营”中实施了此课程。
方法:44名四年级医学生计划描述:课程包括一个交互式教学,重点是我们新颖的CALMER框架,该框架优先考虑六种基于证据的降级技能和单独的标准化患者实践课程。
结果:课程后调查(82%的响应率)发现,使用口头降级的信心从5分(p≤0.001)的2.79显着增加到4.11。各项技能和课程满意度的提高提高,平均为5分之4.79。欧安组织发现接受课程的学生和未接受课程的学生之间的技能水平没有差异。
结论:这种基于证据和可复制的降级技能课程提高了医学生管理躁动患者的信心和准备。
BACKGROUND: Workplace violence disproportionately affects healthcare workers and verbal aggression from patients frequently occurs. While verbal de-escalation is the first-line approach to defusing anger, there is a lack of consistent curricula or robust evaluation in undergraduate medical education.
OBJECTIVE: To develop a medical school curriculum focused on de-escalation skills for adult patients and evaluate effectiveness with surveys and an objective structured clinical examination (OSCE).
METHODS: We implemented this curriculum in the \"Get Ready for Residency Bootcamp\" of a single large academic institution in 2023.
METHODS: Forty-four fourth-year medical students PROGRAM DESCRIPTION: The curriculum consisted of an interactive didactic focused on our novel CALMER framework that prioritized six evidence-based de-escalation skills and a separate standardized patient practice session.
RESULTS: The post-curriculum survey (82% response rate) found a significant increase from 2.79 to 4.11 out of 5 (p ≤ 0.001) in confidence using verbal de-escalation. Preparedness improved with every skill and curriculum satisfaction averaged 4.79 out of 5. The OSCE found no differences in skill level between students who received the curriculum and those who did not.
CONCLUSIONS: This evidence-based and replicable de-escalation skill curriculum improves medical student confidence and preparedness in managing agitated patients.