Sample records for teamwork training evaluation
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Teamwork Assessment Tools in Modern Surgical Practice: A Systematic Review
Whittaker, George; Abboudi, Hamid; Khan, Muhammed Shamim; Dasgupta, Prokar; Ahmed, Kamran
2015-01-01
Introduction. Deficiencies in teamwork skills have been shown to contribute to the occurrence of adverse events during surgery. Consequently, several teamwork assessment tools have been developed to evaluate trainee nontechnical performance. This paper aims to provide an overview of these instruments and review the validity of each tool. Furthermore, the present paper aims to review the deficiencies surrounding training and propose several recommendations to address these issues. Methods. A systematic literature search was conducted to identify teamwork assessment tools using MEDLINE (1946 to August 2015), EMBASE (1974 to August 2015), and PsycINFO (1806 to August 2015) databases. Results. Eight assessment tools which encompass aspects of teamwork were identified. The Nontechnical Skills for Surgeons (NOTSS) assessment was found to possess the highest level of validity from a variety of sources; reliability and acceptability have also been established for this tool. Conclusions. Deficits in current surgical training pathways have prompted several recommendations to meet the evolving requirements of surgeons. Recommendations from the current paper include integration of teamwork training and assessment into medical school curricula, standardised formal training of assessors to ensure accurate evaluation of nontechnical skill acquisition, and integration of concurrent technical and nontechnical skills training throughout training. PMID:26425732
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Freytag, Julia; Stroben, Fabian; Hautz, Wolf E; Eisenmann, Dorothea; Kämmer, Juliane E
2017-01-01
Introduction Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects. Furthermore, teamwork-training sessions and studies examining education effects on undergraduates are rare. The study aims to evaluate the effects of two teamwork-focused debriefings on team performance after an extensive medical student teamwork training. Methods and analyses A prospective experimental study has been designed to compare a well-established three-phase debriefing method (gather–analyse–summarise; the GAS method) to a newly developed and more structured debriefing approach that extends the GAS method with TeamTAG (teamwork techniques analysis grid). TeamTAG is a cognitive aid listing preselected teamwork principles and descriptions of behavioural anchors that serve as observable patterns of teamwork and is supposed to help structure teamwork-focused debriefing. Both debriefing methods will be tested during an emergency room teamwork-training simulation comprising six emergency medicine cases faced by 35 final-year medical students in teams of five. Teams will be randomised into the two debriefing conditions. Team performance during simulation and the number of principles discussed during debriefing will be evaluated. Learning opportunities, helpfulness and feasibility will be rated by participants and instructors. Analyses will include descriptive, inferential and explorative statistics. Ethics and dissemination The study protocol was approved by the institutional office for data protection and the ethics committee of Charité Medical School Berlin and registered under EA2/172/16. All students will participate voluntarily and will sign an informed consent after receiving written and oral information about the study. Results will be published. PMID:28667224
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Carbo, Alexander R; Tess, Anjala V; Roy, Christopher; Weingart, Saul N
2011-06-01
Effective teamwork and communication can prevent error and mitigate harm. High-performance team training was developed in the aviation industry for flight crews and is being incorporated in health care settings, such as emergency departments, operating rooms, and labor and delivery suites. We translated and adapted high-performance teamwork and communication principles from other industries and other disciplines to an inpatient internal medicine environment. We selected key principles from aviation and anesthesia crew training programs in 2004 and organized them into the ABC'S of teamwork. These included appropriate Assertiveness, effective Briefings, Callback and verification, Situational awareness, and Shared mental models. Based on this content, we developed a training session for internal medicine residents and faculty, and evaluated learners' patient safety attitudes and knowledge before and after training with a written survey. More than 50 residents participated in the module. The percentage of correct answers on a question related to key teamwork principles increased from 35% before training to 67% after training (P = 0.03). Before training, 65% of the residents reported that they "would feel comfortable telling a senior clinician his/her plan was unsafe"; this increased to 94% after training (P = 0.005). After the training session, residents were able to provide examples from their clinical practice that emphasized all of the ABC'S of teamwork. Teamwork principles can be adapted from other disciplines and applied to internal medicine. After a single session, residents displayed greater knowledge of teamwork principles and reported changed attitudes toward key teamwork behaviors.
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Littlepage, Glenn E; Hein, Michael B; Moffett, Richard G; Craig, Paul A; Georgiou, Andrea M
2016-12-01
This study evaluates the effectiveness of a training program designed to improve cross-functional coordination in airline operations. Teamwork across professional specializations is essential for safe and efficient airline operations, but aviation education primarily emphasizes positional knowledge and skill. Although crew resource management training is commonly used to provide some degree of teamwork training, it is generally focused on specific specializations, and little training is provided in coordination across specializations. The current study describes and evaluates a multifaceted training program designed to enhance teamwork and team performance of cross-functional teams within a simulated airline flight operations center. The training included a variety of components: orientation training, position-specific declarative knowledge training, position-specific procedural knowledge training, a series of high-fidelity team simulations, and a series of after-action reviews. Following training, participants demonstrated more effective teamwork, development of transactive memory, and more effective team performance. Multifaceted team training that incorporates positional training and team interaction in complex realistic situations and followed by after-action reviews can facilitate teamwork and team performance. Team training programs, such as the one described here, have potential to improve the training of aviation professionals. These techniques can be applied to other contexts where multidisciplinary teams and multiteam systems work to perform highly interdependent activities. © 2016, Human Factors and Ergonomics Society.
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Two Hours of Teamwork Training Improves Teamwork in Simulated Cardiopulmonary Arrest Events.
Mahramus, Tara L; Penoyer, Daleen A; Waterval, Eugene M E; Sole, Mary L; Bowe, Eileen M
2016-01-01
Teamwork during cardiopulmonary arrest events is important for resuscitation. Teamwork improvement programs are usually lengthy. This study assessed the effectiveness of a 2-hour teamwork training program. A prospective, pretest/posttest, quasi-experimental design assessed the teamwork training program targeted to resident physicians, nurses, and respiratory therapists. Participants took part in a simulated cardiac arrest. After the simulation, participants and trained observers assessed perceptions of teamwork using the Team Emergency Assessment Measure (TEAM) tool (ratings of 0 [low] to 4 [high]). A debriefing and 45 minutes of teamwork education followed. Participants then took part in a second simulated cardiac arrest scenario. Afterward, participants and observers assessed teamwork. Seventy-three team members participated-resident physicians (25%), registered nurses (32%), and respiratory therapists (41%). The physicians had significantly less experience on code teams (P < .001). Baseline teamwork scores were 2.57 to 2.72. Participants' mean (SD) scores on the TEAM tool for the first and second simulations were 3.2 (0.5) and 3.7 (0.4), respectively (P < .001). Observers' mean (SD) TEAM scores for the first and second simulations were 3.0 (0.5) and 3.7 (0.3), respectively (P < .001). Program evaluations by participants were positive. A 2-hour simulation-based teamwork educational intervention resulted in improved perceptions of teamwork behaviors. Participants reported interactions with other disciplines, teamwork behavior education, and debriefing sessions were beneficial for enhancing the program.
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Fernandez, Rosemarie; Pearce, Marina; Grand, James A; Rench, Tara A; Jones, Kerin A; Chao, Georgia T; Kozlowski, Steve W J
2013-11-01
To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams. A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011. This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine. Participants (n = 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (nteams = 45). Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module. Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (e.g., "chest radiograph findings communicated to team" and "team member assists with intubation preparation") were standardized before combining to create overall teamwork scores. Similarly, patient care items ("chest radiograph correctly interpreted"; "time to start of compressions") were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity. When controlling for team members' medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42] = 4.81, p < 0.05; ηp = 10%) and patient care (F [1, 42] = 4.66, p < 0.05; ηp = 10%) than did teams in the placebo condition. Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.
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Freytag, Julia; Stroben, Fabian; Hautz, Wolf E; Eisenmann, Dorothea; Kämmer, Juliane E
2017-06-30
Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects. Furthermore, teamwork-training sessions and studies examining education effects on undergraduates are rare. The study aims to evaluate the effects of two teamwork-focused debriefings on team performance after an extensive medical student teamwork training. A prospective experimental study has been designed to compare a well-established three-phase debriefing method (gather-analyse-summarise; the GAS method ) to a newly developed and more structured debriefing approach that extends the GAS method with TeamTAG (teamwork techniques analysis grid). TeamTAG is a cognitive aid listing preselected teamwork principles and descriptions of behavioural anchors that serve as observable patterns of teamwork and is supposed to help structure teamwork-focused debriefing. Both debriefing methods will be tested during an emergency room teamwork-training simulation comprising six emergency medicine cases faced by 35 final-year medical students in teams of five. Teams will be randomised into the two debriefing conditions. Team performance during simulation and the number of principles discussed during debriefing will be evaluated. Learning opportunities, helpfulness and feasibility will be rated by participants and instructors. Analyses will include descriptive, inferential and explorative statistics. The study protocol was approved by the institutional office for data protection and the ethics committee of Charité Medical School Berlin and registered under EA2/172/16. All students will participate voluntarily and will sign an informed consent after receiving written and oral information about the study. Results will be published. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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Interprofessional teamwork among students in simulated codes: a quasi-experimental study.
Garbee, Deborah D; Paige, John; Barrier, Kendra; Kozmenko, Valeriy; Kozmenko, Lyubov; Zamjahn, John; Bonanno, Laura; Cefalu, Jean
2013-01-01
The purpose of this study was to evaluate the efficacy of using crisis resource management (CRM) principles and high-fidelity human patient simulation (HFHPS) for interprofessional (IP) team training of students from undergraduate nursing, nurse anesthesia, medical, and respiratory therapy. IP education using simulation-based training has the potential to transform education by improving teamwork and communication and breaking down silos in education. This one-year study used a quasi-experimental design to evaluate students' acquisition and retention of teamwork and communication skills. A convenience sample consisted of 52 students in the fall semester, with 40 students returning in the spring. Mean scores increased after training, and skills were retained fairly well. Any loss was regained with repeat training in the spring. The results suggest that using CRM and HFHPS is an effective pedagogy for teaching communication and teamwork skills to IP student teams.
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Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu
2014-08-11
The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.
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2014-01-01
Background The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. Methods We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. Results During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Conclusion Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation. PMID:25115403
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Toward an Optimal Pedagogy for Teamwork.
Earnest, Mark A; Williams, Jason; Aagaard, Eva M
2017-10-01
Teamwork and collaboration are increasingly listed as core competencies for undergraduate health professions education. Despite the clear mandate for teamwork training, the optimal method for providing that training is much less certain. In this Perspective, the authors propose a three-level classification of pedagogical approaches to teamwork training based on the presence of two key learning factors: interdependent work and explicit training in teamwork. In this classification framework, level 1-minimal team learning-is where learners work in small groups but neither of the key learning factors is present. Level 2-implicit team learning-engages learners in interdependent learning activities but does not include an explicit focus on teamwork. Level 3-explicit team learning-creates environments where teams work interdependently toward common goals and are given explicit instruction and practice in teamwork. The authors provide examples that demonstrate each level. They then propose that the third level of team learning, explicit team learning, represents a best practice approach in teaching teamwork, highlighting their experience with an explicit team learning course at the University of Colorado Anschutz Medical Campus. Finally, they discuss several challenges to implementing explicit team-learning-based curricula: the lack of a common teamwork model on which to anchor such a curriculum; the question of whether the knowledge, skills, and attitudes acquired during training would be transferable to the authentic clinical environment; and effectively evaluating the impact of explicit team learning.
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Lori, Jody R; Munro, Michelle L; Moore, Jennifer E; Fladger, Jessica
2013-04-11
Post-conflict Liberia has one of the fastest growing populations on the continent and one of the highest maternal mortality rates among the world. However, in the rural regions, less than half of all births are attended by a skilled birth attendant. There is a need to evaluate the relationship between trained traditional healthcare providers and skilled birth attendants to improve maternal health outcomes. This evaluation must also take into consideration the needs and desires of the patients. The purpose of this pilot study was to establish the validity and reliability of a survey tool to evaluate trust and teamwork in the working relationships between trained traditional midwives and certified midwives in a post-conflict country. A previously established scale, the Trust and Teambuilding Scale, was used with non- and low-literate trained traditional midwives (n=48) in rural Liberia to evaluate trust and teamwork with certified midwives in their communities. Initial results indicated that the scale and response keys were culturally inadequate for this population. A revised version of the scale, the Trust and Teamwork Scale - Liberia, was created and administered to an additional group of non- and low-literate, trained traditional midwives (n=42). Exploratory factor analysis using Mplus for dichotomous variables was used to determine the psychometric properties of the revised scale and was then confirmed with the full sample (n=90). Additional analyses included contrast validity, convergent validity, and Kuder-Richardson reliability. Exploratory factor analysis revealed two factors in the revised Trust and Teamwork Scale - Liberia. These two factors, labeled trust and teamwork, included eleven of the original eighteen items used in the Trust and Teamwork Scale and demonstrated contrast and convergent validity and adequate reliability. The revised scale is suitable for use with non- and low-literate, trained traditional midwives in rural Liberia. Continued cross-cultural validation of tools is essential to ensure scale adequacy across populations. Future work should continue to evaluate the use of the Trust and Teamwork Scale - Liberia across cultures and additional work is needed to confirm the factor structure.
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Validation of the self-assessment teamwork tool (SATT) in a cohort of nursing and medical students.
Roper, Lucinda; Shulruf, Boaz; Jorm, Christine; Currie, Jane; Gordon, Christopher J
2018-02-09
Poor teamwork has been implicated in medical error and teamwork training has been shown to improve patient care. Simulation is an effective educational method for teamwork training. Post-simulation reflection aims to promote learning and we have previously developed a self-assessment teamwork tool (SATT) for health students to measure teamwork performance. This study aimed to evaluate the psychometric properties of a revised self-assessment teamwork tool. The tool was tested in 257 medical and nursing students after their participation in one of several mass casualty simulations. Using exploratory and confirmatory factor analysis, the revised self-assessment teamwork tool was shown to have strong construct validity, high reliability, and the construct demonstrated invariance across groups (Medicine & Nursing). The modified SATT was shown to be a reliable and valid student self-assessment tool. The SATT is a quick and practical method of guiding students' reflection on important teamwork skills.
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Organizing for teamwork in healthcare: an alternative to team training?
Rydenfält, Christofer; Odenrick, Per; Larsson, Per Anders
2017-05-15
Purpose The purpose of this paper is to explore how organizational design could support teamwork and to identify organizational design principles that promote successful teamwork. Design/methodology/approach Since traditional team training sessions take resources away from production, the alternative approach pursued here explores the promotion of teamwork by means of organizational design. A wide and pragmatic definition of teamwork is applied: a team is considered to be a group of people that are set to work together on a task, and teamwork is then what they do in relation to their task. The input - process - output model of teamwork provides structure to the investigation. Findings Six teamwork enablers from the healthcare team literature - cohesion, collaboration, communication, conflict resolution, coordination, and leadership - are discussed, and the organizational design measures required to implement them are identified. Three organizational principles are argued to facilitate the teamwork enablers: team stability, occasions for communication, and a participative and adaptive approach to leadership. Research limitations/implications The findings could be used as a foundation for intervention studies to improve team performance or as a framework for evaluation of existing organizations. Practical implications By implementing these organizational principles, it is possible to achieve many of the organizational traits associated with good teamwork. Thus, thoughtful organization for teamwork can be used as an alternative or complement to the traditional team training approach. Originality/value With regards to the vast literature on team training, this paper offers an alternative perspective on how to improve team performance in healthcare.
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Hobgood, Cherri; Sherwood, Gwen; Frush, Karen; Hollar, David; Maynard, Laura; Foster, Beverly; Sawning, Susan; Woodyard, Donald; Durham, Carol; Wright, Melanie; Taekman, Jeffrey
2010-12-01
The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. The authors recruited 203 senior nursing students and 235 fourth-year medical students (total N = 438) from two major universities for a 1-day interdisciplinary teamwork training course. All participants received a didactic lecture and then were randomly assigned to one of four educational methods didactic (control), audience response didactic, role play and human patient simulation. Student performance was assessed for teamwork attitudes, knowledge and skills using: (a) a 36-item teamwork attitudes instrument (CHIRP), (b) a 12-item teamwork knowledge test, (c) a 10-item standardised patient (SP) evaluation of student teamwork skills performance and (d) a 20-item modification of items from the Mayo High Performance Teamwork Scale (MHPTS). All four cohorts demonstrated an improvement in attitudes (F(1,370) = 48.7, p = 0.001) and knowledge (F(1,353) = 87.3, p = 0.001) pre- to post-test. No educational modality appeared superior for attitude (F(3,370) = 0.325, p = 0.808) or knowledge (F(3,353) = 0.382, p = 0.766) acquisition. No modality demonstrated a significant change in teamwork skills (F(3,18) = 2.12, p = 0.134). Each of the four modalities demonstrated significantly improved teamwork knowledge and attitudes, but no modality was demonstrated to be superior. Institutions should feel free to utilise educational modalities, which are best supported by their resources to deliver interdisciplinary teamwork training.
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Teaching nurses teamwork: Integrative review of competency-based team training in nursing education.
Barton, Glenn; Bruce, Anne; Schreiber, Rita
2017-12-20
Widespread demands for high reliability healthcare teamwork have given rise to many educational initiatives aimed at building team competence. Most effort has focused on interprofessional team training however; Registered Nursing teams comprise the largest human resource delivering direct patient care in hospitals. Nurses also influence many other health team outcomes, yet little is known about the team training curricula they receive, and furthermore what specific factors help translate teamwork competency to nursing practice. The aim of this review is to critically analyse empirical published work reporting on teamwork education interventions in nursing, and identify key educational considerations enabling teamwork competency in this group. CINAHL, Web of Science, Academic Search Complete, and ERIC databases were searched and detailed inclusion-exclusion criteria applied. Studies (n = 19) were selected and evaluated using established qualitative-quantitative appraisal tools and a systematic constant comparative approach. Nursing teamwork knowledge is rooted in High Reliability Teams theory and Crew or Crisis Resource Management sources. Constructivist pedagogy is used to teach, practice, and refine teamwork competency. Nursing teamwork assessment is complex; involving integrated yet individualized determinations of knowledge, skills, and attitudes. Future initiatives need consider frontline leadership, supportive followership and skilled communication emphasis. Collective stakeholder support is required to translate teamwork competency into nursing practice. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Studying distributed cognition of simulation-based team training with DiCoT.
Rybing, Jonas; Nilsson, Heléne; Jonson, Carl-Oscar; Bang, Magnus
2016-03-01
Health care organizations employ simulation-based team training (SBTT) to improve skill, communication and coordination in a broad range of critical care contexts. Quantitative approaches, such as team performance measurements, are predominantly used to measure SBTTs effectiveness. However, a practical evaluation method that examines how this approach supports cognition and teamwork is missing. We have applied Distributed Cognition for Teamwork (DiCoT), a method for analysing cognition and collaboration aspects of work settings, with the purpose of assessing the methodology's usefulness for evaluating SBTTs. In a case study, we observed and analysed four Emergo Train System® simulation exercises where medical professionals trained emergency response routines. The study suggests that DiCoT is an applicable and learnable tool for determining key distributed cognition attributes of SBTTs that are of importance for the simulation validity of training environments. Moreover, we discuss and exemplify how DiCoT supports design of SBTTs with a focus on transfer and validity characteristics. Practitioner Summary: In this study, we have evaluated a method to assess simulation-based team training environments from a cognitive ergonomics perspective. Using a case study, we analysed Distributed Cognition for Teamwork (DiCoT) by applying it to the Emergo Train System®. We conclude that DiCoT is useful for SBTT evaluation and simulator (re)design.
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PRONTO training for obstetric and neonatal emergencies in Mexico.
Walker, Dilys M; Cohen, Susanna R; Estrada, Fatima; Monterroso, Marcia E; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer O
2012-02-01
To evaluate the acceptability, feasibility, rating, and potential impact of PRONTO, a low-tech and high-fidelity simulation-based training for obstetric and neonatal emergencies and teamwork using the PartoPants low-cost birth simulator. A pilot project was conducted from September 21, 2009, to April 9, 2010, to train interprofessional teams from 5 community hospitals in the states of Mexico and Chiapas. Module I (teamwork, neonatal resuscitation, and obstetric hemorrhage) was followed 3 months later by module II (dystocia and pre-eclampsia/eclampsia) and an evaluation. Four elements were assessed: acceptability; feasibility and rating; institutional goal achievement; teamwork improvement; and knowledge and self-efficacy. The program was rated highly both by trainees and by non-trainees who completed a survey and interview. Hospital goals identified by participants in the module I strategic-planning sessions were achieved for 65% of goals in 3 months. Teamwork, knowledge, and self-efficacy scores improved. PRONTO brings simulation training to low-resource settings and can empower interprofessional teams to respond more effectively within their institutional limitations to emergencies involving women and newborns. Further study is warranted to evaluate the potential impact of the program on obstetric and neonatal outcome. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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A systematic review of teamwork training interventions in medical student and resident education.
Chakraborti, Chayan; Boonyasai, Romsai T; Wright, Scott M; Kern, David E
2008-06-01
Teamwork is important for improving care across transitions between providers and for increasing patient safety. This review's objective was to assess the characteristics and efficacy of published curricula designed to teach teamwork to medical students and house staff. The authors searched MEDLINE, Education Resources Information Center, Excerpta Medica Database, PsychInfo, Cumulative Index of Nursing and Allied Health Literature, and Scopus for original data articles published in English between January 1980 and July 2006 that reported descriptions of teamwork training and evaluation results. Two reviewers independently abstracted information about curricular content (using Baker's framework of teamwork competencies), educational methods, evaluation design, outcomes measured, and results. Thirteen studies met inclusion criteria. All curricula employed active learning methods; the majority (77%) included multidisciplinary training. Ten curricula (77%) used an uncontrolled pre/post design and 3 (23%) used controlled pre/post designs. Only 3 curricula (23%) reported outcomes beyond end of program, and only 1 (8%) >6 weeks after program completion. One program evaluated a clinical outcome (patient satisfaction), which was unchanged after the intervention. The median effect size was 0.40 (interquartile range (IQR) 0.29, 0.61) for knowledge, 0.38 (IQR 0.32, 0.41) for attitudes, 0.41 (IQR 0.35, 0.49) for skills and behavior. The relationship between the number of teamwork principles taught and effect size achieved a Spearman's correlation of .74 (p = .01) for overall effect size and .64 (p = .03) for median skills/behaviors effect size. Reported curricula employ some sound educational principles and appear to be modestly effective in the short term. Curricula may be more effective when they address more teamwork principles.
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Teamwork Training Needs Analysis for Long-Duration Exploration Missions
NASA Technical Reports Server (NTRS)
Smith-Jentsch, Kimberly A.; Sierra, Mary Jane
2016-01-01
The success of future long-duration exploration missions (LDEMs) will be determined largely by the extent to which mission-critical personnel possess and effectively exercise essential teamwork competencies throughout the entire mission lifecycle (e.g., Galarza & Holland, 1999; Hysong, Galarza, & Holland, 2007; Noe, Dachner, Saxton, & Keeton, 2011). To ensure that such personnel develop and exercise these necessary teamwork competencies prior to and over the full course of future LDEMs, it is essential that a teamwork training curriculum be developed and put into place at NASA that is both 1) comprehensive, in that it targets all teamwork competencies critical for mission success and 2) structured around empirically-based best practices for enhancing teamwork training effectiveness. In response to this demand, the current teamwork-oriented training needs analysis (TNA) was initiated to 1) identify the teamwork training needs (i.e., essential teamwork-related competencies) of future LDEM crews, 2) identify critical gaps within NASA’s current and future teamwork training curriculum (i.e., gaps in the competencies targeted and in the training practices utilized) that threaten to impact the success of future LDEMs, and to 3) identify a broad set of practical nonprescriptive recommendations for enhancing the effectiveness of NASA’s teamwork training curriculum in order to increase the probability of future LDEM success.
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Slootweg, Irene A.; Lombarts, Kiki M. J. M. H.; Boerebach, Benjamin C. M.; Heineman, Maas Jan; Scherpbier, Albert J. J. A.; van der Vleuten, Cees P. M.
2014-01-01
Background Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork. Method To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork. Results In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement. Conclusions This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements. PMID:25393006
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Assessing teamwork performance in obstetrics: A systematic search and review of validated tools.
Fransen, Annemarie F; de Boer, Liza; Kienhorst, Dieneke; Truijens, Sophie E; van Runnard Heimel, Pieter J; Oei, S Guid
2017-09-01
Teamwork performance is an essential component for the clinical efficiency of multi-professional teams in obstetric care. As patient safety is related to teamwork performance, it has become an important learning goal in simulation-based education. In order to improve teamwork performance, reliable assessment tools are required. These can be used to provide feedback during training courses, or to compare learning effects between different types of training courses. The aim of the current study is to (1) identify the available assessment tools to evaluate obstetric teamwork performance in a simulated environment, and (2) evaluate their psychometric properties in order to identify the most valuable tool(s) to use. We performed a systematic search in PubMed, MEDLINE, and EMBASE to identify articles describing assessment tools for the evaluation of obstetric teamwork performance in a simulated environment. In order to evaluate the quality of the identified assessment tools the standards and grading rules have been applied as recommended by the Accreditation Council for Graduate Medical Education (ACGME) Committee on Educational Outcomes. The included studies were also assessed according to the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence. This search resulted in the inclusion of five articles describing the following six tools: Clinical Teamwork Scale, Human Factors Rating Scale, Global Rating Scale, Assessment of Obstetric Team Performance, Global Assessment of Obstetric Team Performance, and the Teamwork Measurement Tool. Based on the ACGME guidelines we assigned a Class 3, level C of evidence, to all tools. Regarding the OCEBM levels of evidence, a level 3b was assigned to two studies and a level 4 to four studies. The Clinical Teamwork Scale demonstrated the most comprehensive validation, and the Teamwork Measurement Tool demonstrated promising results, however it is recommended to further investigate its reliability. Copyright © 2017. Published by Elsevier B.V.
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Slootweg, Irene A; Lombarts, Kiki M J M H; Boerebach, Benjamin C M; Heineman, Maas Jan; Scherpbier, Albert J J A; van der Vleuten, Cees P M
2014-01-01
Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork. To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork. In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement. This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements.
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Semler, Matthew W; Keriwala, Raj D; Clune, Jennifer K; Rice, Todd W; Pugh, Meredith E; Wheeler, Arthur P; Miller, Alison N; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A
2015-04-01
Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel "Recognize, Respond, Reassess" score. Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs(2)] = 0.267, P < 0.001). Among incoming internal medicine interns, teamwork training by expert demonstration resulted in similar teamwork behavior to participation in high-fidelity simulation and was more effective than traditional didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities.
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Development of a self-assessment teamwork tool for use by medical and nursing students.
Gordon, Christopher J; Jorm, Christine; Shulruf, Boaz; Weller, Jennifer; Currie, Jane; Lim, Renee; Osomanski, Adam
2016-08-24
Teamwork training is an essential component of health professional student education. A valid and reliable teamwork self-assessment tool could assist students to identify desirable teamwork behaviours with the potential to promote learning about effective teamwork. The aim of this study was to develop and evaluate a self-assessment teamwork tool for health professional students for use in the context of emergency response to a mass casualty. The authors modified a previously published teamwork instrument designed for experienced critical care teams for use with medical and nursing students involved in mass casualty simulations. The 17-item questionnaire was administered to students immediately following the simulations. These scores were used to explore the psychometric properties of the tool, using Exploratory and Confirmatory Factor Analysis. 202 (128 medical and 74 nursing) students completed the self-assessment teamwork tool for students. Exploratory factor analysis revealed 2 factors (5 items - Teamwork coordination and communication; 4 items - Information sharing and support) and these were justified with confirmatory factor analysis. Internal consistency was 0.823 for Teamwork coordination and communication, and 0.812 for Information sharing and support. These data provide evidence to support the validity and reliability of the self-assessment teamwork tool for students This self-assessment tool could be of value to health professional students following team training activities to help them identify the attributes of effective teamwork.
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Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate
2014-01-01
The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students’ educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student “teams” leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the “inner circle”, or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students’ clinical learning and preparation for practice. PMID:25028569
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Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate
2014-01-01
The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice.
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ERIC Educational Resources Information Center
Kuriloff, Arthur H.; Yoder, Dale
This training manual provides guidelines for effective teamwork and work-team maintenance and development. It was designed for use in the Marine Corps Task Analysis program, in which staff members are organized to form a work-team whose continuing performance as an effective team is crucial for success of the project. Chapter 1, the major portion…
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Training for Interprofessional Teamwork--Evaluation of an Undergraduate Experience.
ERIC Educational Resources Information Center
Richardson, Julie; Montemuro, Maureen; Mohide, E. Ann; Cripps, Donna; Macpherson, A. S.
1999-01-01
In a geriatrics course 15 undergraduates participated in problem-based tutorials on interprofessional health-care teamwork during clinical placement. Compared with 15 controls, the experimental group showed significantly greater knowledge but no difference in perceptions of interprofessional functions. (SK)
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Does team training work? Principles for health care.
Salas, Eduardo; DiazGranados, Deborah; Weaver, Sallie J; King, Heidi
2008-11-01
Teamwork is integral to a working environment conducive to patient safety and care. Team training is one methodology designed to equip team members with the competencies necessary for optimizing teamwork. There is evidence of team training's effectiveness in highly complex and dynamic work environments, such as aviation and health care. However, most quantitative evaluations of training do not offer any insight into the actual reasons why, how, and when team training is effective. To address this gap in understanding, and to provide guidance for members of the health care community interested in implementing team training programs, this article presents both quantitative results and a specific qualitative review and content analysis of team training implemented in health care. Based on this review, we offer eight evidence-based principles for effective planning, implementation, and evaluation of team training programs specific to health care.
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[Evaluating a blended-learning program on developing teamwork competence].
Aguado, David; Arranz, Virginia; Valera-Rubio, Ana; Marín-Torres, Susana
2011-08-01
The knowledge, skills and abilities that are required to work optimally in teams are critical for many types of work. Organizations can provide access to these skills by means of training programs. Diverse studies show how traditional in-site training methodologies can improve teamwork knowledge, skills and abilities. Nevertheless, in-site methods can be complemented with on-line strategies that result in blended-learning programs. The aim of this work is to analyze, following Kirkpatrick's assessment levels, the effectiveness of a blended-learning program of teamwork training in an organizational context. Carried out with 102 professionals, the results show participants' satisfaction with the program, high level of learning (of both declarative and procedural knowledge), and a moderate level of transfer of learning to the job.
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Effect of dyad training on medical students' cardiopulmonary resuscitation performance.
Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen
2017-03-01
We investigated the effects of dyadic training on medical students' resuscitation performance during cardiopulmonary resuscitation (CPR) training.We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills.Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022).Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance.
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Effect of dyad training on medical students’ cardiopulmonary resuscitation performance
Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen
2017-01-01
Abstract We investigated the effects of dyadic training on medical students’ resuscitation performance during cardiopulmonary resuscitation (CPR) training. We provided students with a 2-hour training session on CPR for simulated cardiac arrest. Student teams were split into double groups (Dyad training groups: Groups A and B) or Single Groups. All groups received 2 CPR simulation rounds. CPR simulation training began with peer demonstration for Group A, and peer observation for Group B. Then the 2 groups switched roles. Single Groups completed CPR simulation without peer observation or demonstration. Teams were then evaluated based on leadership, teamwork, and team member skills. Group B had the highest first simulation round scores overall (P = 0.004) and in teamwork (P = 0.001) and team member skills (P = 0.031). Group B also had the highest second simulation round scores overall (P < 0.001) and in leadership (P = 0.033), teamwork (P < 0.001), and team member skills (P < 0.001). In the first simulation, there were no differences between Dyad training groups with those of Single Groups in overall scores, leadership scores, teamwork scores, and team member scores. In the second simulation, Dyad training groups scored higher in overall scores (P = 0.002), leadership scores (P = 0.044), teamwork scores (P = 0.005), and team member scores (P = 0.008). Dyad training groups also displayed higher improvement in overall scores (P = 0.010) and team member scores (P = 0.022). Dyad training was effective for CPR training. Both peer observation and demonstration for peers in dyad training can improve student resuscitation performance. PMID:28353555
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Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles.
Lee, Soo-Hoon; Khanuja, Harpal S; Blanding, Renee J; Sedgwick, Jeanne; Pressimone, Kathleen; Ficke, James R; Jones, Lynne C
2017-10-30
Teamwork training improves short-term teamwork behaviors. However, improvements are often not sustained. The purpose of this study was to explore the extent to which teamwork reinforcement activities for orthopedic surgery teams lead to sustained teamwork behaviors. Seven months after 104 staff from an orthopedic surgical unit were trained in Team Strategies and Tools to Enhance Performance and Patient Safety principles, 4 reinforcement activities were implemented regarding leadership and communication: lectures with videos on leadership skills for nursing staff; an online self-paced learning program on communication skills for nursing staff; a 1-page summary on leadership skills e-mailed to surgical staff; and a 1-hour perioperative grand rounds on Team Strategies and Tools to Enhance Performance and Patient Safety principles for anesthesia staff and new staff. Twenty-four orthopedic surgical teams were evaluated on teamwork behaviors during surgery by 2 observers before and after the reinforcement period using the Observational Teamwork Assessment for Surgery tool. After reinforcement, leadership (P = 0.022) and communication (P = 0.044) behaviors improved compared with prereinforcement levels. Specifically, nursing staff improved in leadership (P = 0.016) and communication (P = 0.028) behaviors, surgical staff improved in leadership behaviors (P = 0.009), but anesthesia staff did not improve in any teamwork behaviors. Sustained improvement in teamwork behaviors requires reinforcement. Level III, prospective pre-post cohort study.
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Health science center faculty attitudes towards interprofessional education and teamwork.
Gary, Jodie C; Gosselin, Kevin; Bentley, Regina
2018-03-01
The attitudes of faculty towards interprofessional education (IPE) and teamwork impact the education of health professions education (HPE) students. This paper reports on a study evaluating attitudes from health professions educators towards IPE and teamwork at one academic health science center (HSC) where modest IPE initiatives have commenced. Drawing from the results of a previous investigation, this study was conducted to examine current attitudes of the faculty responsible for the training of future healthcare professionals. Survey data were collected to evaluate attitudes from HSC faculty, dentistry, nursing, medicine, pharmacy and public health. In general, positive HSC faculty attitudes towards interprofessional learning, education, and teamwork were significantly predicted by those affiliated with the component of nursing. Faculty development aimed at changing attitudes and increasing understanding of IPE and teamwork are critical. Results of this study serve as an underpinning to leverage strengths and evaluate weakness in initiating IPE.
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Keriwala, Raj D.; Clune, Jennifer K.; Rice, Todd W.; Pugh, Meredith E.; Wheeler, Arthur P.; Miller, Alison N.; Banerjee, Arna; Terhune, Kyla; Bastarache, Julie A.
2015-01-01
Rationale: Effective teamwork is fundamental to the management of medical emergencies, and yet the best method to teach teamwork skills to trainees remains unknown. Objectives: In a cohort of incoming internal medicine interns, we tested the hypothesis that expert demonstration of teamwork principles and participation in high-fidelity simulation would each result in objectively assessed teamwork behavior superior to traditional didactics. Methods: This was a randomized, controlled, parallel-group trial comparing three teamwork teaching modalities for incoming internal medicine interns. Participants in a single-day orientation at the Vanderbilt University Center for Experiential Learning and Assessment were randomized 1:1:1 to didactic, demonstration-based, or simulation-based instruction and then evaluated in their management of a simulated crisis by five independent, blinded observers using the Teamwork Behavioral Rater score. Clinical performance was assessed using the American Heart Association Advanced Cardiac Life Support algorithm and a novel “Recognize, Respond, Reassess” score. Measurements and Main Results: Participants randomized to didactics (n = 18), demonstration (n = 17), and simulation (n = 17) were similar at baseline. The primary outcome of average overall Teamwork Behavioral Rater score for those who received demonstration-based training was similar to simulation participation (4.40 ± 1.15 vs. 4.10 ± 0.95, P = 0.917) and significantly higher than didactic instruction (4.40 ± 1.15 vs. 3.10 ± 0.51, P = 0.045). Clinical performance scores were similar between the three groups and correlated only weakly with teamwork behavior (coefficient of determination [Rs2] = 0.267, P < 0.001). Conclusions: Among incoming internal medicine interns, teamwork training by expert demonstration resulted in similar teamwork behavior to participation in high-fidelity simulation and was more effective than traditional didactics. Clinical performance was largely independent of teamwork behavior and did not differ between training modalities. PMID:25730661
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Schwartz, Miriam E; Welsh, Deborah E; Paull, Douglas E; Knowles, Regina S; DeLeeuw, Lori D; Hemphill, Robin R; Essen, Keith E; Sculli, Gary L
2017-11-09
Communication failure is a significant source of adverse events in health care and a leading root cause of sentinel events reported to the Joint Commission. The Veterans Health Administration National Center for Patient Safety established Clinical Team Training (CTT) as a comprehensive program to enhance patient safety and to improve communication and teamwork among health care professionals. CTT is based on techniques used in aviation's Crew Resource Management (CRM) training. The aviation industry has reached a significant safety record in large part related to the culture change generated by CRM and sustained by its recurrent implementation. This article focuses on the improvement of communication, teamwork, and patient safety by utilizing a standardized, CRM-based, interprofessional, immersive training in diverse clinical areas. The Teamwork and Safety Climate Questionnaire was used to evaluate safety climate before and after CTT. The scores for all of the 27 questions on the questionnaire showed an increase from baseline to 12 months, and 11 of those increases were statistically significant. A recurrent training is recommended to maintain the positive outcomes. CTT enhances patient safety and reduces risk of patient harm by improving teamwork and facilitating clear, concise, specific and timely communication among health care professionals. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.
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Team training in obstetrics: A multi-level evaluation.
Sonesh, Shirley C; Gregory, Megan E; Hughes, Ashley M; Feitosa, Jennifer; Benishek, Lauren E; Verhoeven, Dana; Patzer, Brady; Salazar, Maritza; Gonzalez, Laura; Salas, Eduardo
2015-09-01
Obstetric complications and adverse patient events are often preventable. Teamwork and situational awareness (SA) can improve detection and coordination of critical obstetric (OB) emergencies, subsequently improving decision making and patient outcomes. The purpose of this study was to assess the effectiveness of a team training intervention in improving learning and transfer of teamwork, SA, decision making, and cognitive bias as well as patient outcomes in OB. An adapted TeamSTEPPS training program was delivered to OB clinicians. Training targeted communication, mutual support, situation monitoring, leadership, SA, and cognitive bias. We conducted a repeated measures multilevel evaluation of the training using Kirkpatrick's (1994) framework of training evaluation to determine impact on trainee reactions, learning, transfer, and results. Data were collected using surveys, situational judgment tests (SJTs), observations, and patient chart reviews. Participants perceived the training as useful. Additionally, participants acquired knowledge of communication strategies, though knowledge of other team competencies did not significantly improve nor did self-reported teamwork on the unit. Although SJT decision accuracy did not significantly improve for all scenarios, results of behavioral observation suggest that decision accuracy significantly improved on the job, and there was a marginally significant reduction in babies' hospital length of stay. These findings indicate that the training intervention was partially effective, but more work needs to be done to determine the conditions under which training is most effective, and the ways in which to sustain improvements. Future research is needed to confirm its generalizability to additional OB units and departments. (c) 2015 APA, all rights reserved).
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A leadership challenge: staff nurse perceptions after an organizational TeamSTEPPS initiative.
Castner, Jessica; Foltz-Ramos, Kelly; Schwartz, Diane G; Ceravolo, Diane J
2012-10-01
The purpose of this study was to measure RNs' perceptions of teamwork skills and behaviors in their work environment during a multiphase multisite nursing organizational teamwork development initiative. Teamwork is essential for patient safety in healthcare organizations and nursing teams. Organizational development supporting effective teamwork should include a just culture, engaged leadership, and teamwork training. A cross-sectional survey study of bedside RNs was conducted in one 5-hospital healthcare system after a TeamSTEPPS teamwork training initiative. TeamSTEPPS teamwork training related to improved RN perceptions of leadership. Initiatives to align the perspectives and teamwork efforts of leaders and bedside nurses are indicated and should involve charge nurses in the design.
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Team training for safer birth.
Cornthwaite, Katie; Alvarez, Mary; Siassakos, Dimitrios
2015-11-01
Effective and coordinated teamworking is key to achieving safe birth for mothers and babies. Confidential enquiries have repeatedly identified deficiencies in teamwork as factors contributing to poor maternal and neonatal outcomes. The ingredients of a successful multi-professional team are varied, but research has identified some fundamental teamwork behaviours, with good communication, proficient leadership and situational awareness at the heart. Simple, evidence-based methods in teamwork training can be seamlessly integrated into a core, mandatory obstetric emergency training. Training should be an enjoyable, inclusive and beneficial experience for members of staff. Training in teamwork can lead to improved clinical outcomes and better birth experience for women. Copyright © 2015 Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Nielsen, Karina; Randall, Raymond; Christensen, Karl B.
2017-01-01
A mixed methods approach was applied to examine the effects of a naturally occurring teamwork intervention supported with training. The first objective was to integrate qualitative process evaluation and quantitative effect evaluation to examine "how" and "why" the training influence intervention outcomes. The intervention (N =…
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Paull, Douglas E; Deleeuw, Lori D; Wolk, Seth; Paige, John T; Neily, Julia; Mills, Peter D
2013-11-01
Many adverse events in health care are caused by teamwork and communication breakdown. This study was conducted to investigate the effect of a point-of-care simulation-based team training curriculum on measurable teamwork and communication skills in staff caring for postoperative patients. Twelve facilities involving 334 perioperative surgical staff underwent simulation-based training. Pretest and posttest self-report data included the Self-Efficacy of Teamwork Competencies Scale. Observational data were captured with the Clinical Teamwork Scale. Teamwork scores (measured on a five-point Likert scale) improved for all eight survey questions by an average of 18% (3.7 to 4.4, p < .05). The observed communication rating (scale of 1 to 10) increased by 16% (5.6 to 6.4, p < .05). Simulation-based team training for staff caring for perioperative patients is associated with measurable improvements in teamwork and communication. Copyright 2013, SLACK Incorporated.
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Paul, Maureen E; Dodge, Laura E; Intondi, Evelyn; Ozcelik, Guzey; Plitt, Ken; Hacker, Michele R
2017-04-01
Most medical teamwork improvement interventions have occurred in hospitals, and more efforts are needed to integrate them into ambulatory care settings. In 2014, Affiliates Risk Management Services, Inc. (ARMS), the risk management services organization for a large network of reproductive health care organizations in the United States, launched a voluntary 5-year initiative to implement a medical teamwork system in this network using the TeamSTEPPS model. This article describes the ARMS initiative and progress made during the first 2 years, including lessons learned. The ARMS TeamSTEPPS program consists of the following components: preparation of participating organizations, TeamSTEPPS master training, implementation of teamwork improvement programs, and evaluation. We used self-administered questionnaires to assess satisfaction with the ARMS program and with the master training course. In the first 2 years, 20 organizations enrolled. Participants found the preparation phase valuable and were highly satisfied with the master training course. Although most attendees felt that the course imparted the knowledge and tools critical for TeamSTEPPS implementation, they identified time restraints and competing initiatives as potential barriers. The project team has learned valuable lessons about obtaining buy-in, consolidating the change teams, making the curriculum relevant, and evaluation. Ambulatory care settings require innovative approaches to integration of teamwork improvement systems. Evaluating and sharing lessons learned will help to hone best practices as we navigate this new frontier in the field of patient safety. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.
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Enhancing Team Performance for Long-Duration Space Missions
NASA Technical Reports Server (NTRS)
Orasanu, Judith M.
2009-01-01
Success of exploration missions will depend on skilled performance by a distributed team that includes both the astronauts in space and Mission Control personnel. Coordinated and collaborative teamwork will be required to cope with challenging complex problems in a hostile environment. While thorough preflight training and procedures will equip creW'S to address technical problems that can be anticipated, preparing them to solve novel problems is much more challenging. This presentation will review components of effective team performance, challenges to effective teamwork, and strategies for ensuring effective team performance. Teamwork skills essential for successful team performance include the behaviors involved in developing shared mental models, team situation awareness, collaborative decision making, adaptive coordination behaviors, effective team communication, and team cohesion. Challenges to teamwork include both chronic and acute stressors. Chronic stressors are associated with the isolated and confined environment and include monotony, noise, temperatures, weightlessness, poor sleep and circadian disruptions. Acute stressors include high workload, time pressure, imminent danger, and specific task-related stressors. Of particular concern are social and organizational stressors that can disrupt individual resilience and effective mission performance. Effective team performance can be developed by training teamwork skills, techniques for coping with team conflict, intracrew and intercrew communication, and working in a multicultural team; leadership and teamwork skills can be fostered through outdoor survival training exercises. The presentation will conclude with an evaluation of the special requirements associated with preparing crews to function autonomously in long-duration missions.
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What are the critical success factors for team training in health care?
Salas, Eduardo; Almeida, Sandra A; Salisbury, Mary; King, Heidi; Lazzara, Elizabeth H; Lyons, Rebecca; Wilson, Katherine A; Almeida, Paula A; McQuillan, Robert
2009-08-01
Ineffective communication among medical teams is a leading cause of preventable patient harm throughout the health care system. A growing body of literature indicates that medical teamwork improves the quality, safety, and cost-effectiveness of health care delivery, and expectations for teamwork in health care have increased. Yet few health care professions' curricula include teamwork training, and few medical practices integrate teamwork principles. Because of this knowledge gap, growing numbers of health care systems are requiring staff to participate in formal teamwork training programs. Seven evidence-based, practical, systematic success factors for preparing, implementing, and sustaining a team training and performance improvement initiative were identified. Each success factor is accompanied by tips for deployment and a real-world example of application. (1) Align team training objectives and safety aims with organizational goals, (2) provide organizational support for the team training initiative, (3) get frontline care leaders on board, (4) prepare the environment and trainees for team training, (5) determine required resources and time commitment and ensure their availability, (6) facilitate application of trained teamwork skills on the job; and (7) measure the effectiveness of the team training program. Although decades of research in other high-risk organizations have clearly demonstrated that properly designed team training programs can improve team performance, success is highly dependent on organizational factors such as leadership support, learning climate, and commitment to data-driven change. Before engaging in a teamwork training initiative, health care organizations should have a clear understanding of these factors and the strategies for their establishment.
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Assessing teamwork competence.
Torrelles Nadal, Cristina; Paris Mañas, Georgina; Sabrià Bernadó, Betlem; Alsinet Mora, Carles
2015-01-01
In recent years, organizations of all types have undergone major changes, and teamwork is one of them. This way of working generates greater profits for an organization. This article aims to assess the teamwork competence of the employees of various Spanish companies in order to determine how effective the team members are in their professional actions. We contacted 55 teams from different organizations and obtained a non-probabilistic sample comprised of 55 participants (subjects tested) and 218 observers (evaluators: coordinators and co-workers). The instrument used for data collection was the Teamwork Rubric (Torrelles, 2011) and data analysis was based on 360º feedback. 80% of the teams analyzed obtained median scores for teamwork competence that were greater than 3, whereas 20% obtained scores between 2 and 3. The results showed that the workers in the companies studied had not fully acquired teamwork competence. It is necessary to find training solutions to improve their level of acquisition, particularly the dimensions of performance and regulation.
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Wallin, Carl-Johan; Kalman, Sigridur; Sandelin, Annika; Färnert, May-Lena; Dahlstrand, Ursula; Jylli, Leena
2015-03-01
Positive safety and a teamwork climate in the training environment may be a precursor for successful teamwork training. This pilot project aimed to implement and test whether a new interdisciplinary and team-based approach would result in a positive training climate in the operating theatre. A 3-day educational module for training the complete surgical team of specialist nursing students and residents in safe teamwork skills in an authentic operative theatre, named Co-Op, was implemented in a university hospital. Participants' (n=22) perceptions of the 'safety climate' and the 'teamwork climate', together with their 'readiness for inter-professional learning', were measured to examine if the Co-Op module produced a positive training environment compared with the perceptions of a control group (n=11) attending the conventional curriculum. The participants' perceptions of 'safety climate' and 'teamwork climate' and their 'readiness for inter-professional learning' scores were significantly higher following the Co-Op module compared with their perceptions following the conventional curriculum, and compared with the control group's perceptions following the conventional curriculum. The Co-Op module improved 'safety climate' and 'teamwork climate' in the operating theatre, which suggests that a deliberate and designed educational intervention can shape a learning environment as a model for the establishment of a safety culture.
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Attitudes to teamwork and safety among Italian surgeons and operating room nurses.
Prati, Gabriele; Pietrantoni, Luca
2014-01-01
Previous studies have shown that surgical team members' attitudes about safety and teamwork in the operating theatre may play a role in patient safety. The aim of this study was to assess attitudes about teamwork and safety among Italian surgeons and operating room nurses. Fifty-five surgeons and 48 operating room nurses working in operating theatres at one hospital in Italy completed the Operating Room Management Attitudes Questionnaire (ORMAQ). Results showed several discrepancies in attitudes about teamwork and safety between surgeons and operating room nurses. Surgeons had more positive views on the quality of surgical leadership, communication, teamwork, and organizational climate in the theatre than operating room nurses. Operating room nurses reported that safety rules and procedures were more frequently disregarded than the surgeons. The results are only partially aligned with previous ORMAQ surveys of surgical teams in other countries. The differences emphasize the influence of national culture, as well as the particular healthcare system. This study shows discrepancies on many aspects in attitudes to teamwork and safety between surgeons and operating room nurses. The findings support implementation and use of team interventions and human factor training. Finally, attitude surveys provide a method for assessing safety culture in surgery, for evaluating the effectiveness of training initiatives, and for collecting data for a hospital's quality assurance programme.
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ERIC Educational Resources Information Center
Evenhuis, Heleen M.; Penning, Corine
2009-01-01
Training in scientific research methods and skills is a vital part of Dutch specialist training in intellectual disability medicine. The authors evaluated results of such training at one Dutch university medical facility that had an obligatory research program involving projects conducted by the physicians-in-training (topics, teamwork, acquired…
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TeamSTEPPS for health care risk managers: Improving teamwork and communication.
Cooke, Marcia
2016-07-01
Ineffective communication among the health care team is a leading cause of errors in the patient care setting. Studies assessing training related to communication and teamwork in the clinical team are prevalent, however, teamwork training at the administrative level is lacking. This includes individuals in leadership positions such as health care risk managers. The purpose was to determine the impact of an educational intervention on the knowledge and attitudes related to communication and teamwork in the health care risk management population. The educational intervention was an adaptation of a national teamwork training program and incorporated didactic content as well as video vignettes and small group activities. Measurement of knowledge and attitudes were used to determine the impact of the education program. Knowledge and attitudes were assessed pre- and postcourse. Findings indicate that teamwork education tailored to the needs of the specific audience resulted in knowledge gained and improved attitudes toward the components of teamwork. The attitudes that most significantly improved were related to team structure and situation monitoring. There was no improvement in participants' attitudes toward leadership, mutual support, and communication. Team training has been shown to improve safety culture, patient satisfaction, and clinical outcomes. Including risk managers in training on teamwork, communication, and collaboration can serve to foster a common language among clinicians and management. In addition, a measurement related to implementation in the health care setting may yield insight into the impact of training. Qualitative measurement may allow the researcher to delve deeper into how these health care facilities are using team training interventions. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.
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Crew resource management training within the automotive industry: does it work?
Marquardt, Nicki; Robelski, Swantje; Hoeger, Rainer
2010-04-01
This article presents the development, implementation, and evaluation of a crew resource management (CRM) training program specifically designed for employees within the automotive industry. The central objective of this training program was to improve communication, teamwork, and stress management skills as well to increase the workers' situational awareness of potential errors that can occur during the production process. Participants in the training program of this study were 80 employees, all of whom were working in a production unit for gearbox manufacturing. Effectiveness of the CRM training course was evaluated two times (1 month and 6 months after the training program). The results showed a significant improvement in a wide range of CRM-relevant categories, especially in teamwork-related attitudes, in addition to an increase in the workers' situational awareness after the training program. On the basis of the results, it can be stated that CRM training, which was originally developed for the aviation industry, can be transferred to the automotive industry. However, because of the lack of behavioral observations, these effects are limited to CRM attitudes and knowledge changes. Several recommendations for future research and training development in the field of human factors training are made.
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Gettman, Matthew T; Pereira, Claudio W; Lipsky, Katja; Wilson, Torrence; Arnold, Jacqueline J; Leibovich, Bradley C; Karnes, R Jeffrey; Dong, Yue
2009-03-01
Structured opportunities for learning communication, teamwork and laparoscopic principles are limited for urology residents. We evaluated and taught teamwork, communication and laparoscopic skills to urology residents in a simulated operating room. Scenarios related to laparoscopy (insufflator failure, carbon dioxide embolism) were developed using mannequins, urology residents and nurses. These scenarios were developed based on Accreditation Council for Graduate Medical Education core competencies and performed in a simulation center. Between the pretest scenario (insufflation failure) and the posttest scenario (carbon dioxide embolism) instruction was given on teamwork, communication and laparoscopic skills. A total of 19 urology residents participated in the training that involved participation in at least 2 scenarios. Performance was evaluated using validated teamwork instruments, questionnaires and videotape analysis. Significant improvement was noted on validated teamwork instruments between scenarios based on resident (pretest 24, posttest 27, p = 0.01) and expert (pretest 16, posttest 25, p = 0.008) evaluation. Increased teamwork and team performance were also noted between scenarios on videotape analysis with significant improvement for adherence to best practice (p = 0.01) and maintenance of positive rapport among team members (p = 0.02). Significant improvement in the setup of the laparoscopic procedure was observed (p = 0.01). Favorable face and content validity was noted for both scenarios. Teamwork, intraoperative communication and laparoscopic skills of urology residents improved during the high fidelity simulation course. Face and content validity of the individual sessions was favorable. In this study high fidelity simulation was effective for assessing and teaching Accreditation Council for Graduate Medical Education core competencies related to intraoperative communication, teamwork and laparoscopic skills.
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Morgan, Lauren; Hadi, Mohammed; Pickering, Sharon; Robertson, Eleanor; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter; New, Steve
2015-04-20
To evaluate the effectiveness of aviation-style teamwork training in improving operating theatre team performance and clinical outcomes. 3 operating theatres in a UK district general hospital, 1 acting as a control group and the other 2 as the intervention group. 72 operations (37 intervention, 35 control) were observed in full by 2 trained observers during two 3-month observation periods, before and after the intervention period. A 1-day teamwork training course for all staff, followed by 6 weeks of weekly in-service coaching to embed learning. We measured team non-technical skills using Oxford NOTECHS II, (evaluating the whole team and the surgical, anaesthetic and nursing subteams, and evaluated technical performance using the Glitch count. We evaluated compliance with the WHO checklist by recording whether time-out (T/O) and sign-out (S/O) were attempted, and whether T/O was fully complied with. We recorded complications, re-admissions and duration of hospital stay using hospital administrative data. We compared the before-after change in the intervention and control groups using 2-way analysis of variance (ANOVA) and regression modelling. Mean NOTECHS II score increased significantly from 71.6 to 75.4 in the active group but remained static in the control group (p=0.047). Among staff subgroups, the nursing score increased significantly (p=0.006), but the anaesthetic and surgical scores did not. The attempt rate for WHO T/O procedures increased significantly in both active and control groups, but full compliance with T/O improved only in the active group (p=0.003). Mean glitch rate was unchanged in the control group but increased significantly (7.2-10.2/h, p=0.002) in the active group. Teamwork training was associated with improved non-technical skills in theatre teams but also with a rise in operative glitches. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Gilfoyle, Elaine; Koot, Deanna A; Annear, John C; Bhanji, Farhan; Cheng, Adam; Duff, Jonathan P; Grant, Vincent J; St George-Hyslop, Cecilia E; Delaloye, Nicole J; Kotsakis, Afrothite; McCoy, Carolyn D; Ramsay, Christa E; Weiss, Matthew J; Gottesman, Ronald D
2017-02-01
To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. Multicenter prospective interventional study. Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams). A 1-day simulation-based team training course was delivered, involving an interactive lecture, group discussions, and four simulated resuscitation scenarios, each followed by a debriefing. The first scenario of the day (PRE) was conducted prior to any team training. The final scenario of the day (POST) was the same scenario, with a slightly modified patient history. All scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to Pediatric Advanced Life Support guidelines, as measured by the Clinical Performance Tool. Secondary outcome measures were as follows: 1) change in times to initiation of chest compressions and defibrillation and 2) teamwork performance, as measured by the Clinical Teamwork Scale. Correlation between Clinical Performance Tool and Clinical Teamwork Scale scores was also analyzed. Teams significantly improved Clinical Performance Tool scores (67.3-79.6%; p < 0.0001), time to initiation of chest compressions (60.8-27.1 s; p < 0.0001), time to defibrillation (164.8-122.0 s; p < 0.0001), and Clinical Teamwork Scale scores (56.0-71.8%; p < 0.0001). A positive correlation was found between Clinical Performance Tool and Clinical Teamwork Scale (R = 0.281; p < 0.0001). Participation in a simulation-based team training educational intervention significantly improved surrogate measures of clinical performance, time to initiation of key clinical tasks, and teamwork during simulated pediatric resuscitation. A positive correlation between clinical and teamwork performance suggests that effective teamwork improves clinical performance of resuscitation teams.
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Kiesewetter, Jan; Fischer, Martin R
2015-01-01
Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine. The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance. Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components (Team Coordination, Team Cooperation, Information Exchange, Team Adjustment Behaviours) were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters. In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach's α=.75). In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64) and the sufficient psychometric properties were replicated (Cronbach's α=.78). The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure teamwork by physicians. Further studies are needed to verify the applicability of the instrument.
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Kiesewetter, Jan; Fischer, Martin R.
2015-01-01
Background: Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine. Purposes: The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance. Methods: Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components (Team Coordination, Team Cooperation, Information Exchange, Team Adjustment Behaviours) were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters. Results: In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach’s α=.75). In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64) and the sufficient psychometric properties were replicated (Cronbach’s α=.78). Conclusions: The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure teamwork by physicians. Further studies are needed to verify the applicability of the instrument. PMID:26038684
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Evaluation of Team Development in a Corporate Adventure Training Program.
ERIC Educational Resources Information Center
Bronson, Jim; And Others
1992-01-01
An intact work unit of 17 corporate managers participated in a 3-day adventure training program to develop teamwork and group unity. The unit improved significantly on 8 of 10 items of the Team Development Inventory, administered before and 2 months after training, relative to an intact control group. (SV)
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George, Katie L; Quatrara, Beth
The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A semistructured debriefing guided by the TENTS tool highlighted important aspects of teamwork. Participants took knowledge and Teamwork Skills Scale (TSS) pretests, posttests, and 1-month posttests. Mean scores were calculated for each time point (pre, post, and 1-month post), and paired t tests were used to evaluate changes. Mean knowledge test and TSS scores both significantly increased after the simulation and remained significantly elevated at 1-month follow-up. Participants recommended retraining intervals of 3 to 6 months. Cost of each simulation was estimated to be $324.44. Analysis of nursing turnover rates did not demonstrate a statistically significant reduction in turnover; however, confounding factors were not controlled for. Significant improvements on both knowledge test and TSS scores demonstrate the effectiveness of the intervention, and retention of the information gained and teamwork skills learned. Participants valued the intervention and recommended to increase the frequency of training. Future studies should develop a framework for "best practice" IPS, analyze the relationship with nursing turnover, and ultimately seek correlations between IPS and improved patient outcomes.
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Cole, Kenneth D; Waite, Martha S; Nichols, Linda O
2003-01-01
For a nationwide Geriatric Interdisciplinary Team Training (GITT) program evaluation of 8 sites and 26 teams, team evaluators developed a quantitative and qualitative team observation scale (TOS), examining structure, process, and outcome, with specific focus on the training function. Qualitative data provided an important expansion of quantitative data, highlighting positive effects that were not statistically significant, such as role modeling and training occurring within the clinical team. Qualitative data could also identify "too much" of a coded variable, such as time spent in individual team members' assessments and treatment plans. As healthcare organizations have increasing demands for productivity and changing reimbursement, traditional models of teamwork, with large teams and structured meetings, may no longer be as functional as they once were. To meet these constraints and to train students in teamwork, teams of the future will have to make choices, from developing and setting specific models to increasing the use of information technology to create virtual teams. Both quantitative and qualitative data will be needed to evaluate these new types of teams and the important outcomes they produce.
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Non-technical skills assessment in surgery.
Sharma, Bharat; Mishra, Amit; Aggarwal, Rajesh; Grantcharov, Teodor P
2011-09-01
Adverse events in surgery have highlighted the importance of non-technical skills, such as communication, decision-making, teamwork, situational awareness and leadership, to effective organizational performance. These skills carry particular importance to surgical oncology, as members of a multidisciplinary team must work cohesively to formulate effective patient care plans. Several non-technical skills evaluation tools have been developed for use in surgery, without adequate comparison and consensus on which should be standard for training. Eleven articles describing the use of three non-technical evaluation tools related to surgery: NOTSS (Non Technical Skills for Surgeons), NOTECHS (Non Technical Skills) and OTAS (Observational Teamwork Assessment for Surgery) were analyzed with respect to scale formulation, validity, reliability and feasibility. Furthermore, their use in training thus far and the future of non-technical rating scales in surgical curricula was discussed. Future work should focus on incorporating these assessment tools into training and into a real operating room setting to provide formative evaluations for surgical residents. Copyright © 2010 Elsevier Ltd. All rights reserved.
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The impact of improving teamwork on patient outcomes in surgery: A systematic review.
Sun, Rosa; Marshall, Dominic C; Sykes, Mark C; Maruthappu, Mahiben; Shalhoub, Joseph
2018-05-01
The aviation industry pioneered formalised crew training in order to improve safety and reduce consequences of non-technical error. This formalised training has been successfully adapted and used to in the field of surgery to improve post-operative patient outcomes. The need to implement teamwork training as an integral part of a surgical programme is increasingly being recognised. We aim to systematically review the impact of surgical teamwork training on post-operative outcomes. Two independent researchers systematically searched MEDLINE and Embase in accordance with PRISMA guidelines. Studies were screened and subjected to inclusion/exclusion criteria. Study characteristics and outcomes were reported and analysed. Our initial search identified 2720 articles. Following duplicate removal, title and abstract screening, 107 full text articles were analysed. Eight articles met our inclusion criteria. Overall, three articles supported a positive effect of good teamwork on post-operative patient outcomes. We identified key areas in study methodology that can be improved upon, including small cohort size, lack of unified training programme, and short training duration, should future studies be designed and implemented in this field. At present, there is insufficient evidence to support the hypothesis that teamwork training interventions improve patient outcomes. We believe that non-significant and conflicting results can be attributed to flaws in methodology and non-uniform training methods. With increasing amounts of evidence in this field, we predict a positive association between teamwork training and patient outcomes will come to light. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
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Analysis of Decision Making Skills for Large Scale Disaster Response
2015-08-21
Capability to influence and collaborate Compassion Teamwork Communication Leadership Provide vision of outcome / set priorities Confidence, courage to make...project evaluates the viability of expanding the use of serious games to augment classroom training, tabletop and full scale exercise, and actual...training, evaluation, analysis, and technology ex- ploration. Those techniques have found successful niches, but their wider applicability faces
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Dettinger, Julia C; Kamau, Stephen; Calkins, Kimberly; Cohen, Susanna R; Cranmer, John; Kibore, Minnie; Gachuno, Onesmus; Walker, Dilys
2018-02-01
As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO International (PRONTO) simulation-based training as part of the Linda Afya ya Mama na Mtoto (LAMMP, Protect the Health of mother and child) in Kenya. Changes in knowledge of obstetric and neonatal emergency response, self-efficacy, and teamwork were analyzed using longitudinal, fixed-effects, linear regression models. Participants from 26 facilities participated in the training between 2013 and 2014. The results demonstrate improvements in knowledge, self-efficacy, and teamwork self-assessment. When comparing pre-Module I scores with post-training scores, improvements range from 9 to 24 percentage points (p values < .0001 to .026). Compared to baseline, post-Module I and post-Module II (3 months later) scores in these domains were similar. The intervention not only improved participant teamwork skills, obstetric and neonatal knowledge, and self-efficacy but also fostered sustained changes at 3 months. The proportion of facilities achieving self-defined strategic goals was high: 95.8% of the 192 strategic goals. Participants rated the PRONTO intervention as extremely useful, with an overall score of 1.4 out of 5 (1, extremely useful; 5, not at all useful). Evaluation of how these improvements affect maternal and perinatal clinical outcomes is forthcoming. © 2018 John Wiley & Sons Ltd.
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Ross, Alastair J; Anderson, Janet E; Kodate, Naonori; Thomas, Libby; Thompson, Kellie; Thomas, Beth; Key, Suzie; Jensen, Heidi; Schiff, Rebekah; Jaye, Peter
2013-06-01
This paper describes the evaluation of a 2-day simulation training programme for staff designed to improve teamwork and inpatient care and compassion in an older persons' unit. The programme was designed to improve inpatient care for older people by using mixed modality simulation exercises to enhance teamwork and empathetic and compassionate care. Healthcare professionals took part in: (a) a 1-day human patient simulation course with six scenarios and (b) a 1-day ward-based simulation course involving five 1-h exercises with integrated debriefing. A mixed methods evaluation included observations of the programme, precourse and postcourse confidence rating scales and follow-up interviews with staff at 7-9 weeks post-training. Observations showed enjoyment of the course but some anxiety and apprehension about the simulation environment. Staff self-confidence improved after human patient simulation (t=9; df=56; p<0.001) and ward-based exercises (t=9.3; df=76; p<0.001). Thematic analysis of interview data showed learning in teamwork and patient care. Participants thought that simulation had been beneficial for team practices such as calling for help and verbalising concerns and for improved interaction with patients. Areas to address in future include widening participation across multi-disciplinary teams, enhancing post-training support and exploring further which aspects of the programme enhance compassion and care of older persons. The study demonstrated that simulation is an effective method for encouraging dignified care and compassion for older persons by teaching team skills and empathetic and sensitive communication with patients and relatives.
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Effects of team-building on communication and teamwork among nursing students.
Yi, Y J
2016-03-01
The aim of this study was to assess the effects of team-building on communication and teamwork (i.e. teamwork skills and team effectiveness) among nursing students. Team-building is effective for improving communication and teamwork among the nursing organization. However, the effects of team-building are not well known especially in Korea. This study used a quasi-experimental design. The sample was composed of 195 junior-year nursing students in Korea. The experimental group (100 subjects) participated in team-building activities over a 100-day period, whereas no intervention was applied to the control group (95 subjects). Pretest was conducted in both groups, and post-test was conducted after the 100-day intervention. The pre-post change in mean communication competence score did not differ between the two groups. However, the mean scores for teamwork skills and team effectiveness differed significantly between the two groups after team-building activity. This study was not a double-blind test, and randomized sampling was not implemented. Caution should thus be used when interpreting the findings. Team-building activities were effective for improving the teamwork skills and team effectiveness among Korean nursing students. It is recommended that team-building activities should be included regularly as an integral educational approach in nursing education. The findings suggest that suggests that team-building for improving communication and teamwork should be designated as one of the required criteria for nursing college programme accreditation in many countries, including Korea. However team-building requires further testing to verify this across cultures. Nurses need to receive formal team-building training for improving communication and teamwork, and formal education should be included in their job training schedule. It is recommended that communication competence and teamwork be used as one of job performance evaluations in their workplace. © 2015 International Council of Nurses.
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Training for teamwork through in situ simulations
Sorensen, Asta; Poehlman, Jon; Bollenbacher, John; Riggan, Scott; Davis, Stan; Miller, Kristi; Ivester, Thomas; Kahwati, Leila
2015-01-01
In situ simulations allow healthcare teams to practice teamwork and communication as well as clinical management skills in a team's usual work setting with typically available resources and equipment. The purpose of this video is to demonstrate how to plan and conduct in situ simulation training sessions, with particular emphasis on how such training can be used to improve communication and teamwork. The video features an in situ simulation conducted at a labour and delivery unit in response to postpartum hemorrhage. PMID:26294962
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Couto, Thomaz Bittencourt; Kerrey, Benjamin T; Taylor, Regina G; FitzGerald, Michael; Geis, Gary L
2015-04-01
Pediatric emergencies require effective teamwork. These skills are developed and demonstrated in actual emergencies and in simulated environments, including simulation centers (in center) and the real care environment (in situ). Our aims were to compare teamwork performance across these settings and to identify perceived educational strengths and weaknesses between simulated settings. We hypothesized that teamwork performance in actual emergencies and in situ simulations would be higher than for in-center simulations. A retrospective, video-based assessment of teamwork was performed in an academic, pediatric level 1 trauma center, using the Team Emergency Assessment Measure (TEAM) tool (range, 0-44) among emergency department providers (physicians, nurses, respiratory therapists, paramedics, patient care assistants, and pharmacists). A survey-based, cross-sectional assessment was conducted to determine provider perceptions regarding simulation training. One hundred thirty-two videos, 44 from each setting, were reviewed. Mean total TEAM scores were similar and high in all settings (31.2 actual, 31.1 in situ, and 32.3 in-center, P = 0.39). Of 236 providers, 154 (65%) responded to the survey. For teamwork training, in situ simulation was considered more realistic (59% vs. 10%) and more effective (45% vs. 15%) than in-center simulation. In a video-based study in an academic pediatric institution, ratings of teamwork were relatively high among actual resuscitations and 2 simulation settings, substantiating the influence of simulation-based training on instilling a culture of communication and teamwork. On the basis of survey results, providers favored the in situ setting for teamwork training and suggested an expansion of our existing in situ program.
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Fransen, A F; van de Ven, J; Merién, A E R; de Wit-Zuurendonk, L D; Houterman, S; Mol, B W; Oei, S G
2012-10-01
To determine whether obstetric team training in a medical simulation centre improves the team performance and utilisation of appropriate medical technical skills of healthcare professionals. Cluster randomised controlled trial. The Netherlands. The obstetric departments of 24 Dutch hospitals. The obstetric departments were randomly assigned to a 1-day session of multiprofessional team training in a medical simulation centre or to no such training. Team training was given with high-fidelity mannequins by an obstetrician and a communication expert. More than 6 months following training, two unannounced simulated scenarios were carried out in the delivery rooms of all 24 obstetric departments. The scenarios, comprising a case of shoulder dystocia and a case of amniotic fluid embolism, were videotaped. The team performance and utilisation of appropriate medical skills were evaluated by two independent experts. Team performance evaluated with the validated Clinical Teamwork Scale (CTS) and the employment of two specific obstetric procedures for the two clinical scenarios in the simulation (delivery of the baby with shoulder dystocia in the maternal all-fours position and conducting a perimortem caesarean section within 5 minutes for the scenario of amniotic fluid embolism). Seventy-four obstetric teams from 12 hospitals in the intervention group underwent teamwork training between November 2009 and July 2010. The teamwork performance in the training group was significantly better in comparison to the nontraining group (median CTS score: 7.5 versus 6.0, respectively; P = 0.014). The use of the predefined obstetric procedures for the two clinical scenarios was also significantly more frequent in the training group compared with the nontraining group (83 versus 46%, respectively; P = 0.009). Team performance and medical technical skills may be significantly improved after multiprofessional obstetric team training in a medical simulation centre. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
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ERIC Educational Resources Information Center
Sargent, Leisa D.; Allen, Belinda C.; Frahm, Jennifer A.; Morris, Gayle
2009-01-01
To address the increasing demand for mass undergraduate management education and, at the same time, a greater emphasis on student teamwork, this study outlines the development, delivery, and evaluation of a training intervention designed to build team-coaching skills in teaching assistants. Specifically, "practice-centered" and…
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Jakobsen, Rune Bruhn; Gran, Sarah Frandsen; Grimsmo, Bergsvein; Arntzen, Kari; Fosse, Erik; Frich, Jan C; Hjortdahl, Per
2018-01-01
High quality care relies on interprofessional teamwork. We developed a short simulation-based course for final year medical, nursing and nursing anaesthesia students, using scenarios from emergency medicine. The aim of this paper is to describe the adaptation of an interprofessional simulation course in an undergraduate setting and to report participants' experiences with the course and students' learning outcomes. We evaluated the course collecting responses from students through questionnaires with both closed-ended and open-ended questions, supplemented by the facilitators' assessment of students' performance. Our data is based on responses from 310 students and 16 facilitators who contributed through three evaluation phases. In the analysis, we found that students reported emotional activation and learning outcomes within the domains self-insight and stress management, understanding of the leadership role, insight into teamwork, and skills in team communication. In subsequent questionnaire studies students reported having gained insights about communication, teamwork and leadership, and they believed they would be better leaders of teams and/or team members after having completed the course. Facilitators' observations suggested a progress in students' non-technical skills during the course. The facilitators observed that nursing anaesthesia students seemed to be more comfortable in finding their role in the team than the two other groups. In conclusion, we found that an interprofessional simulation-based emergency team training course with a focus on leadership, communication and teamwork, was feasible to run on a regular basis for large groups of students. The course improved the students' team skills and received a favourable evaluation from both students and faculty.
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Becker, Sonja; Körner, Mirjam; Müller, Christian; Lippenberger, Corinna; Rundel, Manfred; Zimmermann, Linda
2017-07-14
Interprofessional teamwork is considered to be a key component of patient-centred treatment in healthcare, and especially in the rehabilitation sector. To date, however, no interventions exist for improving teamwork in rehabilitation clinics in Germany. A team training programme was therefore designed that is individualised in content but standardised regarding methods and process. It is clinic specific, task related, solution focused and context oriented. The aim of the study was to implement and evaluate this training for interprofessional teams in rehabilitation clinics in Germany. The measure consists of a training of a varying number of sessions with rehabilitation teams that consists of four distinct phases. Those are undergone chronologically, each with clinic-specific contents. It was implemented between 2013 and 2014 in five rehabilitation clinics in Germany and evaluated by the participants via questionnaire (n = 52). Staff in three clinics evaluated the programme as helpful, in particular rating moderation, discussions and communication during the training positively. Staff in the remaining two clinics rated it as not very or not helpful and mentioned long-term structural problems or a lack of need for team training as a reason for this. The team training is applicable and accepted by staff. It should, however, be tested in a greater sample and compared with a control group. Processes should be studied in more detail in order to determine what differentiates successful from non-successful interventions and the different requirements each of these might have.
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Team-training in healthcare: a narrative synthesis of the literature.
Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A
2014-05-01
Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.
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Team-training in healthcare: a narrative synthesis of the literature
Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A
2014-01-01
Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes. PMID:24501181
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Human Systems Integration Competency Development for Navy Systems Commands
2012-09-01
cognizance of Applied Engineering /Psychology relative to knowledge engineering, training, teamwork, user interface design and decision sciences. KSA...cognizance of Applied Engineering /Psychology relative to knowledge engineering, training, teamwork, user interface design and decision sciences...requirements (as required). Fundamental cognizance of Applied Engineering / Psychology relative to knowledge engineering, training, team work, user
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Paige, John T; Kozmenko, Valeriy; Yang, Tong; Paragi Gururaja, Ramnarayan; Hilton, Charles W; Cohn, Isidore; Chauvin, Sheila W
2009-02-01
The operating room (OR) is a dynamic, high risk setting requiring effective teamwork for the safe delivery of care. Teamwork in the modern OR, however, is less than ideal. High fidelity simulation is an attractive approach to training key teamwork competencies. We have developed a portable simulation platform, the mobile mock OR (MMOR) that permits bringing team training over long distances to the point of care. We examined the effectiveness of this innovative, simulation-based interdisciplinary operating room (OR) team training model on its participants. All general surgical OR team members at an academic affiliated medical center underwent scenario-based training using a mobile mock OR. Pre- and post-session mean scores were calculated and analyzed for 15 Likert-type items measuring self-efficacy in teamwork competencies using t test. The mean gain in pre-post item scores for 38 participants averaged 0.4 units on a 6-point Likert scale. The significance was demonstrated in 4 of the items: role clarity (Delta = 0.6 units, P = .02), anticipatory response (Delta = 0.6 units, P = .01), cross monitoring (Delta = 0.6 units, P < .01), and team cohesion and interaction (Delta = 0.7 units, P < .01). High-fidelity, simulation-based OR team training at the point of care positively impacts self-efficacy for effective teamwork performance in everyday practice.
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2016-10-01
and implementation of embedded, adaptive feedback and performance assessment. The investigators also initiated work designing a Bayesian Belief ...training; Teamwork; Adaptive performance; Leadership; Simulation; Modeling; Bayesian belief networks (BBN) 16. SECURITY CLASSIFICATION OF: 17. LIMITATION...Trauma teams Team training Teamwork Adaptability Adaptive performance Leadership Simulation Modeling Bayesian belief networks (BBN) 6
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An Event-Based Approach to Design a Teamwork Training Scenario and Assessment Tool in Surgery.
Nguyen, Ngan; Watson, William D; Dominguez, Edward
2016-01-01
Simulation is a technique recommended for teaching and measuring teamwork, but few published methodologies are available on how best to design simulation for teamwork training in surgery and health care in general. The purpose of this article is to describe a general methodology, called event-based approach to training (EBAT), to guide the design of simulation for teamwork training and discuss its application to surgery. The EBAT methodology draws on the science of training by systematically introducing training exercise events that are linked to training requirements (i.e., competencies being trained and learning objectives) and performance assessment. The EBAT process involves: Of the 4 teamwork competencies endorsed by the Agency for Healthcare Research Quality and Department of Defense, "communication" was chosen to be the focus of our training efforts. A total of 5 learning objectives were defined based on 5 validated teamwork and communication techniques. Diagnostic laparoscopy was chosen as the clinical context to frame the training scenario, and 29 KSAs were defined based on review of published literature on patient safety and input from subject matter experts. Critical events included those that correspond to a specific phase in the normal flow of a surgical procedure as well as clinical events that may occur when performing the operation. Similar to the targeted KSAs, targeted responses to the critical events were developed based on existing literature and gathering input from content experts. Finally, a 29-item EBAT-derived checklist was created to assess communication performance. Like any instructional tool, simulation is only effective if it is designed and implemented appropriately. It is recognized that the effectiveness of simulation depends on whether (1) it is built upon a theoretical framework, (2) it uses preplanned structured exercises or events to allow learners the opportunity to exhibit the targeted KSAs, (3) it assesses performance, and (4) it provides formative and constructive feedback to bridge the gap between the learners' KSAs and the targeted KSAs. The EBAT methodology guides the design of simulation that incorporates these 4 features and, thus, enhances training effectiveness with simulation. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Building high reliability teams: progress and some reflections on teamwork training.
Salas, Eduardo; Rosen, Michael A
2013-05-01
The science of team training in healthcare has progressed dramatically in recent years. Methodologies have been refined and adapted for the unique and varied needs within healthcare, where once team training approaches were borrowed from other industries with little modification. Evidence continues to emerge and bolster the case that team training is an effective strategy for improving patient safety. Research is also elucidating the conditions under which teamwork training is most likely to have an impact, and what determines whether improvements achieved will be maintained over time. The articles in this special issue are a strong representation of the state of the science, the diversity of applications, and the growing sophistication of teamwork training research and practice in healthcare. In this article, we attempt to situate the findings in this issue within the broader context of healthcare team training, identify high level themes in the current state of the field, and discuss existing needs.
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Robertson, Eleanor; Morgan, Lauren; New, Steve; Pickering, Sharon; Hadi, Mohammed; Collins, Gary; Rivero Arias, Oliver; Griffin, Damian; McCulloch, Peter
2015-01-01
Background To investigate the effectiveness of combining teamwork training and lean process improvement, two distinct approaches to improving surgical safety. We conducted a controlled interrupted time series study in a specialist UK Orthopaedic hospital incorporating a plastic surgery team (which received the intervention) and an Orthopaedic theatre team acting as a control. Study Design We used a 3 month intervention with 3 months data collection period before and after it. A combined teamwork training and lean process improvement intervention was delivered by an experienced specialist team. Before and after the intervention we evaluated team non-technical skills using NOTECHS II, technical performance using the glitch rate and WHO checklist compliance using a simple 3 point scale. We recorded complication rate, readmission rate and length of hospital stay data for 6 months before and after the intervention. Results In the active group, but not the control group, full compliance with WHO Time Out (T/O) increased from 14 to 71% (p = 0.032), Sign Out attempt rate (S/O) increased from 0% to 50% (p<0.001) and Oxford NOTECHS II scores increased after the intervention (P = 0.058). Glitch rate decreased in the active group and increased in the control group (p = 0.001). Complications and length of stay appeared to rise in the control group and fall in the active group. Conclusions Combining teamwork training and systems improvement enhanced both technical and non-technical operating team process measures, and were associated with a trend to better safety outcome measures in a controlled study comparison. We suggest that approaches which address both system and culture dimensions of safety may prove valuable in reducing risks to patients. PMID:26381643
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Siassakos, Dimitrios; Fox, Robert; Bristowe, Katherine; Angouri, Jo; Hambly, Helen; Robson, Lauren; Draycott, Timothy J
2013-11-01
We describe lessons for safety from a synthesis of seven studies of teamwork, leadership and team training across a healthcare region. Two studies identified successes and challenges in a unit with embedded team training: a staff survey demonstrated a positive culture but a perceived need for greater senior presence; training improved actual emergency care, but wide variation in team performance remained. Analysis of multicenter simulation records showed that variation in patient safety and team efficiency correlated with their teamwork but not individual knowledge, skills or attitudes. Safe teams tended to declare the emergency earlier, hand over in a more structured way, and use closed-loop communication. Focused and directed communication was also associated with better patient-actor perception of care. Focus groups corroborated these findings, proposed that the capability and experience of the leader is more important than seniority, and identified teamwork and leadership issues that require further research. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.
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Foundations of teamwork and collaboration.
Driskell, James E; Salas, Eduardo; Driskell, Tripp
2018-01-01
The term teamwork has graced countless motivational posters and office walls. However, although teamwork is often easy to observe, it is somewhat more difficult to describe and yet more difficult to produce. At a broad level, teamwork is the process through which team members collaborate to achieve task goals. Teamwork refers to the activities through which team inputs translate into team outputs such as team effectiveness and satisfaction. In this article, we describe foundational research underlying current research on teamwork. We examine the evolution of team process models and outline primary teamwork dimensions. We discuss selection, training, and design approaches to enhancing teamwork, and note current applications of teamwork research in real-world settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.
Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini
2017-06-01
Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.
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Peer Assessment of Soft Skills and Hard Skills
ERIC Educational Resources Information Center
Zhang, Aimao
2012-01-01
Both the information technology (IT) industry and the Accreditation Board for Engineering and Technology (ABET) demand soft-skill training in higher education and require IT graduates to demonstrate competence in interpersonal communication, teamwork, and conflict management. Group projects provide teamwork environment for soft-skill training, but…
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Managing emergencies and abnormal situations in air traffic control (part II): teamwork strategies.
Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry
2010-07-01
Team performance has been studied in many safety-critical organizations including aviation, nuclear power plant, offshore oil platforms and health organizations. This study looks into teamwork strategies that air traffic controllers employ to manage emergencies and abnormal situations. Two field studies were carried out in the form of observations of simulator training in emergency and unusual scenarios of novices and experienced controllers. Teamwork strategies covered aspects of team orientation and coordination, information exchange, change management and error handling. Several performance metrics were used to rate the efficiency of teamwork and test the construct validity of a prototype model of teamwork. This is a companion study to an earlier investigation of taskwork strategies in the same field (part I) and contributes to the development of a generic model for Taskwork and Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). Suggestions are made on how to use T(2)EAM to develop training programs, assess team performance and improve mishap investigations. Copyright 2010 Elsevier Ltd. All rights reserved.
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Practicality of intraoperative teamwork assessments.
Phitayakorn, Roy; Minehart, Rebecca; Pian-Smith, May C M; Hemingway, Maureen W; Milosh-Zinkus, Tanya; Oriol-Morway, Danika; Petrusa, Emil
2014-07-01
High-quality teamwork among operating room (OR) professionals is a key to efficient and safe practice. Quantification of teamwork facilitates feedback, assessment, and improvement. Several valid and reliable instruments are available for assessing separate OR disciplines and teams. We sought to determine the most feasible approach for routine documentation of teamwork in in-situ OR simulations. We compared rater agreement, hypothetical training costs, and feasibility ratings from five clinicians and two nonclinicians with instruments for assessment of separate OR groups and teams. Five teams of anesthesia or surgery residents and OR nurses (RN) or surgical technicians were videotaped in simulations of an epigastric hernia repair where the patient develops malignant hyperthermia. Two anesthesiologists, one OR clinical RN specialist, one educational psychologist, one simulation specialist, and one general surgeon discussed and then independently completed Anesthesiologists' Non-Technical Skills, Non-Technical Skills for Surgeons, Scrub Practitioners' List of Intraoperative Non-Technical Skills, and Observational Teamwork Assessment for Surgery forms to rate nontechnical performance of anesthesiologists, surgeons, nurses, technicians, and the whole team. Intraclass correlations of agreement ranged from 0.17-0.85. Clinicians' agreements were not different from nonclinicians'. Published rater training was 4 h for Anesthesiologists' Non-Technical Skills and Scrub Practitioners' List of Intraoperative Non-Technical Skills, 2.5 h for Non-Technical Skills for Surgeons, and 15.5 h for Observational Teamwork Assessment for Surgery. Estimated costs to train one rater to use all instruments ranged from $442 for a simulation specialist to $6006 for a general surgeon. Additional training is needed to achieve higher levels of agreement; however, costs may be prohibitive. The most cost-effective model for real-time OR teamwork assessment may be to use a simulation technician combined with one clinical rater to allow complete documentation of all participants. Copyright © 2014 Elsevier Inc. All rights reserved.
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Crisis Management Simulation: Establishing a Dual Neurosurgery and Anesthesia Training Experience.
Ciporen, Jeremy; Gillham, Haley; Noles, Michele; Dillman, Dawn; Baskerville, Mark; Haley, Caleb; Spight, Donn; Turner, Ryan C; Lucke-Wold, Brandon P
2018-01-01
Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique. Learners were evaluated on communication skills, crisis management algorithms, and implementation of appropriate skill sets at the right time. A preanatomic and postanatomic examination and postsimulation survey was administered to neurosurgery learners. Anesthesia learners provided posttraining evaluation through a tailored realism and teaching survey. Neurosurgery learners' anatomic examination score improved from presimulation (33.89%) to postsimulation (86.11%). No significant difference between learner specialties was observed for situation awareness, decision making, communications and teamwork, or leadership evaluations. Learners reported the simulation realistic, beneficial, and highly instructive. Realistic, first of kind, clinical simulation scenarios were presented to a neurosurgery/anesthesia resident team who worked together to manage an intraoperative crisis. Learners were effectively trained on crisis management, the importance of communication, and how to develop algorithms for future implementation in difficult scenarios. Learners were highly satisfied with the simulation training experience and requested that it be integrated more consistently into their residency training programs.
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Teaching Teamwork to Public Relations Students: Does It Matter?
ERIC Educational Resources Information Center
Baker-Schena, Lori
2011-01-01
Purpose: The first purpose of this study was to determine the extent to which students in university capstone public relations classes who receive teamwork training demonstrate effective team behaviors, produce quality work, experience satisfaction in the teamwork process, and engender client satisfaction. The second purpose was to determine the…
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Teambuilding and Leadership Training in an Internal Medicine Residency Training Program
Stoller, James K; Rose, Mark; Lee, Rita; Dolgan, Colleen; Hoogwerf, Byron J
2004-01-01
OBJECTIVE The purpose of this report is to describe and evaluate the impact of a 1-day retreat focused on developing leadership skills and teambuilding among postgraduate year 1 residents in an internal medicine residency. METHOD A group of organizers, including members of the staff, the chief medical residents, administrative individuals in the residency office, and an internal organizational development consultant convened to organize an off-site retreat with activities that would provide experiential learning regarding teamwork and leadership, including a “reef survival exercise” and table discussions regarding the characteristics of ideal leaders. In addition, several energizing activities and recreational free time was provided to enhance the interaction and teamwork dimensions of the retreat. To evaluate the impact of the retreat, attendees completed baseline and follow-up questionnaires regarding their experience of the retreat. RESULTS Attendees universally regarded the retreat as having value for them. Comparison of baseline to postretreat responses indicated that attendees felt that the retreat enhanced their abilities to be better physicians, resident supervisors, and leaders. Follow-up responses indicated significant increases in attendees’ agreement that good leaders challenge the process, make decisions based on shared visions, allow others to act, recognize individual contributions, and serve as good role models. Results on the survival exercise indicated a high frequency with which team-based decisions surpassed individual members’ decisions, highlighting the importance and value of teamwork to attendees. CONCLUSIONS Our main findings were that: participants universally found this 1-day retreat beneficial in helping to develop teamwork and leadership skills and the experiential learning aspects of the retreat were more especially highly rated and highlighted the advantages of teamwork. In the context that this 1-day retreat was deemed useful by faculty and residents alike, further study is needed to assess the impact of this learning on actual clinical practice and the durability of these lessons. PMID:15209609
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ERIC Educational Resources Information Center
Chen, Chung-Yang; Hong, Ya-Chun; Chen, Pei-Chi
2014-01-01
Software development relies heavily on teamwork; determining how to streamline this collaborative development is an essential training subject in computer and software engineering education. A team process known as the meetings-flow (MF) approach has recently been introduced in software capstone projects in engineering programs at various…
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Filling in the gaps of predeployment fleet surgical team training using a team-centered approach.
Hoang, Tuan N; Kang, Jeff; Laporta, Anthony J; Makler, Vyacheslav I; Chalut, Carissa
2013-01-01
Teamwork and successful communication are essential parts of any medical specialty, especially in the trauma setting. U.S. Navy physicians developed a course for deploying fleet surgical teams to reinforce teamwork, communication, and baseline knowledge of trauma management. The course combines 22 hours of classroom didactics along with 28 hours of hands-on simulation and cadaver-based laboratories to reinforce classroom concepts. It culminates in a 6-hour, multiwave exercise of multiple, critically injured victims of a mass casualty and uses the ?Cut Suit? (Human Worn Partial Task Surgical Simulator; Strategic Operations), which enables performance of multiple realistic surgical procedures as encountered on real casualties. Participants are graded on time taken from initial patient encounter to disposition and the number of errors made. Pre- and post-training written examinations are also given. The course is graded based on participants? evaluation of the course. The majority of the participants indicated that the course promoted teamwork, enhanced knowledge, and gave confidence. Only 51.72% of participants felt confident in dealing with trauma patients before the course, while 82.76% felt confident afterward (p = .01). Both the time spent on each patient and the number of errors made also decreased after course completion. The course was successful in improving teamwork, communication and base knowledge of all the team members. 2013.
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Sparks, Jessica L; Crouch, Dustin L; Sobba, Kathryn; Evans, Douglas; Zhang, Jing; Johnson, James E; Saunders, Ian; Thomas, John; Bodin, Sarah; Tonidandel, Ashley; Carter, Jeff; Westcott, Carl; Martin, R Shayn; Hildreth, Amy
2017-09-01
The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers. This pre-post educational intervention pilot study compared the gains in teamwork skills for midlevel surgical residents at Wake Forest Baptist Medical Center after they participated in a standardized multidisciplinary team training scenario with 3 possible levels of surgical realism: (1) SimMan (Laerdal) (control group, no surgical anatomy); (2) "synthetic anatomy for surgical tasks" mannequin (medium-fidelity anatomy), and (3) a patient simulated by a deceased donor (high-fidelity anatomy). Participation in the simulation scenario and the subsequent debriefing. Teamwork competency was assessed using several instruments with extensive validity evidence, including the Nontechnical Skills assessment, the Trauma Management Skills scoring system, the Crisis Resource Management checklist, and a self-efficacy survey instrument. Participant satisfaction was assessed with a Likert-scale questionnaire. Scenario participants included midlevel surgical residents, anesthesia providers, scrub nurses, and circulating nurses. Statistical models showed that surgical residents exposed to medium-fidelity simulation (synthetic anatomy for surgical tasks) team training scenarios demonstrated greater gains in teamwork skills compared with control groups (SimMan) (Nontechnical Skills video score: 95% CI, 1.06-16.41; Trauma Management Skills video score: 95% CI, 0.61-2.90) and equivalent gains in teamwork skills compared with high-fidelity simulations (deceased donor) (Nontechnical Skills video score: 95% CI, -8.51 to 6.71; Trauma Management Skills video score: 95% CI, -1.70 to 0.49). Including a surgical task in operating room team training significantly enhanced the acquisition of teamwork skills among midlevel surgical residents. Incorporating relatively inexpensive, medium-fidelity synthetic anatomy in human patient simulators was as effective as using high-fidelity anatomies from deceased donors for promoting teamwork skills in this learning group.
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Teams communicating through STEPPS.
Stead, Karen; Kumar, Saravana; Schultz, Timothy J; Tiver, Sue; Pirone, Christy J; Adams, Robert J; Wareham, Conrad A
2009-06-01
To evaluate the effectiveness of the implementation of a TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) program at an Australian mental health facility. TeamSTEPPS is an evidence-based teamwork training system developed in the United States. Five health care sites in South Australia implemented TeamSTEPPS using a train-the-trainer model over an 8-month intervention period commencing January 2008 and concluding September 2008. A team of senior clinical staff was formed at each site to drive the improvement process. Independent researchers used direct observation and questionnaire surveys to evaluate the effectiveness of the implementation in three outcome areas: observed team behaviours; staff attitudes and opinions; and clinical performance and outcome. The results reported here focus on one site, an inpatient mental health facility. Team knowledge, skills and attitudes; patient safety culture; incident reporting rates; seclusion rates; observation for the frequency of use of TeamSTEPPS tools. Outcomes included restructuring of multidisciplinary meetings and the introduction of structured communication tools. The evaluation of patient safety culture and of staff knowledge, skills and attitudes (KSA) to teamwork and communication indicated a significant improvement in two dimensions of patient safety culture (frequency of event reporting, and organisational learning) and a 6.8% increase in the total KSA score. Clinical outcomes included reduced rates of seclusion. TeamSTEPPS implementation had a substantial impact on patient safety culture, teamwork and communication at an Australian mental health facility. It encouraged a culture of learning from patient safety incidents and making continuous improvements.
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ERIC Educational Resources Information Center
Bonifas, Robin P.; Gray, Amanda K.
2013-01-01
Although several interprofessional education projects have addressed training allied health students for effective teamwork in geriatrics, few curriculum evaluation studies have examined differences in learning outcomes between interprofessional and traditional uniprofessional approaches, especially for social work students. This paper compares…
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Human Factors in Training - Space Flight Resource Management Training
NASA Technical Reports Server (NTRS)
Bryne, Vicky; Connell, Erin; Barshi, Immanuel; Arsintescu, L.
2009-01-01
Accidents and incidents show that high workload-induced stress and poor teamwork skills lead to performance decrements and errors. Research on teamwork shows that effective teams are able to adapt to stressful situations, and to reduce workload by using successful strategies for communication and decision making, and through dynamic redistribution of tasks among team members. Furthermore, superior teams are able to recognize signs and symptoms of workload-induced stress early, and to adapt their coordination and communication strategies to the high workload, or stress conditions. Mission Control Center (MCC) teams often face demanding situations in which they must operate as an effective team to solve problems with crew and vehicle during onorbit operations. To be successful as a team, flight controllers (FCers) must learn effective teamwork strategies. Such strategies are the focus of Space Flight Resource Management (SFRM) training. SFRM training in MOD has been structured to include some classroom presentations of basic concepts and case studies, with the assumption that skill development happens in mission simulation. Integrated mission simulations do provide excellent opportunities for FCers to practice teamwork, but also require extensive technical knowledge of vehicle systems, mission operations, and crew actions. Such technical knowledge requires lengthy training. When SFRM training is relegated to integrated simulations, FCers can only practice SFRM after they have already mastered the technical knowledge necessary for these simulations. Given the centrality of teamwork to the success of MCC, holding SFRM training till late in the flow is inefficient. But to be able to train SFRM earlier in the flow, the training cannot rely on extensive mission-specific technical knowledge. Hence, the need for a generic SFRM training framework that would allow FCers to develop basic teamwork skills which are mission relevant, but without the required mission knowledge. Work on SFRM training has been conducted in collaboration with the Expedition Vehicle Division at the Mission Operations Directorate (MOD) and with United Space Alliance (USA) which provides training to Flight Controllers. The space flight resource management training work is part of the Human Factors in Training Directed Research Project (DRP) of the Space Human Factors Engineering (SHFE) Project under the Space Human Factors and Habitability (SHFH) Element of the Human Research Program (HRP). Human factors researchers at the Ames Research Center have been investigating team work and distributed decision making processes to develop a generic SFRM training framework for flight controllers. The work proposed for FY10 continues to build on this strong collaboration with MOD and the USA Training Group as well as previous research in relevant domains such as aviation. In FY10, the work focuses on documenting and analyzing problem solving strategies and decision making processes used in MCC by experienced FCers.
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Teamwork, Soft Skills, and Research Training.
Gibert, Anaïs; Tozer, Wade C; Westoby, Mark
2017-02-01
We provide a list of soft skills that are important for collaboration and teamwork, based on our own experience and from an opinion survey of team leaders. Each skill can be learned to some extent. We also outline workable short courses for graduate schools to strengthen teamwork and collaboration skills among research students. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Total Quality Management (TQM): Training Module on "Empowerment/Teamwork."
ERIC Educational Resources Information Center
Leigh, David
This module for a 1-semester Total Quality Management (TQM) course for high school or community college students covers the topics of empowerment and teamwork. It includes the following components: (1) a narrative summary of the topics; (2) a discussion of employee empowerment; (3) a discussion of teamwork and self-directed teams; (4) a discussion…
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Sweigart, Linda I; Umoren, Rachel A; Scott, Patrician J; Carlton, Kay Hodson; Jones, James A; Truman, Barbara; Gossett, Evalyn J
2016-01-01
The majority of the estimated 400,000 or more patient deaths per year in the United States are from preventable medical errors due to poor communication. Team training programs have been established to teach teamwork skills to health professions students. However, it is often challenging to provide this training at a physical site. A brief intervention using a virtual learning environment with TeamSTEPPS(®)-based scenarios is described. Using a pretest-posttest design, the effects on teamwork attitudes in 109 health professional students from two institutions and multiple disciplines were measured using the TeamSTEPPS Teamwork Attitudes questionnaire. Participants showed significant attitude changes in the categories of leadership, situation monitoring, mutual support, and communication (p ⩽ .05), with significance in four of the six indicator attitudes in the communication section at the p ⩽ .001 level. These findings indicate the potential impact that virtual learning experiences may have on teamwork attitudes in learners across professions on multiple campuses. Copyright 2016, SLACK Incorporated.
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Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F
2016-08-05
We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, p<0.001). Previous research suggests that this improved teamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.
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Cooper, Jeffrey B; Singer, Sara J; Hayes, Jennifer; Sales, Michael; Vogt, Jay W; Raemer, Daniel; Meyer, Gregg S
2011-08-01
We developed a training program to introduce managers and informal leaders of healthcare organizations to key concepts of teamwork, safety leadership, and simulation to motivate them to act as leaders to improve safety within their sphere of influence. This report describes the simulation scenario and debriefing that are core elements of that program. Twelve teams of clinician and nonclinician managers were selected from a larger set of volunteers to participate in a 1-day, multielement training program. Two simulation exercises were developed: one for teams of nonclinicians and the other for clinicians or mixed groups. The scenarios represented two different clinical situations, each designed to engage participants in discussions of their safety leadership and teamwork issues immediately after the experience. In the scenarios for nonclinicians, participants conducted an anesthetic induction and then managed an ethical situation. The scenario for clinicians simulated a consulting visit to an emergency room that evolved into a problem-solving challenge. Participants in this scenario had a limited time to prepare advice for hospital leadership on how to improve observed safety and cultural deficiencies. Debriefings after both types of scenarios were conducted using principles of "debriefing with good judgment." We assessed the relevance and impact of the program by analyzing participant reactions to the simulation through transcript data and facilitator observations as well as a postcourse questionnaire. The teams generally reported positive perceptions of the relevance and quality of the simulation with varying types and degrees of impact on their leadership and teamwork behaviors. These kinds of clinical simulation exercises can be used to teach healthcare leaders and managers safety leadership and teamwork skills and behaviors.
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A study of deficiencies in teamwork skills among Jordan caregivers.
Al-Araidah, Omar; Al Theeb, Nader; Bader, Mariam; Mandahawi, Nabeel
2018-05-14
Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members. Surveyed care providers included physicians, nursing and anesthesiologists operating in emergency departments, surgical operating rooms and intensive care units from various hospitals. Findings With a response rate of 78.8 percent, statistical analysis of collected data of opposing staff members revealed low levels of satisfaction (40.7-48 percent opposing), lack of awareness on the impact of teamwork on quality of care (15.6-22.1 percent opposing), low levels of involvement of top management (27.1-57.3 percent opposing), lack of training (52.5-69.8 percent opposing), lack of leadership skills (29.8-60 percent opposing), lack of communication (22.3-62.1 percent opposing), lack of employee involvement (37.6-50.8 percent opposing) and lack of collaboration among team members (28.6-50 percent opposing). Among the many, results illustrate the need for improving leadership skills of team leaders, improving communication and involving team members in decision making. Originality/value Several studies investigated relationships between teamwork skills and quality of care in many countries. To the authors' knowledge, no local study investigated the deficiencies of teamwork skills among Jordan caregivers and its impact on quality of care. The study provides the ground for management at Jordan hospitals and to healthcare academic departments to tailor training courses to improve teamwork skills of caregivers. Data of this study are collected from the society who is working in the field of healthcare. As the results of this are produced from a real data, it is expected that applying the recommendations will impact the society positively by enhancing the patients' satisfaction.
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McEwan, Desmond; Ruissen, Geralyn R.; Eys, Mark A.; Zumbo, Bruno D.; Beauchamp, Mark R.
2017-01-01
The objective of this study was to conduct a systematic review and meta-analysis of teamwork interventions that were carried out with the purpose of improving teamwork and team performance, using controlled experimental designs. A literature search returned 16,849 unique articles. The meta-analysis was ultimately conducted on 51 articles, comprising 72 (k) unique interventions, 194 effect sizes, and 8439 participants, using a random effects model. Positive and significant medium-sized effects were found for teamwork interventions on both teamwork and team performance. Moderator analyses were also conducted, which generally revealed positive and significant effects with respect to several sample, intervention, and measurement characteristics. Implications for effective teamwork interventions as well as considerations for future research are discussed. PMID:28085922
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Medina, Maria Del Consuelo; Calderon, Angelica; Blunk, Dan I; Mills, Brandy W; Leiner, Marie
2018-06-01
: Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.
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Teamwork and team training in the ICU: where do the similarities with aviation end?
Reader, Tom W; Cuthbertson, Brian H
2011-01-01
The aviation industry has made significant progress in identifying the skills and behaviors that result in effective teamwork. Its conceptualization of teamwork, development of training programs, and design of assessment tools are highly relevant to the intensive care unit (ICU). Team skills are important for maintaining safety in both domains, as multidisciplinary teams must work effectively under highly complex, stressful, and uncertain conditions. However, there are substantial differences in the nature of work and structure of teams in the ICU in comparison with those in aviation. While intensive care medicine may wish to use the advances made by the aviation industry for conceptualizing team skills and implementing team training programs, interventions must be tailored to the highly specific demands of the ICU.
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Teamwork and team training in the ICU: Where do the similarities with aviation end?
2011-01-01
The aviation industry has made significant progress in identifying the skills and behaviors that result in effective teamwork. Its conceptualization of teamwork, development of training programs, and design of assessment tools are highly relevant to the intensive care unit (ICU). Team skills are important for maintaining safety in both domains, as multidisciplinary teams must work effectively under highly complex, stressful, and uncertain conditions. However, there are substantial differences in the nature of work and structure of teams in the ICU in comparison with those in aviation. While intensive care medicine may wish to use the advances made by the aviation industry for conceptualizing team skills and implementing team training programs, interventions must be tailored to the highly specific demands of the ICU. PMID:22136283
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2014-01-01
Background Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. Methods The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). Results The results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. Conclusions This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies. PMID:25124090
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Aase, Ingunn; Hansen, Britt Sæthre; Aase, Karina
2014-08-14
Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students' understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students' perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). The results show that traditional patterns of professional role perception still prevail and strongly influence students' professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit "huddles," or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students' assessments and criteria proposed in previous studies.
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Çelen, Özay; Teke, Abdulkadir; Cihangiroglu, Necmettin
2014-11-01
In this study, our aim was to determine the effect of the socio-cultural characteristics of health workers on the effectiveness of teamwork. In this study, a questionnaire method was used for data collection. To this end, a scale was first developed to assess the effectiveness of teamwork. The study was conducted in 34 departments/divisions within the GMMF Training Hospital with 423 health workers. "Specialist opinion" was used to determine the content validity of the "Teamwork Effectiveness Scale" developed for this study, while "factor analysis" was used to test the scale's construct validity. Cronbach Alpha values were calculated to test the reliability of the scale. To determine the effect of socio-cultural characteristics on the effectiveness of teamwork, the "Kruskal-Wallis" test, the "Mann-Whitney U" test and "Logistic Regression Analysis" were used within the context of the study. Based on the study results, it was observed that "assignment, "age" and "status" did not have an effect on the effectiveness of teamwork (p > 0.05). On the other hand, a significant and negative relationship was observed between "the obligation to perform compulsory service" and the attitudes that considered teamwork to be effective (p = 0.029). Similarly, a difference was identified between the workers' attitudes towards the effectiveness of teamwork depending on the size of the place of assignment (p = 0,042). It was thus observed that the "effectiveness of teamwork" was affected by the presence or absence of the "obligation to perform compulsory service" and by the "size of the place of assignment.
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Brazilian cross-cultural adaptation of the DocCom online module: communication for teamwork 1
Borges, Tatiane Angélica Phelipini; Vannuchi, Marli Terezinha Oliveira; Grosseman, Suely; González, Alberto Durán
2017-01-01
ABSTRACT Objective: to carry out the cross-cultural adaptation of DocCom online module 38, which deals with teamwork communication into Portuguese for the Brazilian contexto. Method: the transcultural translation and adaptation were accomplished through initial translations, synthesis of the translations, evaluation and synthesis by a committee of experts, analysis by translators and back translation, pre-test with nurses and undergraduate students in Nursing, and analysis of the translators to obtain the final material. Results: in evaluation and synthesis of the translated version with the original version by the expert committee, the items obtained higher than 80% agreement. Few modifications were suggested according to the analysis by pretest participants. The final version was adequate to the proposed context and its purpose. Conclusion: it is believed that by making this new teaching-learning strategy of communication skills and competencies for teamwork available, it can be used systematically in undergraduate and postgraduate courses in the health area in Brazil in order to contribute to training professionals, and also towards making advances in this field.
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The effects of Crew Resource Management (CRM) training on flight attendants' safety attitudes.
Ford, Jane; Henderson, Robert; O'Hare, David
2014-02-01
A number of well-known incidents and accidents had led the aviation industry to introduce Crew Resource Management (CRM) training designed specifically for flight attendants, and joint (pilot and flight attendant) CRM training as a way to improve teamwork and communication. The development of these new CRM training programs during the 1990s highlighted the growing need for programs to be evaluated using research tools that had been validated for the flight attendant population. The FSAQ (Flight Safety Attitudes Questionnaire-Flight Attendants) was designed specifically to obtain safety attitude data from flight attendants working for an Asia-Pacific airline. Flight attendants volunteered to participate in a study before receiving CRM training (N=563) and again (N=526) after CRM training. Almost half (13) of the items from the 36-item FSAQ showed highly significant changes following CRM training. Years of experience, crew position, seniority, leadership roles, flight attendant crew size, and length of route flown were all predictive of safety attitudes. CRM training for flight attendants is a valuable tool for increasing positive teamwork behaviors between the flight attendant and pilot sub-groups. Joint training sessions, where flight attendants and pilots work together to find solutions to in-flight emergency scenarios, provide a particularly useful strategy in breaking down communication barriers between the two sub-groups. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.
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Oxelmark, Lena; Nordahl Amorøe, Torben; Carlzon, Liisa; Rystedt, Hans
2017-01-01
This study explores how interprofessional simulation-based education (IPSE) can contribute to a change in students' understanding of teamwork and professional roles. A series of 1-day training sessions was arranged involving undergraduate nursing and medical students. Scenarios were designed for practicing teamwork principles and interprofessional communication skills by endorsing active participation by all team members. Four focus groups occurred 2-4 weeks after the training. Thematic analysis of the transcribed focus groups was applied, guided by questions on what changes in students' understanding of teamwork and professional roles were identified and how such changes had been achieved. The first question, aiming to identify changes in students' understanding of teamwork, resulted in three categories: realizing and embracing teamwork fundamentals, reconsidering professional roles, and achieving increased confidence. The second question, regarding how participation in IPSE could support the transformation of students' understanding of teamwork and of professional roles, embraced another three categories: feeling confident in the learning environment, embodying experiences, and obtaining an outside perspective. This study showed the potential of IPSE to transform students' understanding of others' professional roles and responsibilities. Students displayed extensive knowledge on fundamental teamwork principles and what these meant in the midst of participating in the scenarios. A critical prerequisite for the development of these new insights was to feel confident in the learning environment. The significance of how the environment was set up calls for further research on the design of IPSE in influencing role understanding and communicative skills in significant ways.
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Dietz, Aaron S; Pronovost, Peter J; Mendez-Tellez, Pedro Alejandro; Wyskiel, Rhonda; Marsteller, Jill A; Thompson, David A; Rosen, Michael A
2014-12-01
Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research. A keyword search of the PubMed database was conducted in February 2013. Keyword combinations focused on 3 areas: (1) teamwork, (2) the ICU, and (3) training/quality improvement interventions. All studies that investigated teamwork, team tasks, or team interventions within the ICU (ie, intradepartment) were selected for inclusion. Teamwork has been investigated across an array of research contexts and task types. The terminology used to describe team factors varied considerably across studies. The most common team tasks involved strategy and goal formulation. Team training and structured protocols were the most widely implemented quality improvement strategies. Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work. Copyright © 2014 Elsevier Inc. All rights reserved.
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Hamman, William R; Beaudin-Seiler, Beth M; Beaubien, Jeffrey M
2010-09-01
In the report "Five Years After 'To Err is Human' ", it was noted that "the combination of complexity, professional fragmentation, and a tradition of individualism, enhanced by a well-entrenched hierarchical authority structure and diffuse accountability, forms a daunting barrier to creating the habits and beliefs of common purpose, teamwork, and individual accountability for successful interdependence that a safe culture requires". Training physicians, nurses, and other professionals to work in teams is a concept that has been promoted by many patient safety experts. However the model of teamwork in healthcare is diffusely defined, no clear performance metrics have been established, and the use of simulation to train teams has been suboptimal. This paper reports on the first three years of work performed in the Michigan Economic Development Corporation (MEDC) Tri-Corridor life science grant to apply concepts and processes of simulation design that were developed in the air carrier industry to understand and train healthcare teams. This work has been monitored by the American Academy for the Advancement of Science (AAA) and is based on concepts designed in the Advanced Qualification Program (AQP) from the air carrier industry, which trains and assesses teamwork skills in the same manner as technical skills. This grant has formed the foundation for the Center of Excellence for Simulation Education and Research (CESR).
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ERIC Educational Resources Information Center
Brannick, Michael T., Ed.; Salas, Eduardo, Ed.; Prince, Carolyn, Ed.
This volume presents thoughts on measuring team performance written by experts currently working with teams in fields such as training, evaluation, and process consultation. The chapters are: (1) "An Overview of Team Performance Measurement" (Michael T. Brannick and Carolyn Prince); (2) "A Conceptual Framework for Teamwork Measurement" (Terry L.…
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ERIC Educational Resources Information Center
Hixson, Katharine
2013-01-01
Due to the long-duration and long distance nature of future exploration missions, coupled with significant communication delays from ground-based personnel, NASA astronauts will be living and working within confined, isolated environments for significant periods of time. This extreme environment poses concerns for the flight crews' ability to…
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Goldsmith, Joy; Wittenberg-Lyles, Elaine; Rodriguez, Dariela; Sanchez-Reilly, Sandra
2010-01-01
Despite the development and implementation of team training models in geriatrics and palliative care, little attention has been paid to the nature and process of teamwork. Geriatrics and palliative care in the clinical setting offer an interdisciplinary approach structured to meet the comprehensive needs of a patient and his or her family. Fellowship members of an interdisciplinary geriatric and palliative care team participated in semistructured interviews. Team members represented social work, chaplaincy, psychology, nursing, and medicine. A functional narrative analysis revealed four themes: voice of the lifeworld, caregiver teamwork, alone on a team, and storying disciplinary communication. The content-ordering function of narratives revealed a divergence in team members' conceptualization of teamwork and team effectiveness, and group ordering of narratives documented the collaborative nature of teams. The study findings demonstrate the potential for narratives as a pedagogical tool in team training, highlighting the benefits of reflective practice for improving teamwork and sustainability.
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Maynard, M Travis; Marshall, David; Dean, Matthew D
2012-01-01
In an attempt to enhance patient safety, health care facilities are increasingly turning to crew resource management (CRM) and other teamwork training interventions. However, there is still quite a bit about such training interventions that remain unclear. Accordingly, our primary intent herein is to provide some clarity by providing a review of the literature, in hopes of highlighting the current state of the literature as well as identifying the areas that should be addressed by researchers in this field going forward. We searched various electronic databases and utilized numerous relevant search terms to maximize the likelihood of identifying all empirical research related to the use of CRM training within health care. Additionally, we conducted a manual search of the most relevant journals and also conducted a legacy search to identify even more articles. Furthermore, given that as a research team we have experience with CRM initiatives, we also integrate the lessons learned through this experience. Based on our review of the literature, CRM and teamwork training programs generally appear beneficial to individual employees, the groups and teams within such settings, and overall health care organizations. In addition to reviewing the literature that addressed CRM and teamwork training, we also highlight some of the more critical aspects of CRM training programs in order for such initiatives to be as successful as possible. Additionally, we detail various factors that appear essential to sustaining any benefits of CRM over the long haul.
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Teamwork and collaboration in long-duration space missions: Going to extremes.
Landon, Lauren Blackwell; Slack, Kelley J; Barrett, Jamie D
2018-01-01
The scientific study of teamwork in the context of spaceflight has uncovered a considerable amount of knowledge over the past 20 years. Although much is known about the underlying factors and processes of teamwork, much is left to be discovered for teams who will be operating in extreme isolation and confinement during a future Mars mission. Special considerations must be made to enhance teamwork and team well-being for multi-year missions during which the small team will live and work together. We discuss the unique challenges of effective teamwork in a Mars mission scenario, and the difficulties of studying teamwork using analogs of the space environment. We then describe the National Aeronautics and Space Administration's current practices and research on teamwork, which includes team selection and composition, teamwork training, countermeasures to mitigate risks to effective team performance, and the measurement and monitoring of team functioning. We end with a discussion of the teamwork research areas that are most critical for a successful journey to Mars. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Hull, Louise; Arora, Sonal; Stefanidis, Dimitrios; Sevdalis, Nick
2015-11-01
Effective teamwork is critical to safety in the operating room; however, implementation of phase III of the American College of Surgeons (ACS) and Association of Program Directors in Surgery (APDS) Curriculum that focuses on team-based skills remains worryingly low. Training and assessing the complexities of teamwork is challenging. The objective of this study was to establish guidelines and recommendations for training faculty in assessing/debriefing team skills. A multistage survey-based consensus study was completed by 108 experts responsible for training and assessing surgical residents from the ACS Accredited Educational Institutes. Experts agreed that a program to teach faculty to assess team-based skills should include training in the recognition of teamwork skills, practice rating these skills, and training in the provision of feedback/debriefing. Agreement was reached that faculty responsible for conducting team-based skills assessment should be revalidated every 2 years and stringent proficiency criteria should be met. Faculty development is critical to ensure high-quality, standardized training and assessment. Training faculty to assess team-based skills has the potential to facilitate the effective implementation of phase III of the ACS and APDS Curriculum. Copyright © 2015 Elsevier Inc. All rights reserved.
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Eddy, Kylie; Jordan, Zoe; Stephenson, Matthew
2016-04-01
Teamwork is seen as an important element of patient care in acute hospital settings. The complexity of the journey of care for patients highlights the need for health professionals to collaborate and communicate clearly with each other. Health organizations in western countries are committed to improving patient safety through education of staff and teamwork education programs have been integral to this focus. There are no current systematic reviews of the experience of health professionals who participate in teamwork education in acute hospital settings. The objective of this systematic review was to search for the best available evidence on the experiences of health professionals who participate in teamwork education in acute hospital settings. This review considered studies reporting on experiences of registered health professionals who work in acute hospitals. This included medical, nursing and midwifery and allied health professionals. The focus of the meta-synthesis was the experiences and reflections of health professionals who were involved in teamwork education in acute hospital settings. The geographical context for this review was acute hospitals in rural or metropolitan settings in Australia and overseas countries. The review focused on the experiences of health professionals who work in acute hospitals and participated in teamwork education programs. This review considered studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research.In the absence of research studies, other text such as opinion papers, discussion papers and reports were considered. Studies published in English and from 1990 to 2013 were included in this review. The literature search for relevant papers occurred between 13 September and 26 October 2013. A three-step search strategy was utilized in this review. The databases searched were PubMed, CINAHL, Embase and Scopus. The standardized critical appraisal tool the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to assess the methodological quality of included papers. Data that included statements and text of interest was extracted from papers included in the study using the standardized data extraction tool from JBI-QARI. Qualitative research findings were pooled using JBI-QARI. This involved the aggregation and synthesis of findings to generate a set of statements that represented that aggregation. In total, 116 papers were selected for analysis of full text, 11 papers were selected for critical appraisal and seven papers were selected for data synthesis. This resulted in 44 findings. The findings were assigned to 16 categories based on identified similarities across the papers. The categories were integrated into six meta-syntheses. These were: Meta-synthesis One: It is important to recognize that organizational culture and expectations have an impact on health professionals' participation and experience of teamwork education. Meta-synthesis Two: Understanding how successful teams function is central to the development of teamwork education programs and the experience of participants. Meta-synthesis Three: A health professional's experience of teamwork education will be influenced by his/her starting point of learning. Meta-synthesis Four: Participants highly value teamwork education programs that are implemented by facilitators who create practical authentic learning opportunities and foster reflection and debriefing for participants. Meta-synthesis Five: High fidelity simulation used with specific communication strategies provides a powerful learning opportunity for health professions to practice teamwork skills. Meta-synthesis Six: Participants have increased confidence and are motivated to apply their newly learnt teamwork skills into their daily practice. The review identified qualitative evidence that can guide organizations and education facilitators in the development and implementation of teamwork education in acute hospital settings. Although the quality of the specific teamwork education programs was an important factor, there were a number of issues that also impacted on the experiences of health professionals who participated in teamwork education programs. These included the context that the program was delivered in, the diversity of health care teams, starting points of individual learners, the type of tools utilized in education programs, the levels of confidence and motivation of learners post training and the opportunity to transfer into practice new learning. Drawing from the synthesized findings of the review, recommendations for practice have been devised in order to guide the development and implementation of teamwork education in acute hospital settings and to improve the experience of participating health professionals. The Joanna Briggs Institute utilizes Grades of Recommendation to rate a health management strategy in terms of its desirable effects, evidence of adequate quality supporting its use, benefits of use, and the inclusion of patient experience, values and preferences. A strong recommendation has a Grade A and a weak recommendation has a Grade B. The FAME (Feasibility, Appropriateness, Meaningfulness and Effectiveness) scale was used to inform the strength of the following six recommendations for practice from the review: RECOMMENDATION ONE: All members of a team should be encouraged by their organization/managers to participate in teamwork education programs in order to foster a positive culture of learning and teamwork within the team.JBI Recommendation: Grade A. This recommendation is appropriate and applicable to all health professionals in acute hospital settings, is associated with positive experiences for participants of teamwork education programs and has a beneficial effect on participants. Facilitators of teamwork education programs should understand how successful teams function and consider these factors when planning or delivering training.JBI Recommendation: Grade A. This recommendation is associated with positive experiences for participants and creates a beneficial effect to the quality of a teamwork education program. Facilitators of teamwork education programs need to explore participant learning needs and their prior experiences of working in teams before implementing teamwork education programs.JBI Recommendation: Grade A. This recommendation creates a beneficial effect to the participants of teamwork education programs and to the quality of education provided by facilitators. Facilitators of teamwork education programs should provide learning opportunities that are practical, authentic to participants and foster constructive debriefing and reflection.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs, is associated with positive experiences and has a beneficial effect on participants. High fidelity simulation should be considered in acute hospitals for the training of teamwork skills in addition to clinical skills. Scenarios provide realistic opportunities for participants to practice communication strategies that enhance teamwork.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs and has a beneficial effect on participants of education programs. Team managers should harness the new confidence and motivation of staff around teamwork skills following participation in teamwork education programs and ensure that there are opportunities in the workplace to apply new skills and knowledge into daily practice.JBI Recommendation: Grade A. This recommendation is applicable to all health professionals and circumstances in which teamwork education occurs, is adaptable to a variety of circumstances and has a beneficial effect on health professional's daily practice of teamwork skills. In order to strengthen the evidence base about teamwork education in acute hospital settings there needs to be quantitative and qualitative research into:How organizations that have successfully embedded a culture of collaboration and safety in health teams have planned, implemented and evaluated teamwork education programs in acute hospital settings?What are the characteristics of teams that have led to successful participation in teamwork education and positive outcomes for team performance?What are the experiences, training and support provided to education facilitators who successfully implement teamwork education programs in acute hospitals?
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Multidisciplinary teamwork and communication training.
Deering, Shad; Johnston, Lindsay C; Colacchio, Kathryn
2011-04-01
Every delivery is a multidisciplinary event, involving nursing, obstetricians, anesthesiologists, and pediatricians. Patients are often in labor across multiple provider shifts, necessitating numerous handoffs between teams. Each handoff provides an opportunity for errors. Although a traditional approach to improving patient outcomes has been to address individual knowledge and skills, it is now recognized that a significant number of complications result from team, rather than individual, failures. In 2004, a Sentinel Alert issued by the Joint Commission revealed that most cases of perinatal death and injury are caused by problems with an organization's culture and communication failures. It was recommended that hospitals implement teamwork training programs in an effort to improve outcomes. Instituting a multidisciplinary teamwork training program that uses simulation offers a risk-free environment to practice skills, including communication, role clarification, and mutual support. This experience should improve patient safety and outcomes, as well as enhance employee morale. Published by Elsevier Inc.
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McGettigan, Patricia; McKendree, Jean
2015-10-26
Multiple care failings in hospitals have led to calls for increased interprofessional training in medical education to improve multi-disciplinary teamwork. Providing practical interprofessional training has many challenges and remains uncommon in medical schools in the UK. Unlike most previous research, this evaluation of an interprofessional training placement takes a multi-faceted approach focusing not only on the impact on students, but also on clinical staff delivering the training and on outcomes for patients. We used mixed methods to examine the impact of a two-week interprofessional training placement undertaken on a medical rehabilitation ward by three cohorts of final year medical, nursing and therapy students. We determined the effects on staff, ward functioning and participating students. Impact on staff was evaluated using the Questionnaire for Psychological and Social factors at work (QPSNordic) and focus groups. Ward functioning was inferred from standard measures of care including length of stay, complaints, and adverse events. Impact on students was evaluated using the Readiness for Interprofessional Learning Survey (RIPLS) among all students plus a placement survey among medical students. Between 2007 and 2010, 362 medical students and 26 nursing and therapy students completed placements working alongside the ward staff to deliver patient care. Staff identified benefits including skills recognition and expertise sharing. Ward functioning was stable. Students showed significant improvements in the RIPLS measures of Teamwork, Professional Identity and Patient-Centred Care. Despite small numbers of students from other professions, medical students' rated the placement highly. Increasing student numbers and budgetary constraints led to the cessation of the placement after three years. Interprofessional training placements can be delivered in a clinical setting without detriment to care and with benefits for all participants. While financial support is a necessity, it appears that having students from multiple professions is not critical for a valuable training experience; staff from different professions and students from a single profession can work successfully together. Difficulty in aligning the schedules of different student professions is commonly cited as a barrier to interprofessional training. Our experience challenges this and should encourage provision of authentic interprofessional training experience.
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Gordon, Morris; Fell, Christopher W R; Box, Helen; Farrell, Michael; Stewart, Alison
2017-01-01
Healthcare increasingly recognises and focusses on the phenomena of 'safe practice' and 'patient safety.' Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of 'safety' amongst learners. Participants receiving a non-technical skills (NTS) safety focussed training package were invited to take part in a focus group interview which set out to explore communication, teamwork, and the phenomenon of safety in the context of the learning experiences they had within the training programme. The analysis was aligned with a constructivist paradigm and took an interactive methodological approach. The analysis proceeded through three stages, consisting of open, axial, and selective coding, with constant comparisons taking place throughout each phase. Each stage provided categories that could be used to explore the themes of the data. Additionally, to ensure thematic saturation, transcripts of observed simulated learning encounters were then analysed. Six themes were established at the axial coding level, i.e., analytical skills, personal behaviours, communication, teamwork, context, and pedagogy. Underlying these themes, two principal concepts emerged, namely: intergroup contact anxiety - as both a result of and determinant of communication - and teamwork, both of which must be considered in relation to context. These concepts have subsequently been used to propose a framework for NTS learning. This study highlights the role of intergroup contact anxiety and teamwork as factors in NTS behaviour and its dissipation through interprofessional simulation learning. Therefore, this should be a key consideration in NTS education. Future research is needed to consider the role of the affective non-technical attributes of intergroup contact anxiety and teamwork as focuses for education and determinants of safe behaviour. AUM: Anxiety/uncertainty management; NTS: Non-technical skills; TINSELS: Training in non-technical skills to enhance levels of medicines safety.
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Teaching interprofessional teamwork skills to health professional students: A scoping review.
Fox, Lanae; Onders, Robert; Hermansen-Kobulnicky, Carol J; Nguyen, Thanh-Nga; Myran, Leena; Linn, Becky; Hornecker, Jaime
2018-03-01
An expanding body of literature is examining interprofessional teamwork and its effect in healthcare. To produce capable healthcare professionals prepared to participate in interprofessional roles, teamwork training must begin early in health professional students' training. The focus of this scoping review was to explore interprofessional education (IPE) studies designed to teach and/or assess interprofessional teamwork skills to students from two or more different health professions, to find and describe effective pedagogy and assessment strategies. Using a scoping review methodology, 1,106 abstracts were reviewed by three teams of investigators. Eligibility criteria were inclusion of students in interprofessional teams, an intervention to improve interprofessional teamwork skills and assessment of outcomes related to teamwork. Thirty-three studies met the criteria for inclusion. The literature was varied in terms of study design, teaching methods and assessment measures for interprofessional teamwork. The lack of rigorous, comparable studies in this area makes recommending one teaching method or assessment measure over another difficult. Regardless of teaching method, it appears that most learning activities where interprofessional teams interact result in positive changes in student perceptions and attitudes towards IPE and practice. As health education programs seek to incorporate more interprofessional activities into their respective programs, it is important to review methods and measures that would best fit their individual program. This review highlights the importance of standardising the reporting of methods and outcomes for those who wish to incorporate the studied methods into their curricula.
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Obstetric simulation as a risk control strategy: course design and evaluation.
Gardner, Roxane; Walzer, Toni B; Simon, Robert; Raemer, Daniel B
2008-01-01
Patient safety initiatives aimed at reducing medical errors and adverse events are being implemented in Obstetrics. The Controlled Risk Insurance Company (CRICO), Risk Management Foundation (RMF) of the Harvard Medical Institutions pursued simulation as an anesthesia risk control strategy. Encouraged by their success, CRICO/RMF promoted simulation-based team training as a risk control strategy for obstetrical providers. We describe the development, implementation, and evaluation of an obstetric simulation-based team training course grounded in crisis resource management (CRM) principles. We pursued systematic design of course development, implementation, and evaluation in 3 phases, including a 1-year or more posttraining follow-up with self-assessment questionnaires. The course was highly rated overall by participants immediately after the course and 1-year or more after the course. Most survey responders reported having experienced a critical clinical event since the course and that various aspects of their teamwork had significantly or somewhat improved as a result of the course. Most (86%) reported CRM principles as useful for obstetric faculty and most (59%) recommended repeating the simulation course every 2 years. A simulation-based team-training course for obstetric clinicians was developed and is a central component of CRICO/RMF's obstetric risk management incentive program that provides a 10% reduction in annual obstetrical malpractice premiums. The course was highly regarded immediately and 1 year or more after completing the course. Most survey responders reported improved teamwork and communication in managing a critical obstetric event in the interval since taking the course. Simulation-based CRM training can serve as a strategy for mitigating adverse perinatal events.
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Leasure, Emily L; Jones, Ronald R; Meade, Lauren B; Sanger, Marla I; Thomas, Kris G; Tilden, Virginia P; Bowen, Judith L; Warm, Eric J
2013-05-01
Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed. Here, the authors review a well-delineated set of teamwork competencies that are important for high-functioning teams and suggest how these competencies might be useful for interprofessional team training and achievement of PCMH standards. The five competencies are (1) team leadership, the ability to coordinate team members' activities, ensure appropriate task distribution, evaluate effectiveness, and inspire high-level performance, (2) mutual performance monitoring, the ability to develop a shared understanding among team members regarding intentions, roles, and responsibilities so as to accurately monitor one another's performance for collective success, (3) backup behavior, the ability to anticipate the needs of other team members and shift responsibilities during times of variable workload, (4) adaptability, the capability of team members to adjust their strategy for completing tasks on the basis of feedback from the work environment, and (5) team orientation, the tendency to prioritize team goals over individual goals, encourage alternative perspectives, and show respect and regard for each team member. Relating each competency to a vignette from an academic primary care clinic, the authors describe potential strategies for improving teamwork learning and applying the teamwork competences to academic PCMH practices.
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[Human factors and crisis resource management: improving patient safety].
Rall, M; Oberfrank, S
2013-10-01
A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.
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Zimmermann, Katja; Holzinger, Iris Bachmann; Ganassi, Lorena; Esslinger, Peter; Pilgrim, Sina; Allen, Meredith; Burmester, Margarita; Stocker, Martin
2015-10-29
Inter-professional teamwork is key for patient safety and team training is an effective strategy to improve patient outcome. In-situ simulation is a relatively new strategy with emerging efficacy, but best practices for the design, delivery and implementation have yet to be evaluated. Our aim is to describe and evaluate the implementation of an inter-professional in-situ simulated team and resuscitation training in a teaching hospital with a programmatic approach. We designed and implemented a team and resuscitation training program according to Kern's six steps approach for curriculum development. General and specific needs assessments were conducted as independent cross-sectional surveys. Teamwork, technical skills and detection of latent safety threats were defined as specific objectives. Inter-professional in-situ simulation was used as educational strategy. The training was embedded within the workdays of participants and implemented in our highest acuity wards (emergency department, intensive care unit, intermediate care unit). Self-perceived impact and self-efficacy were sampled with an anonymous evaluation questionnaire after every simulated training session. Assessment of team performance was done with the team-based self-assessment tool TeamMonitor applying Van der Vleuten's conceptual framework of longitudinal evaluation after experienced real events. Latent safety threats were reported during training sessions and after experienced real events. The general and specific needs assessments clearly identified the problems, revealed specific training needs and assisted with stakeholder engagement. Ninety-five interdisciplinary staff members of the Children's Hospital participated in 20 in-situ simulated training sessions within 2 years. Participant feedback showed a high effect and acceptance of training with reference to self-perceived impact and self-efficacy. Thirty-five team members experiencing 8 real critical events assessed team performance with TeamMonitor. Team performance assessment with TeamMonitor was feasible and identified specific areas to target future team training sessions. Training sessions as well as experienced real events revealed important latent safety threats that directed system changes. The programmatic approach of Kern's six steps for curriculum development helped to overcome barriers of design, implementation and assessment of an in-situ team and resuscitation training program. This approach may help improve effectiveness and impact of an in-situ simulated training program.
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Renschler, Lauren; Rhodes, Darson; Cox, Carol
2016-05-01
This article reports on a study involving a range of health professions students who participated in similar one-semester (short) or two-semester (long) interprofessional clinical education programmes that focused on clinical assessment of senior citizens living independently in the community. Students' attitudes towards teamwork skills and perceptions of their own teamwork skills both before and after the programmes were assessed using two validated scales. Osteopathic medical student participants reported no significant changes in attitudes towards interprofessional healthcare teamwork skills or their perceptions of their own interprofessional teamwork skills after either the one- or two-semester programmes. For athletic training, speech-language pathology, exercise sciences, public health, and nursing students, though, attitudes towards teamwork skills significantly improved (p < .05) after the one-semester programme; and perceptions of their own team skills significantly improved (p < .05) after both the one- and two-semester programmes. Overall, this study provides some support for interprofessional teamwork attitude change, but with a significant difference between medical as compared to nursing, allied health, and public health students.
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Setting goals, not just roles: Improving teamwork through goal-focused debriefing.
Gardner, Aimee K; Kosemund, Matthew; Hogg, Deborah; Heymann, Abraham; Martinez, Joseph
2017-02-01
The role of goal setting within post-simulation debriefing is not well known. This study sought to examine how inclusion of group-level goals, individual-level goals, or no goals in the debriefing process impacts teamwork. Students participated in two high-fidelity team training scenarios. Between scenarios, teams were assigned to one of three debriefing groups: jointly creating five teamwork goals for the group to achieve (group-level goals); independently creating five teamwork goals for each individual to attain (individual-level goals); or no goals. Paired-samples t tests and one-way ANOVA with post-hoc Tukey tests were used to examine performance improvements and differences between groups. 86 MS3s participated in the training program across 22 groups. Percentage of items achieved on the teamwork tool from first to second scenario were 61.7±20.4 to 60.2±8.8 (no goals; ns), 59.8±14.0 to 76.8±7.0 (individual goals; p<0.01), and 62.5±9.5 to 67.0±10.0 (group goals; ns). Performance improvement in the individual goals group was significantly higher than the no goals group (p<0.05). Debriefing facilitators should encourage learners to focus on creating and achieving personal goals contributing to teamwork. Copyright © 2016 Elsevier Inc. All rights reserved.
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Introducing Teamwork Challenges in Simulation Using Game Cards.
Chang, Todd P; Kwan, Karen Y; Liberman, Danica; Song, Eric; Dao, Eugene H; Chung, Dayun; Morton, Inge; Festekjian, Ara
2015-08-01
Poor teamwork and communication during resuscitations are linked to patient safety problems and poorer outcomes. We present a novel simulation-based educational intervention using game cards to introduce challenges in teamwork. This intervention uses sets of game cards that designate roles, limitations, or communication challenges designed to introduce common communication or teamwork problems. Game cards are designed to be applicable for any simulation-based scenario and are independent from patient physiology. In our example, participants were pediatric emergency medicine fellows undergoing simulation training for orientation. We describe the use of card sets in different scenarios with increasing teamwork challenge and difficulty. Both postscenario and summative debriefings were facilitated to allow participants to reflect on their performance and discover ways to apply their strategies to real resuscitations. In this article, we present our experience with the novel use of game cards to modify simulation scenarios to improve communication and teamwork skills.
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Do transactive memory and participative teamwork improve nurses' quality of work life?
Brunault, Paul; Fouquereau, Evelyne; Colombat, Philippe; Gillet, Nicolas; El-Hage, Wissam; Camus, Vincent; Gaillard, Philippe
2014-03-01
Improvement in nurses' quality of work life (QWL) has become a major issue in health care organizations. We hypothesized that the level of transactive memory (defined as the way groups collectively encode, store, and retrieve knowledge) and participative teamwork (an organizational model of care based on vocational training, a specific service's care project, and regular interdisciplinary staffing) positively affect nurses' QWL. This cross-sectional study enrolled 84 ward-based psychiatric nurses. We assessed transactive memory, participative teamwork, perceived organizational justice, perceived organizational support, and QWL using psychometrically reliable and valid scales. Participative teamwork and transactive memory were positively associated with nurses' QWL. Perceived organizational support and organizational justice fully mediated the relationship between participative teamwork and QWL, but not between transactive memory and QWL. Improved transactive memory could directly improve nurses' QWL. Improved participative teamwork could improve nurses' QWL through better perceived organizational support and perceived organizational justice.
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Amiel, Imri; Simon, Daniel; Merin, Ofer; Ziv, Amitai
2016-01-01
Medical simulation is an increasingly recognized tool for teaching, coaching, training, and examining practitioners in the medical field. For many years, simulation has been used to improve trauma care and teamwork. Despite technological advances in trauma simulators, including better means of mobilization and control, most reported simulation-based trauma training has been conducted inside simulation centers, and the practice of mobile simulation in hospitals' trauma rooms has not been investigated fully. The emergency department personnel from a second-level trauma center in Israel were evaluated. Divided into randomly formed trauma teams, they were reviewed twice using in situ mobile simulation training at the hospital's trauma bay. In all, 4 simulations were held before and 4 simulations were held after a structured learning intervention. The intervention included a 1-day simulation-based training conducted at the Israel Center for Medical Simulation (MSR), which included video-based debriefing facilitated by the hospital's 4 trauma team leaders who completed a 2-day simulation-based instructors' course before the start of the study. The instructors were also trained on performance rating and thus were responsible for the assessment of their respective teams in real time as well as through reviewing of the recorded videos; thus enabling a comparison of the performances in the mobile simulation exercise before and after the educational intervention. The internal reliability of the experts' evaluation calculated in the Cronbach α model was found to be 0.786. Statistically significant improvement was observed in 4 of 10 parameters, among which were teamwork (29.64%) and communication (24.48%) (p = 0.00005). The mobile in situ simulation-based training demonstrated efficacy both as an assessment tool for trauma teams' function and an educational intervention when coupled with in vitro simulation-based training, resulting in a significant improvement of the teams' function in various aspects of treatment. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Passauer-Baierl, S; Chiapponi, C; Bruns, C J; Weigl, M
2014-12-01
The quality of surgical teamwork contributes to performance of the operating theatre team, service quality and patient safety in surgery. Observational tools are a feasible and reliable way to capture and evaluate teamwork in the operating theatre (OT). We introduce the German version of the Observational Teamwork Assessment for Surgery (OTAS-D) and present the first observational results from German OTs. Quality of surgical teamwork was assessed with observational teamwork assessment for surgery (OTAS-D). It evaluates five dimensions of OT teamwork: communication, coordination, cooperation/backup behaviour, leadership, and team monitoring/situation awareness. Each dimension is evaluated for each profession (surgical, nursing, and anaesthesia team) as well for each phase of the procedure (pre-, intra-, and post-operative). We observed n = 63 procedures, mainly in abdominal/general and orthopaedic surgery. Additionally, all OT team members scored their individual evaluation of the intra-operative teamwork (standardised 1-item questions). The OTAS-D evaluations showed meaningful results and differences for the OT professions as well as across the different phases of the procedures. Overall, a medium to good level of the OT teamwork was observed. There were no differences in regard to type of surgery (minimally invasive vs. open) or surgical specialties. With an increased coordination of the surgical team we observed a significantly increased cooperation of the nursing team (r = 0.36, p = 0.004). Concerning the OT staffs self-reports, the surgical and nursing teams reported higher scores for quality of surgical teamwork during the procedure than their anaesthesia team members. No significant relationships between observed quality of OT teamwork and self-reports were found. The German version of OTAS-D is a psychometrically robust method to capture the quality of teamwork in operating theatres. It enables the analyses of teamwork between the surgical, nursing and anaesthesia professions in acute surgical care. Limitations of the first application results are considered. Finally, potential applications for surgical teaching, research and quality management are discussed. Georg Thieme Verlag KG Stuttgart · New York.
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Evaluating the Navy’s Enlisted Accessions Testing Program Based on Future Talent Needs
2017-03-01
Increased Fit ....... 36 2. Better Team Leader Selection ......................................... 37 3. Enhancing Teamwork Effectiveness through the...40 3. Case Study No. 3—Navy SEALs: Selecting and Training for an Elite Fighting Force...and potential importance of using personality traits’ information as a mechanism for selecting recruits with the appropriate attributes for
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Design of a Screen Based Simulation for Training and Automated Assessment of Teamwork Skills
2017-08-01
AWARD NUMBER: W81XWH-16-1-0308 TITLE: Design of a Screen-Based Simulation for Training and Automated Assessment of Teamwork Skills PRINCIPAL...the author(s) and should not be construed as an official Department of the Army position, policy or decision unless so designated by other...currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE August 2017 2. REPORT TYPE Annual 3. DATES
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Paige, John T; Garbee, Deborah D; Kozmenko, Valeriy; Yu, Qingzhao; Kozmenko, Lyubov; Yang, Tong; Bonanno, Laura; Swartz, William
2014-01-01
Effective teamwork in the operating room (OR) is often undermined by the "silo mentality" of the differing professions. Such thinking is formed early in one's professional experience and is fostered by undergraduate medical and nursing curricula lacking interprofessional education. We investigated the immediate impact of conducting interprofessional student OR team training using high-fidelity simulation (HFS) on students' team-related attitudes and behaviors. Ten HFS OR interprofessional student team training sessions were conducted involving 2 standardized HFS scenarios, each of which was followed by a structured debriefing that targeted team-based competencies. Pre- and post-session mean scores were calculated and analyzed for 15 Likert-type items measuring self-efficacy in teamwork competencies using the t-test. Additionally, mean scores of observer ratings of team performance after each scenario and participant ratings after the second scenario for an 11-item Likert-type teamwork scale were calculated and analyzed using one-way ANOVA and t-test. Eighteen nursing students, 20 nurse anesthetist students, and 28 medical students participated in the training. Statistically significant gains from mean pre- to post-training scores occurred on 11 of the 15 self-efficacy items. Statistically significant gains in mean observer performance scores were present on all 3 subscales of the teamwork scale from the first scenario to the second. A statistically significant difference was found in comparisons of mean observer scores with mean participant scores for the team-based behaviors subscale. High-fidelity simulation OR interprofessional student team training improves students' team-based attitudes and behaviors. Students tend to overestimate their team-based behaviors. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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Teamwork: Education for Entrants to the Environment Professions
ERIC Educational Resources Information Center
Meehan, Barry; Thomas, Ian
2006-01-01
Numerous reports over recent years emphasise the importance of teamwork training in undergraduate programs in environment education at tertiary level. This paper describes a project undertaken by a team of final year undergraduate environment students from four faculties at RMIT University in Australia working on a multi-disciplinary environment…
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Zanotti, Renzo; Sartor, Giada; Canova, Cristina
2015-07-29
Interprofessional Education (IPE) implies how to achieve successful teamwork, and is based on collaborative practice which enhance occasions for relationships between two or more healthcare professions. This study evaluates the effectiveness of IPE in changing attitudes after a training recently introduced to medical education for second-year students at the University of Padova, Italy. All medical students following a new program for IPE were enrolled in this study. The Interdisciplinary Education Perception Scale (IEPS) was administered before and after training, according to observation-based and practice-based learning. Data were analysed with Student's paired t-test and Wilcoxon's signed rank test. 277 medical students completed both questionnaires. Statistically significant improvements were found in students' overall attitudes as measured by the IEPS and four subscale scores. Gender-stratified analyses showed that improvements were observed only in female students in subscale 4 ("Understanding Others' Values"). Students who had a physician and/or health worker in their family did not show any improvement in subscales 2 ("Perceived need for cooperation") or 4 ("Understanding Others' Values"). Our results indicate that IPE training has a positive influence on students' understanding of collaboration and better attitudes in interprofessional teamwork. More research is needed to explore other factors which may influence specific perceptions among medical students.
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Unannounced in situ simulations: integrating training and clinical practice.
Walker, Susanna T; Sevdalis, Nick; McKay, Anthony; Lambden, Simon; Gautama, Sanjay; Aggarwal, Rajesh; Vincent, Charles
2013-06-01
Simulation-based training for healthcare providers is well established as a viable, efficacious training tool, particularly for the training of non-technical team-working skills. These skills are known to be critical to effective teamwork, and important in the prevention of error and adverse events in hospitals. However, simulation suites are costly to develop and releasing staff to attend training is often difficult. These factors may restrict access to simulation training. We discuss our experiences of 'in situ' simulation for unannounced cardiac arrest training when the training is taken to the clinical environment. This has the benefit of decreasing required resources, increasing realism and affordability, and widening multidisciplinary team participation, thus enabling assessment and training of non-technical team-working skills in real clinical teams. While there are practical considerations of delivering training in the clinical environment, we feel there are many potential benefits compared with other forms of simulation training. We are able to tailor the training to the needs of the location, enabling staff to see a scenario that is relevant to their practice. This is particularly useful for staff who have less exposure to cardiac arrest events, such as radiology staff. We also describe the important benefit of risk assessment for a clinical environment. During our simulations we have identified a number of issues that, had they occurred during a real resuscitation attempt, may have led to patient harm or patient death. For these reasons we feel in situ simulation should be considered by every hospital as part of a patient safety initiative.
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What is the impact of multi-professional emergency obstetric and neonatal care training?
Bergh, Anne-Marie; Baloyi, Shisana; Pattinson, Robert C
2015-11-01
This paper reviews evidence regarding change in health-care provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed - five randomised controlled trials, two quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in high-income countries and adapted for use in low- and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all health-care providers. The challenges are as follows: scaling up such training to all institutions, sustaining regular in-service training, integrating training into institutional and health-system patient safety initiatives and 'thinking out of the box' in evaluation research. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Lamb, Benjamin W; Green, James S A; Benn, Jonathan; Brown, Katrina F; Vincent, Charles A; Sevdalis, Nick
2013-09-01
Due to its complexity, cancer care is increasingly being delivered by multidisciplinary tumor boards (MTBs). Few studies have investigated how best to organize and run MTBs to optimize clinical decision making. We developed and evaluated a multicomponent intervention designed to improve the MTB's ability to reach treatment decisions. We conducted a prospective longitudinal study during 16 months that evaluated MTB decision making for urological cancer patients at a university hospital in London, UK. After a baseline period, MTB improvement interventions (eg, MTBs checklist, MTB team training, and written guidance) were delivered sequentially. Outcomes measures were the MTB's ability to reach a decision, the quality of information presentation, and the quality of teamwork (as assessed by trained assessors using a previously validated observational assessment tool). The efficacy of the intervention was evaluated using multivariate analyses. There were 1,421 patients studied between December 2009 and April 2, 2011. All outcomes improved considerably between baseline and intervention implementation: the MTB's ability to reach a decision rose from 82.2% to 92.7%, quality of information presentation rose from 29.6% to 38.3%, and quality of teamwork rose from 37.8% to 43.0%. The MTB's ability to reach a treatment decision was related to the quality of available information (r = 0.298; p < 0.05) and quality of teamwork within the MTB (r = 0.348; p < 0.05). The most common barriers to reaching clinical decisions were inadequate radiologic information (n = 77), inadequate pathologic information (n = 51), and inappropriate patient referrals (n = 21). Multidisciplinary tumor board-delivered treatment is becoming the standard for cancer care worldwide. Our intervention is efficacious and applicable to MTBs and can improve decision making and expedite cancer care. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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Virtual worlds and team training.
Dev, Parvati; Youngblood, Patricia; Heinrichs, W Leroy; Kusumoto, Laura
2007-06-01
An important component of all emergency medicine residency programs is managing trauma effectively as a member of an emergency medicine team, but practice on live patients is often impractical and mannequin-based simulators are expensive and require all trainees to be physically present at the same location. This article describes a project to develop and evaluate a computer-based simulator (the Virtual Emergency Department) for distance training in teamwork and leadership in trauma management. The virtual environment provides repeated practice opportunities with life-threatening trauma cases in a safe and reproducible setting.
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Effective healthcare teams require effective team members: defining teamwork competencies
Leggat, Sandra G
2007-01-01
Background Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. Methods Members of a state branch of the professional association of Australian health service managers participated in a teamwork survey. Results The 37% response rate enabled identification of a management teamwork competency set comprising leadership, knowledge of organizational goals and strategies and organizational commitment, respect for others, commitment to working collaboratively and to achieving a quality outcome. Conclusion Although not part of the research question the data suggested that the competencies for effective teamwork are perceived to be different for management and clinical teams, and there are differences in the perceptions of effective teamwork competencies between male and female health service managers. This study adds to the growing evidence that the focus on individual skill development and individual accountability and achievement that results from existing models of health professional training, and which is continually reinforced by human resource management practices within healthcare systems, is not consistent with the competencies required for effective teamwork. PMID:17284324
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Teamwork as an Essential Component of High-Reliability Organizations
Baker, David P; Day, Rachel; Salas, Eduardo
2006-01-01
Organizations are increasingly becoming dynamic and unstable. This evolution has given rise to greater reliance on teams and increased complexity in terms of team composition, skills required, and degree of risk involved. High-reliability organizations (HROs) are those that exist in such hazardous environments where the consequences of errors are high, but the occurrence of error is extremely low. In this article, we argue that teamwork is an essential component of achieving high reliability particularly in health care organizations. We describe the fundamental characteristics of teams, review strategies in team training, demonstrate the criticality of teamwork in HROs and finally, identify specific challenges the health care community must address to improve teamwork and enhance reliability. PMID:16898980
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Using Standardized Patients to Teach Interprofessional Competencies to Dental Students.
Anders, Patrick L; Scherer, Yvonne Krall; Hatton, Michael; Antonson, Donald; Austin-Ketch, Tammy; Campbell-Heider, Nancy
2016-01-01
The aims of this study were to develop, implement, and evaluate a novel interprofessional standardized patient exercise (ISPE) with oral-systemic and interprofessional collaborative practice (IPCP) components. Dental students and doctor of nursing practice (DNP) students at one U.S. university participated in the simulation, which was primarily designed to test their teamwork skills. In spring 2014, DNP students worked in the dental clinics with dental students under the supervision of nursing and dental faculty members. To test the teamwork outcomes for both groups of students, a standardized patient (SP) scenario was designed to include multiple chronic medical diagnoses and an oral-systemic component. The exercise was filmed for later review. Outcomes measures included SP and student self-evaluations and faculty evaluation of student documentation. The primary outcome of interest from a dental standpoint was faculty evaluation of IPCP competencies derived from the Core Competencies of Interprofessional Collaborative Practice and were deemed to be observable by faculty when viewing the videotaped scenario. Eight teams of students participated with an SP trained in the scenario. Each team consisted of a DNP student, a fourth-year dental student, and a second-year dental student. All eligible students in the DNP class (n=20) and eight students from each dental class (approximately 110 each) participated. The results showed that the teams scored highest on the role/responsibilities subscale, indicating students were respectful of each other's roles and expertise and effectively engaged each other to develop strategies to meet the patient's needs. Scores on the three other subscales (values/ethics, interprofessional communication, and teams/teamwork) were also high. These findings appeared to support IPCP as a method to foster knowledge and respect for other roles and responsibilities, improve appreciation of teamwork, and encourage better communication among health care providers. The ISPE scenario provided an effective way to evaluate IPCP competencies.
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Modeling and simulating human teamwork behaviors using intelligent agents
NASA Astrophysics Data System (ADS)
Fan, Xiaocong; Yen, John
2004-12-01
Among researchers in multi-agent systems there has been growing interest in using intelligent agents to model and simulate human teamwork behaviors. Teamwork modeling is important for training humans in gaining collaborative skills, for supporting humans in making critical decisions by proactively gathering, fusing, and sharing information, and for building coherent teams with both humans and agents working effectively on intelligence-intensive problems. Teamwork modeling is also challenging because the research has spanned diverse disciplines from business management to cognitive science, human discourse, and distributed artificial intelligence. This article presents an extensive, but not exhaustive, list of work in the field, where the taxonomy is organized along two main dimensions: team social structure and social behaviors. Along the dimension of social structure, we consider agent-only teams and mixed human-agent teams. Along the dimension of social behaviors, we consider collaborative behaviors, communicative behaviors, helping behaviors, and the underpinning of effective teamwork-shared mental models. The contribution of this article is that it presents an organizational framework for analyzing a variety of teamwork simulation systems and for further studying simulated teamwork behaviors.
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Family physicians' perspectives on interprofessional teamwork: Findings from a qualitative study.
Szafran, Olga; Torti, Jacqueline M I; Kennett, Sandra L; Bell, Neil R
2018-03-01
The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes. The study findings revealed that family physicians consistently perceived themselves as having the leadership role on in the primary care team. Facilitators of teamwork included: communication; trust and respect; defined roles/responsibilities of team members; co-location; task shifting to other health professionals; and appropriate payment mechanisms. Barriers to teamwork included: undefined roles/responsibilities; lack of space; frequent staff turnover; network boundaries; and a culture of power and control. The findings suggest that moving family physicians toward more integrative and interdependent functioning within the primary care team will require overcoming the culture of traditional professional roles, addressing facilitators and barriers to teamwork, and providing training in teamwork.
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Ford, Jane; O'Hare, David; Henderson, Robert
2013-06-01
The study was designed to investigate the effectiveness of a manipulation derived from social categorization and social identity theory to promote greater cabin crew willingness to engage in intergroup communication and teamwork in airline operations. Failures of communication and teamwork between airline crew have been implicated in a number of airline crashes. Flight attendants based domestically (n = 254) or overseas (n = 230) received a manipulation designed to prime either their social identity or personal identity and then read a brief outline of an in-flight event before completing a teamwork questionnaire. Flight attendants who received a social identity prime indicated increased willingness to engage in coordinated team action compared with those who received a personal identity prime. Priming social identity can enhance attitudes toward teamwork and communication, potentially leading to increased willingness to engage in intergroup cooperation. Social categorization and social identity theories can be used to inform joint training program development for flight attendants and pilots to create increased willingness for group members to participate in effective communication and teamwork behaviors.
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ERIC Educational Resources Information Center
Infante, Taline Dadian
2012-01-01
Health professions students have limited exposure to each other during their education and training, yet there are many expectations for their interaction in the workplace as part of functioning health-care teams. Interprofessional education is a mechanism to facilitate teamwork and relationships between health-care professionals by encouraging…
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Cornthwaite, Katie; Edwards, Sian; Siassakos, Dimitrios
2013-08-01
Poor teamwork results in preventable morbidity and mortality for mothers and babies. Suboptimal communication and lack of leadership cost not only lives but also money that is diverted from clinical care to insurance and litigation. Avoidable harm is usually not the result of staff failing their duty of care, it is the result of poor training failing hard-worked staff. A few simple teamwork and leadership behaviours can make a huge difference to outcome and experience for women and their companions, yet they are often missing from maternity care. Recent research has identified the problems and solutions, including the best way to train maternity teams to make a palpable difference. We describe simple yet evidence-based methods to improve teams and leaders. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J
2018-04-11
Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their reliability as teamwork-observers was a valuable learning experience and also yielded an opportunity to gather unique, and otherwise difficult to attain, data from a hospital unit for use by quality managers and administrators.
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Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter
2015-02-01
Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (p<0.001) improved significantly after the intervention in the active versus the control group. Glitch count improved in both groups and there was no significant effect on clinical outcomes. Combined training in teamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Measuring Effectiveness of TQM Training: An Indian Study.
ERIC Educational Resources Information Center
Palo, Sasmita; Padhi, Nayantara
2003-01-01
Responses from 372 employees of a steel manufacturer in India were analyzed to measure effectiveness of total quality management training. Training created awareness, built commitment to quality, facilitated teamwork, and enhanced professional standards. However, communication competencies and customer value training needed improvement. (Contains…
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Larkin, Anne C; Cahan, Mitchell A; Whalen, Giles; Hatem, David; Starr, Susan; Haley, Heather-Lyn; Litwin, Demetrius; Sullivan, Kate; Quirk, Mark
2010-08-01
This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques. Members of the Department of Surgery and the Center for Clinical Communication and Performance Outcomes jointly constructed a curriculum for PGY1 and PGY2 residents on topics ranging from challenging communication to time and stress management. Video demonstrations, triggers, and simulated scenarios involving acting patients were created by surgeons and medical educators. Pre- and postintervention measures were obtained for communication skills, perceived stress level, and teamwork. Communication skills were evaluated using a series of video vignettes. The validated Perceived Stress Scale and Teamwork and Patient Safety Attitudes survey were used. Residents' perceptions of the program were also measured. Twenty-seven PGY1 residents and 15 PGY2 residents participated during 2 years. Analyses of video vignette tests indicated significant improvement in empathic communication for PGY1 (t = 3.62, p = 0.001) and PGY2 (t = 5.00, p = 0.004). There were no significant changes to teamwork attitudes. Perceived levels of stress became considerably higher. PGY1 residents reported trying 1 to 3 strategies taught in the time management session, with 60% to 75% reporting improvement post-training. This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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Frankel, Allan S; Leonard, Michael W; Denham, Charles R
2006-01-01
Background Disparate health care provider attitudes about autonomy, teamwork, and administrative operations have added to the complexity of health care delivery and are a central factor in medicine's unacceptably high rate of errors. Other industries have improved their reliability by applying innovative concepts to interpersonal relationships and administrative hierarchical structures (Chandler 1962). In the last 10 years the science of patient safety has become more sophisticated, with practical concepts identified and tested to improve the safety and reliability of care. Objective Three initiatives stand out as worthy regarding interpersonal relationships and the application of provider concerns to shape operational change: The development and implementation of Fair and Just Culture principles, the broad use of Teamwork Training and Communication, and tools like WalkRounds that promote the alignment of leadership and frontline provider perspectives through effective use of adverse event data and provider comments. Methods Fair and Just Culture, Teamwork Training, and WalkRounds are described, and implementation examples provided. The argument is made that they must be systematically and consistently implemented in an integrated fashion. Conclusions There are excellent examples of institutions applying Just Culture principles, Teamwork Training, and Leadership WalkRounds—but to date, they have not been comprehensively instituted in health care organizations in a cohesive and interdependent manner. To achieve reliability, organizations need to begin thinking about the relationship between these efforts and linking them conceptually. PMID:16898986
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Promoting Learning Skills through Teamwork Assessment and Self/Peer Evaluation in Higher Education
ERIC Educational Resources Information Center
Issa, Tomayess
2012-01-01
In the education sector, teamwork assessment and self/peer evaluation are widely applied in higher education nationally and internationally. This assessment is designed to encourage students to promote and improve their skills in teamwork, communication (writing, interpersonal interaction and cultural awareness, and presenting), critical and…
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The Impact of Video Gaming on Decision-Making and Teamworking Skills
ERIC Educational Resources Information Center
Campus-Wide Information Systems, 2005
2005-01-01
Purpose: To discuss the considerable impact of video gaming on young players' decision-making and teamworking skills, and the belief that video games provide an invaluable "training camp" for business. Design/methodology/approach: An interview with John Beck, the author of the book Got Game: How a New Generation of Gamers Is Reshaping Business…
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ERIC Educational Resources Information Center
Dunne, Elisabeth; Rawlins, Mike
2000-01-01
Discusses the need for college graduates who are prepared for employment and skilled in teamwork, outlines a rationale for the development of groupwork in higher education, and describes a program sponsored by British Petroleum in 10 institutions in England and Scotland to provide academics with professional development in teaching groupwork…
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Teamwork and patient safety in dynamic domains of healthcare: a review of the literature.
Manser, T
2009-02-01
This review examines current research on teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. Evidence from three main areas of research supports the relationship between teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that teamwork plays an important role in the causation and prevention of adverse events. (2) Research focusing on healthcare providers' perceptions of teamwork demonstrated that (a) staff's perceptions of teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care. (3) Observational studies on teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective teamwork. In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare. The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review. This will help to improve team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care.
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Multidisciplinary crisis simulations: the way forward for training surgical teams.
Undre, Shabnam; Koutantji, Maria; Sevdalis, Nick; Gautama, Sanjay; Selvapatt, Nowlan; Williams, Samantha; Sains, Parvinderpal; McCulloch, Peter; Darzi, Ara; Vincent, Charles
2007-09-01
High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.
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Shrader, Sarah; Kern, Donna; Zoller, James; Blue, Amy
2013-01-01
Teaching interprofessional (IP) teamwork skills is a goal of interprofessional education. The purpose of this study was to examine the relationship between IP teamwork skills, attitudes and clinical outcomes in a simulated clinical setting. One hundred-twenty health professions students (medicine, pharmacy, physician assistant) worked in interprofessional teams to manage a "patient" in a health care simulation setting. Students completed the Interdisciplinary Education Perception Scale (IEPS) attitudinal survey instrument. Students' responses were averaged by team to create an IEPS attitudes score. Teamwork skills for each team were rated by trained observers using a checklist to calculate a teamwork score (TWS). Clinical outcome scores (COS) were determined by summation of completed clinical tasks performed by the team based on an expert developed checklist. Regression analyses were conducted to determine the relationship of IEPS and TWS with COS. IEPS score was not a significant predictor of COS (p=0.054), but TWS was a significant predictor (p<0.001) of COS. Results suggest that in a simulated clinical setting, students' interprofessional teamwork skills are significant predictors of positive clinical outcomes. Interprofessional curricular models that produce effective teamwork skills can improve student performance in clinical environments and likely improve teamwork practice to positively affect patient care outcomes.
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The first 3 minutes: Optimising a short realistic paediatric team resuscitation training session.
McKittrick, Joanne T; Kinney, Sharon; Lima, Sally; Allen, Meredith
2018-01-01
Inadequate resuscitation leads to death or brain injury. Recent recommendations for resuscitation team training to complement knowledge and skills training highlighted the need for development of an effective team resuscitation training session. This study aimed to evaluate and revise an interprofessional team training session which addressed roles and performance during provision of paediatric resuscitation, through incorporation of real-time, real team simulated training episodes. This study was conducted applying the principles of action research. Two cycles of data collection, evaluation and refinement of a 30-40 minute resuscitation training session for doctors and nurses occurred. Doctors and nurses made up 4 groups of training session participants. Their responses to the training were evaluated through thematic analysis of rich qualitative data gathered in focus groups held immediately after each training session. Major themes included the importance of realism, teamwork, and reflective learning. Findings informed important training session changes. These included; committed in-situ training; team diversity; realistic resources; role flexibility, definition and leadership; increased debriefing time and the addition of a team goal. In conclusion, incorporation of interprofessional resuscitation training which addresses team roles and responsibilities into standard medical and nursing training will enhance preparedness for participation in paediatric resuscitation. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Doran, Diane; Clarke, Sean; Hayes, Laureen; Nincic, Vera
2014-09-01
Much has been written about interventions to improve the nursing work environment, yet little is known about their effectiveness. A Delphi survey of nurse experts was conducted to explore perceptions about workplace interventions in terms of feasibility and likelihood of positive impact on nurse outcomes such as job satisfaction and nurse retention. The interventions that received the highest ratings for likelihood of positive impact included: bedside handover to improve communication at shift report and promote patient-centred care; training program for nurses in dealing with violent or aggressive behaviour; development of charge nurse leadership team; training program focused on creating peer-supportive atmospheres and group cohesion; and schedule that recognizes work balance and family demands. The overall findings are consistent with the literature that highlights the importance of communication and teamwork, nurse health and safety, staffing and scheduling practices, professional development and leadership and mentorship. Nursing researchers and decision-makers should work in collaboration to implement and evaluate interventions for promoting practice environments characterized by effective communication and teamwork, professional growth and adequate support for the health and well-being of nurses.
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Toward a definition of teamwork in emergency medicine.
Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo
2008-11-01
The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.
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Training future health providers to care for the underserved: a pilot interprofessional experience.
Hasnain, Memoona; Koronkowski, Michael J; Kondratowicz, Diane M; Goliak, Kristen L
2012-01-01
Interprofessional teamwork is essential for effective delivery of health care to all patients, particularly the vulnerable and underserved. This brief communication describes a pilot interprofessional learning experience designed to introduce medicine and pharmacy students to critical health issues affecting at-risk, vulnerable patients and helping students learn the value of functioning effectively in interprofessional teams. With reflective practice as an overarching principle, readings, writing assignments, a community-based immersion experience, discussion seminars, and presentations were organized to cultivate students' insights into key issues impacting the health and well-being of vulnerable patients. A written program evaluation form was used to gather students' feedback about this learning experience. Participating students evaluated this learning experience positively. Both quantitative and qualitative input indicated the usefulness of this learning experience in stimulating learners' thinking and helping them learn to work collaboratively with peers from another discipline to understand and address health issues for at-risk, vulnerable patients within their community. This pilot educational activity helped medicine and pharmacy students learn the value of functioning effectively in interprofessional teams. Given the importance of interprofessional teamwork and the increasing need to respond to the health needs of underserved populations, integrating interprofessional learning experiences in health professions training is highly relevant, feasible, and critically needed.
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The dynamics of CRM attitude change: Attitude stability
NASA Technical Reports Server (NTRS)
Gregorich, Steven E.
1993-01-01
Special training seminars in cockpit resource management (CRM) are designed to enhance crew effectiveness in multicrew air-transport cockpits. In terms of CRM, crew effectiveness is defined by teamwork rather than technical proficiency. These seminars are designed to promote factual learning, alter aviator attitudes, and motivate aviators to make use of what they have learned. However, measures of attitude change resulting from CRM seminars have been the most common seminar evaluation technique. The current investigation explores a broader range of attitude change parameters with specific emphasis on the stability of change between recurrent visits to the training center. This allows for a comparison of training program strengths in terms of seminar ability to effect lasting change.
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Medical Team Training Improves Team Performance: AOA Critical Issues.
Carpenter, James E; Bagian, James P; Snider, Rebecca G; Jeray, Kyle J
2017-09-20
Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case. This training program led to measured improvements in job satisfaction and compliance with checklist tasks, and identified opportunities to improve training sessions. MTT provides the potential for sustainable change and a positive impact on the environment of the operating room.
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Team development interventions: Evidence-based approaches for improving teamwork.
Lacerenza, Christina N; Marlow, Shannon L; Tannenbaum, Scott I; Salas, Eduardo
2018-01-01
The rate of teamwork and collaboration within the workforce has burgeoned over the years, and the use of teams is projected to continue increasing. With the rise of teamwork comes the need for interventions designed to enhance teamwork effectiveness. Successful teams produce desired outcomes; however, it is critical that team members demonstrate effective processes to achieve these outcomes. Team development interventions (TDIs) increase effective team competencies and processes, thereby leading to improvements in proximal and distal outcomes. The effectiveness of TDIs is evident across domains (e.g., education, health care, military, aviation), and they are applicable in a wide range of settings. To stimulate the adoption and effective use of TDIs, the current article provides a review of four types of evidence-based TDIs including team training, leadership training, team building, and team debriefing. In doing so, we aim to provide psychologists with an understanding of the scientific principles underlying TDIs and their impact on team dynamics. Moreover, we provide evidence-based recommendations regarding how to increase the effectiveness of TDIs as well as a discussion on future research needed within this domain. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Grover, Elise; Porter, Joanne E; Morphet, Julia
2017-05-01
Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Three major themes emerged from the data. The first theme 'when teamwork works' supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme 'team support' revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme 'no time for teamwork' centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
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ERIC Educational Resources Information Center
Britton, Emily; Simper, Natalie; Leger, Andrew; Stephenson, Jenn
2017-01-01
Effective teamwork skills are essential for success in an increasingly team-based workplace. However, research suggests that there is often confusion concerning how teamwork is measured and assessed, making it difficult to develop these skills in undergraduate curricula. The goal of the present study was to develop a sustainable tool for assessing…
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Teamwork and communication: an effective approach to patient safety.
Mujumdar, Sandhya; Santos, Diana
2014-01-01
Teamwork and communication failures are leading causes of patient safety incidents in health care. Though health care providers must work in teams, they are not well-trained in teamwork and communication skills. Health care faces the problems of differences in communication styles, communication failures and poor teamwork. There is enough evidence in the literature to show that communication failure is detrimental to patient safety. It is estimated that 80% of serious medical errors worldwide take place because of miscommunication between medical providers. NUH recognizes that effective communication and teamwork are essential in the delivery of high quality safe patient care, especially in a complex organization. NUH is a good example, where there is a rich mix of nationalities and races, in staff and in patients, and there is a rapidly expanding care environment. NUH had to overcome these challenges by adopting a multi-pronged approach. The trials and tribulations of NUH in this journey were worthwhile as the patient safety climate survey scores improved over the years.
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Thomas, E; Sexton, J; Helmreich, R
2004-01-01
Improving teamwork in healthcare may help reduce and manage errors. This paper takes a step toward that goal by (1) proposing a set of teamwork behaviours, or behavioural markers, for neonatal resuscitation; (2) presenting a data form for recording observations about these markers; and (3) comparing and contrasting different sets of teamwork behaviours that have been developed for healthcare. Data from focus groups of neonatal providers, surveys, and video recordings of neonatal resuscitations were used to identify some new teamwork behaviours, to translate existing aviation team behaviours to this setting, and to develop a data collection form. This behavioural marker audit form for neonatal resuscitation lists and defines 10 markers that describe specific, observable behaviours seen during the resuscitation of newborn infants. These markers are compared with those developed by other groups. Future research should determine the relations among these behaviours and errors, and test their usefulness in measuring the impact of team training interventions. PMID:15465957
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ERIC Educational Resources Information Center
Gore, C.; Murray, K.
1991-01-01
Interviews with 147 students and 14 teachers at Leicester Polytechnic (England) identified differing perceptions and attitudes about "enterprise," entrepreneurial qualities and skills, and self-perception. Training for enterprise should address communication, teamwork, risk taking, decision making, and appropriate attitudes. (SK)
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Evaluation of PCMH Model Adoption on Teamwork and Impact on Patient Access and Safety
Khanna, Niharika; Shaya, Fadia T.; Gaitonde, Priyanka; Abiamiri, Andrea; Steffen, Ben; Sharp, David
2016-01-01
Purpose: Each of the participating patient-centered medical home (PCMH) received coaching and participated in learning collaborative for improving teamwork. The objective of the study was to assess the impact of trainings on patient-centered teamwork. Methods: The Teamwork Perception Questionnaire (TPQ) was administered once in spring 2014 and then in fall 2015. The TPQ consists of 35 questions across 5 domains: mutual support, situation monitoring, communication, team structure, and leadership. Based on our objective we compared the frequencies of strongly agree/agree by domain. The difference was tested using chi-square test. We compared the scores on each domain (strongly agree/agree = 1; maximum score = 7) via Wilcoxon rank sum test. Results: The response rate for this survey was n = 29 (80.6%) in spring 2014, and n = 31 (86.1%) in fall 2015. We found that the practice members significantly (P < .05) strongly agreed/agreed more in fall 2015 than spring 2014 for characteristics—“staff relay relevant information in a timely manner” (64.5% vs 83.9%) and “staff follow a standardized method of sharing information when handing off patients” (67.7% vs 90.3%) under communication domain and for characteristic—“staff within my practice share information that enables timely decision making” (74.2% vs 90.3%). However, there was no statistical significant difference observed in the scores for the overall TPQ at the 2 time points. Conclusion: Despite the statistical insignificance, the observations in PCMHs across the spectrum of practices participating in the Maryland Multi-Payer Program demonstrated enhanced teamwork specifically in communication and in leadership. This we believe will continue to result in enhanced patient access to care and safety. PMID:27838621
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Evaluation of PCMH Model Adoption on Teamwork and Impact on Patient Access and Safety.
Khanna, Niharika; Shaya, Fadia T; Gaitonde, Priyanka; Abiamiri, Andrea; Steffen, Ben; Sharp, David
2017-04-01
Each of the participating patient-centered medical home (PCMH) received coaching and participated in learning collaborative for improving teamwork. The objective of the study was to assess the impact of trainings on patient-centered teamwork. The Teamwork Perception Questionnaire (TPQ) was administered once in spring 2014 and then in fall 2015. The TPQ consists of 35 questions across 5 domains: mutual support, situation monitoring, communication, team structure, and leadership. Based on our objective we compared the frequencies of strongly agree/agree by domain. The difference was tested using chi-square test. We compared the scores on each domain (strongly agree/agree = 1; maximum score = 7) via Wilcoxon rank sum test. The response rate for this survey was n = 29 (80.6%) in spring 2014, and n = 31 (86.1%) in fall 2015. We found that the practice members significantly ( P < .05) strongly agreed/agreed more in fall 2015 than spring 2014 for characteristics-"staff relay relevant information in a timely manner" (64.5% vs 83.9%) and "staff follow a standardized method of sharing information when handing off patients" (67.7% vs 90.3%) under communication domain and for characteristic-"staff within my practice share information that enables timely decision making" (74.2% vs 90.3%). However, there was no statistical significant difference observed in the scores for the overall TPQ at the 2 time points. Despite the statistical insignificance, the observations in PCMHs across the spectrum of practices participating in the Maryland Multi-Payer Program demonstrated enhanced teamwork specifically in communication and in leadership. This we believe will continue to result in enhanced patient access to care and safety.
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Rovamo, Liisa; Nurmi, Elisa; Mattila, Minna-Maria; Suominen, Pertti; Silvennoinen, Minna
2015-11-12
Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50% of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies. Ninety-nine participants of two delivery units (17 pediatricians, 16 anesthesiologists, 14 obstetricians, 31 midwives, and 21 neonatal nurses) were divided to an intervention group (I-group, 9 teams) and a control group (C-group, 6 teams). The I-group attended a CRM and ANTS instruction before the first scenario. After each scenario the I-group performed either self- or peer-assessment depending on whether they had acted or observed in the scenario. All the teams participated in two and observed another two scenarios. All the scenarios were video-recorded and scored by three experts with Team Emergency Assessment Measure (TEAM). SPSS software and nlme package were used for the statistical analyses. The total TEAM scores of the first scenario between the I- and C-group did not differ from each other. Neither there was an increase in the TEAM scoring between the first and second scenario between the groups. The CRM instruction did not improve the I-group's teamwork performance. Unfortunately the teams were not comparable because the teams had been allowed to self-select their members in the study design. The total TEAM scores varied a lot between the teams. Mixed-model linear regression revealed that the background of the team leader had an impact on differences of the total teamwork scores (D = 6.50, p = 0.039). When an anesthesia consultant was the team leader the mean teamwork improved by 6.41 points in comparison to specialists of other disciplines (p = 0.043). The instruction of non-technical skills before simulation training did not enhance the acquisition of teamwork skills of the intervention groups over the corresponding set of skills of the control groups. The teams led by an anesthesiologist scored the best. Experience of team leaders improved teamwork over the CRM instruction.
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Evans, J; Henderson, A; Johnson, N
2010-03-13
Teamwork is essential for the provision of contemporary, high quality oral health care. Teamwork skills need to be taught and learnt and therefore ought to be one of the core competencies in all dental education programmes: dentistry, oral health therapy, dental technology and dental assisting. Currently, lack of opportunities for collaborative learning and practice within educational establishments, and in the practising professions, hamper the development of effective teamwork. For students across oral health care, learning 'together' requires positive action for teamwork skills to be developed. Interprofessional curricula need to be formally developed, based on evidence from the wider education literature that demonstrates how to maximise the engagements needed for teamwork in practice. Rigorous study of interprofessional education within dentistry and oral health is in its infancy. Anecdotal evidence indicates that dental technology students who experience an interprofessional curriculum are better prepared for collaborative practice. Formalised interprofessional education is posited as an effective strategy to improve interactions among oral health professionals leading to improved patient care. This paper reviews the extant literature and describes the approach currently being trialled at Griffith University.
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The role of teamwork and communication in the emergency department: a systematic review.
Kilner, Emily; Sheppard, Lorraine A
2010-07-01
The aim of this study was to develop a systematic review using international research to describe the role of teamwork and communication in the emergency department, and its relevance to physiotherapy practice in the emergency department. Searches were conducted of CINAHL, Academic Search Premier, Scopus, Cochrane, PEDro, Medline, Embase, Amed and PubMed. Selection criteria included full-text English language research papers related to teamwork and/or communication based directly in the emergency department, involvement of any profession in the emergency department, publication in peer-reviewed journals, and related to adult emergency services. Studies were appraised using a validated critical appraisal tool. Fourteen eligible studies, all of mid-range quality, were identified. They demonstrated high levels of staff satisfaction with teamwork training interventions and positive staff attitudes towards the importance of teamwork and communication. There is moderate evidence that the introduction of multidisciplinary teams to the ED may be successful in reducing access block, and physiotherapists may play a role in this. The need for teamwork and communication in the ED is paramount, and their roles are closely linked, with the common significant purposes of improving patient safety, reducing clinical errors, and reducing waiting times. 2009 Elsevier Ltd. All rights reserved.
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Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan
2014-02-01
Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.
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Hoang, Tuan N; Kang, Jeff; Siriratsivawong, Kris; LaPorta, Anthony; Heck, Amber; Ferraro, Jessica; Robinson, Douglas; Walsh, Jonathan
2016-01-01
The high-stress, fast-paced environment of combat casualty care relies on effective teamwork and communication which translates into quality patient care. A training course was developed for U.S. Navy Fleet Surgical Teams to address these aspects of patient care by emphasizing efficiency and appropriate patient care. An effective training course provides knowledge and skills to pass the course evaluation and sustain the knowledge and skills acquired over time. The course included classroom didactic hours, and hands-on simulation sessions. A pretest was administered before the course, a posttest upon completion, and a sustainment test 5 months following course completion. The evaluation process measured changes in patient time to disposition and critical errors made during patient care. Naval Base San Diego, with resuscitation and surgical simulations carried out within the shipboard medical spaces. United States Navy medical personnel including physicians of various specialties, corpsmen, nurses, and nurse anesthetists deploying aboard ships. Time to disposition improved significantly, 11 ± 3 minutes, from pretest to posttest, and critical errors improved by 4 ± 1 errors per encounter. From posttest to sustainment test, time to disposition increased by 3 ± 1, and critical errors decreased by 1 ± 1. This course showed value in improving teamwork and communication skills of participants, immediately upon completion of the course, and after 5 months had passed. Therefore, with ongoing sustainment activities within 6 months, this course can substantially improve trauma care provided by shipboard deployed Navy medical personnel to wounded service members. Published by Elsevier Inc.
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Organisational Change and the Management of Training in Australian Enterprises.
ERIC Educational Resources Information Center
Smith, Andrew; Oczkowski, Edward; Macklin, Robert; Noble, Charles
2003-01-01
A survey of 584 Australian companies investigated the impact of 5 management practices (total quality management, teamwork, lean production, reengineering, learning organizations) in relation to 8 training practices. New management practices had significant but differing effects on the organization of training: total quality management had the…
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Arain, Nabeel A; Hogg, Deborah C; Gala, Rajiv B; Bhoja, Ravi; Tesfay, Seifu T; Webb, Erin M; Scott, Daniel J
2012-01-01
Our aim was to develop an objective scoring system and evaluate construct and face validity for a laparoscopic troubleshooting team training exercise. Surgery and gynecology novices (n = 14) and experts (n = 10) participated. Assessments included the following: time-out, scenario decision making (SDM) score (based on essential treatments rendered and completion time), operating room communication assessment (investigator developed), line operations safety audits (teamwork), and National Aeronautics and Space Administration-Task Load Index (workload). Significant differences were detected for SDM scores for scenarios 1 (192 vs 278; P = .01) and 3 (129 vs 225; P = .004), operating room communication assessment (67 vs 91; P = .002), and line operations safety audits (58 vs 87; P = .001), but not for time-out (46 vs 51) or scenario 2 SDM score (301 vs 322). Workload was similar for both groups and face validity (8.8 on a 10-point scale) was strongly supported. Objective decision-making scoring for 2 of 3 scenarios and communication and teamwork ratings showed construct validity. Face validity and participant feedback were excellent. Copyright © 2012 Elsevier Inc. All rights reserved.
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West, Courtney; Landry, Karen; Graham, Anna; Graham, Lori; Cianciolo, Anna T; Kalet, Adina; Rosen, Michael; Sherman, Deborah Witt
2015-01-01
SGEA 2015 CONFERENCE ABSTRACT (EDITED). Evaluating Interprofessional Teamwork During a Large-Scale Simulation. Courtney West, Karen Landry, Anna Graham, and Lori Graham. CONSTRUCT: This study investigated the multidimensional measurement of interprofessional (IPE) teamwork as part of large-scale simulation training. Healthcare team function has a direct impact on patient safety and quality of care. However, IPE team training has not been the norm. Recognizing the importance of developing team-based collaborative care, our College of Nursing implemented an IPE simulation activity called Disaster Day and invited other professions to participate. The exercise consists of two sessions: one in the morning and another in the afternoon. The disaster scenario is announced just prior to each session, which consists of team building, a 90-minute simulation, and debriefing. Approximately 300 Nursing, Medicine, Pharmacy, Emergency Medical Technicians, and Radiology students and over 500 standardized and volunteer patients participated in the Disaster Day event. To improve student learning outcomes, we created 3 competency-based instruments to evaluate collaborative practice in multidimensional fashion during this exercise. A 20-item IPE Team Observation Instrument designed to assess interprofessional team's attainment of Interprofessional Education Collaborative (IPEC) competencies was completed by 20 faculty and staff observing the Disaster Day simulation. One hundred sixty-six standardized patients completed a 10-item Standardized Patient IPE Team Evaluation Instrument developed from the IPEC competencies and adapted items from the 2014 Henry et al. PIVOT Questionnaire. This instrument assessed the standardized or volunteer patient's perception of the team's collaborative performance. A 29-item IPE Team's Perception of Collaborative Care Questionnaire, also created from the IPEC competencies and divided into 5 categories of Values/Ethics, Roles and Responsibilities, Communication, Teamwork, and Self-Evaluation, was completed by 188 students including 99 from Nursing, 43 from Medicine, 6 from Pharmacy, and 40 participants who belonged to more than one component, were students at another institution, or did not indicate their institution. The team instrument was designed to assess each team member's perception of how well the team and him- or herself met the competencies. Five of the items on the team perceptions questionnaire mirrored items on the standardized patient evaluation: demonstrated leadership practices that led to effective teamwork, discussed care and decisions about that care with patient, described roles and responsibilities clearly, worked well together to coordinate care, and good/effective communication. Internal consistency reliability of the IPE Team Observation Instrument was 0.80. In 18 of the 20 items, more than 50% of observers indicated the item was demonstrated. Of those, 6 of the items were observed by 50% to 75% of the observers, and the remaining 12 were observed by more than 80% of the observers. Internal consistency reliability of the IPE Team's Perception of Collaborative Care Instrument was 0.95. The mean response score-1 (strongly disagree) to 4 (strongly agree)-was calculated for each section of the instrument. The overall mean score was 3.57 (SD = .11). Internal consistency reliability of the Standardized Patient IPE Team Evaluation Instrument was 0.87. The overall mean score was 3.28 (SD = .17). The ratings for the 5 items shared by the standardized patient and team perception instruments were compared using independent sample t tests. Statistically significant differences (p < .05) were present in each case, with the students rating themselves higher on average than the standardized patients did (mean differences between 0.2 and 0.6 on a scale of 1-4). Multidimensional, competency-based instruments appear to provide a robust view of IPE teamwork; however, challenges remain. Due to the large scale of the simulation exercise, observation-based assessment did not function as well as self- and standardized patient-based assessment. To promote greater variation in observer assessments during future Disaster Day simulations, we plan to adjust the rating scale from "not observed," "observed," and "not applicable" to a 4-point scale and reexamine interrater reliability.
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Gillespie, Brigid M; Harbeck, Emma; Kang, Evelyn; Steel, Catherine; Fairweather, Nicole; Panuwatwanich, Kriengsak; Chaboyer, Wendy
2017-04-27
Up to 60% of adverse events in surgery are the result of poor communication and teamwork. Nontechnical skills in surgery (NOTSS) are critical to the success of surgery and patient safety. The study aim was to evaluate the effect of a brief team training intervention on teams' observed NOTSS. Pretest-posttest interrupted time-series design with statistical process control analysis was used to detect longitudinal changes in teams' NOTSS. We evaluated NOTSS using the revised NOTECHS weekly for 20 to 25 weeks before and after implementation of a team training program. We observed 179 surgical procedures with cardiac, vascular, upper gastrointestinal, and hepatobiliary teams. Mean posttest NOTECHS scores increased across teams, showing special cause variation. There were also significant before and after improvements in NOTECHS scores in respect to professional role and in the use of the Surgical Safety Checklist. Our results suggest associated improvements in teams' NOTSS after implementation of the team training program.
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Ten Teamwork Terminators and Some Sure Cures.
ERIC Educational Resources Information Center
Child Care Information Exchange, 1992
1992-01-01
This article describes 10 behaviors of day care center directors that undermine the team performance of the caregiving staff. Also described are three behaviors that are crucial to fostering successful teamwork. A day care center teamwork evaluation form for staff is provided. (BC)
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Van den Bulcke, Bo; Vyt, Andre; Vanheule, Stijn; Hoste, Eric; Decruyenaere, Johan; Benoit, Dominique
2016-05-01
This article describes a study that evaluated the quality of teamwork in a surgical intensive care unit and assessed whether teamwork could be improved significantly through a tailor-made intervention. The quality of teamwork prior to and after the intervention was assessed using the Interprofessional Practice and Education Quality Scales (IPEQS) using the PROSE online diagnostics and documenting system, which assesses three domains of teamwork: organisational factors, care processes, and team members' attitudes and beliefs. Furthermore, team members evaluated strengths and weaknesses of the teamwork through open-ended questions. Information gathered by means of the open questions was used to design a tailor-made 12-week intervention consisting of (1) optimising the existing weekly interdisciplinary meetings with collaborative decision-making and clear communication of goal-oriented actions, including the psychosocial aspects of care; and (2) organising and supporting the effective exchange of information over time between all professions involved. It was found that the intervention had a significant impact on organisational factors and care processes related to interprofessional teamwork for the total group and within all subgroups, despite baseline differences between the subgroups in interprofessional teamwork. In conclusion, teamwork, and more particularly the organisational aspects of interprofessional collaboration and processes of care, can be improved by a tailor-made intervention that takes into account the professional needs of healthcare workers.
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Walker, Dilys; Cohen, Susanna; Fritz, Jimena; Olvera, Marisela; Lamadrid-Figueroa, Hector; Cowan, Jessica Greenberg; Hernandez, Dolores Gonzalez; Dettinger, Julia C; Fahey, Jenifer O
2014-11-20
Ineffective management of obstetric emergencies contributes significantly to maternal and neonatal morbidity and mortality in Mexico. PRONTO (Programa de Rescate Obstétrico y Neonatal: Tratamiento Óptimo y Oportuno) is a highly-realistic, low-tech simulation-based obstetric and neonatal emergency training program. A pair-matched hospital-based controlled implementation trial was undertaken in three states in Mexico, with pre/post measurement of process indicators at intervention hospitals. This report assesses the impact of PRONTO simulation training on process indicators from the pre/post study design for process indicators. Data was collected in twelve intervention facilities on process indicators, including pre/post changes in knowledge and self-efficacy of obstetric emergencies and neonatal resuscitation, achievement of strategic planning goals established during training and changes in teamwork scores. Authors performed a longitudinal fixed-effects linear regression model to estimate changes in knowledge and self-efficacy and logistic regression to assess goal achievement. A total of 450 professionals in interprofessional teams were trained. Significant increases in knowledge and self-efficacy were noted for both physicians and nurses (p <0.001- 0.009) in all domains. Teamwork scores improved and were maintained over a three month period. A mean of 58.8% strategic planning goals per team in each hospital were achieved. There was no association between high goal achievement and knowledge, self-efficacy, proportion of doctors or nurses in training, state, or teamwork score. These results suggest that PRONTO's highly realistic, locally appropriate simulation and team training in maternal and neonatal emergency care may be a promising avenue for optimizing emergency response and improving quality of facility-based obstetric and neonatal care in resource-limited settings. NCT01477554.
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A human factors curriculum for surgical clerkship students.
Cahan, Mitchell A; Larkin, Anne C; Starr, Susan; Wellman, Scott; Haley, Heather-Lyn; Sullivan, Kate; Shah, Shimul; Hirsh, Michael; Litwin, Demetrius; Quirk, Mark
2010-12-01
Early introduction of a full-day human factors training experience into the surgical clerkship curriculum will teach effective communication skills and strategies to gain professional satisfaction from a career in surgery. In pilot 1, which took place between July 1, 2007, and December 31, 2008, 50 students received training and 50 did not; all received testing at the end of the rotation for comparison of control vs intervention group performance. In pilot 2, a total of 50 students were trained and received testing before and after rotation to examine individual change over time. University of Massachusetts Medical School. A total of 148 third-year medical students in required 12-week surgical clerkship rotations. Full-day training with lecture and small-group exercises, cotaught by surgeons and educators, with focus on empathetic communication, time management, and teamwork skills. Empathetic communication skill, teamwork, and patient safety attitudes and self-reported use of time management strategies. Empathy scores were not higher for trained vs untrained groups in pilot 1 but improved from 2.32 to 3.45 on a 5-point scale (P < .001) in pilot 2. Students also were more likely to ask for the nurse's perspective and to seek agreement on an action plan after team communication training (pilot 1, f = 7.52, P = .007; pilot 2, t = 2.65, P = .01). Results were mixed for work-life balance, with some trained groups scoring significantly lower than untrained groups in pilot 1 and no significant improvement shown in pilot 2. The significant increase in student-patient communication scores suggests that a brief focused presentation followed by simulation of difficult patient encounters can be successful. A video demonstration can improve interdisciplinary teamwork.
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Wong, Ambrose Hon-Wai; Gang, Maureen; Szyld, Demian; Mahoney, Heather
2016-04-01
Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P < 0.0001, P = 0.029, P = 0.014, and P = 0.003, respectively). For Hospital Survey on Patient Safety Culture, 3 of 6 composites directly related to teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to teamwork and communication.
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Gillespie, Brigid M; Chaboyer, Wendy; Murray, Patrick
2010-12-01
In surgery, up to 70% of adverse events are attributable to failures in communication. The purpose of this systematic literature review was to critically assess the results of team training interventions used in the OR. In the 12 studies that met the inclusion criteria, there were statistically significant before-and-after improvements in teamwork practices and in some secondary outcomes such as complication rates. Our findings suggest that team training interventions have utility in enhancing team communication and cohesion. Team training interventions that are developed in response to the nuances of the context are more likely to become embedded in clinical practice. The introduction of more complex interventions has implications for resources and staffing. Further research is needed to identify and evaluate strategies that address the sustainability of complex team training interventions across multiple OR contexts. Published by Elsevier Inc. All rights reserved.
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Arora, Sonal; Hull, Louise; Fitzpatrick, Maureen; Sevdalis, Nick; Birnbach, David J
2015-05-01
To establish the efficacy of simulation-based training for improving residents' management of postoperative complications on a surgical ward. Effective postoperative care is a crucial determinant of patient outcome, yet trainees learn this through the Halstedian approach. Little evidence exists on the efficacy of simulation in this safety-critical environment. A pre-/postintervention design was employed with 185 residents from 5 hospitals. Residents participated in 2 simulated ward-based scenarios consisting of a deteriorating postoperative patient. A debriefing intervention was implemented between scenarios. Resident performance was evaluated by calibrated, blinded assessors using the validated Global Assessment Toolkit for Ward Care. This included an assessment of clinical skills (checklist of 35 tasks), team-working skills (score range 1-6 per skill), and physician-patient interaction skills. Excellent interrater reliability was achieved in all assessments (reliability 0.89-0.99, P < 0.001). Clinically, improvements were obtained posttraining in residents' ability to recognize/respond to falling saturations (pre = 73.7% vs post = 94.8%, P < 0.01), check circulatory status (pre = 21.1% vs post = 84.2% P < 0.001), continuously reassess patient (pre = 42.1% vs post = 100%, P < 0.001), and call for help (pre = 36.8% vs post = 89.8%, P < 0.001). Regarding teamwork, there was a significant improvement in residents' communication (pre = 1.75 vs post = 3.43), leadership (pre = 2.43 vs post = 4.20), and decision-making skills (pre = 2.20 vs post = 3.81, P < 0.001). Finally, residents improved in all elements of interaction with patients: empathy, organization, and verbal and nonverbal expression (Ps < 0.001). The study provides evidence for the efficacy of ward-based team training using simulation. Such exercises should be formally incorporated into training curricula to enhance patient safety in the high-risk surgical ward environment.
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Wang, Candice; Huang, Chin-Chou; Lin, Shing-Jong; Chen, Jaw-Wen
2016-01-01
Objectives The goal of our study was to shed light on educational methods to strengthen medical students' cardiopulmonary resuscitation (CPR) leadership and team skills in order to optimise CPR understanding and success using didactic videos and high-fidelity simulations. Design An observational study. Setting A tertiary medical centre in Northern Taiwan. Participants A total of 104 5–7th year medical students, including 72 men and 32 women. Interventions We provided the medical students with a 2-hour training session on advanced CPR. During each class, we divided the students into 1–2 groups; each group consisted of 4–6 team members. Medical student teams were trained by using either method A or B. Method A started with an instructional CPR video followed by a first CPR simulation. Method B started with a first CPR simulation followed by an instructional CPR video. All students then participated in a second CPR simulation. Outcome measures Student teams were assessed with checklist rating scores in leadership, teamwork and team member skills, global rating scores by an attending physician and video-recording evaluation by 2 independent individuals. Results The 104 medical students were divided into 22 teams. We trained 11 teams using method A and 11 using method B. Total second CPR simulation scores were significantly higher than first CPR simulation scores in leadership (p<0.001), teamwork (p<0.001) and team member skills (p<0.001). For methods A and B students' first CPR simulation scores were similar, but method A students' second CPR simulation scores were significantly higher than those of method B in leadership skills (p=0.034), specifically in the support subcategory (p=0.049). Conclusions Although both teaching strategies improved leadership, teamwork and team member performance, video exposure followed by CPR simulation further increased students' leadership skills compared with CPR simulation followed by video exposure. PMID:27678539
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[Interprofessional education: training for healthcare professionals for teamwork focusing on users].
Peduzzi, Marina; Norman, Ian James; Germani, Ana Claudia Camargo Gonçalves; da Silva, Jaqueline Alcântara Marcelino; de Souza, Geisa Colebrusco
2013-08-01
The theoretical constructs of interprofessional education (IPE) are analyzed based on two reviews of the literature, taking the context of training for healthcare professionals in Brazil into consideration. Three types of training are identified: uniprofessional, multiprofessional and interprofessional, with predominance of the first type. The first occurs among students of the same profession, in isolation; the second occurs among students of two or more professions, in parallel without interaction; and the third involves shared learning, with interaction between students and/or professionals from different fields. The distinction between interprofessionalism and interdisciplinarity is highlighted: these refer to integration, respectively, of professional practices and disciplines or fields of knowledge. Through the analysis presented, it is concluded that in the Brazilian context, IPE (the basis for collaborative teamwork) is still limited to some recent initiatives, which deserve to be investigated.
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NASA Technical Reports Server (NTRS)
Davis, Donald D.; Bryant, Janet L.; Tedrow, Lara; Liu, Ying; Selgrade, Katherine A.; Downey, Heather J.
2005-01-01
This report describes results of a study conducted for NASA-Langley Research Center. This study is part of a program of research conducted for NASA-LARC that has focused on identifying the influence of national culture on the performance of flight crews. We first reviewed the literature devoted to models of teamwork and team performance, crew resource management, error management, and cross-cultural psychology. Davis (1999) reported the results of this review and presented a model that depicted how national culture could influence teamwork and performance in flight crews. The second study in this research program examined accident investigations of foreign airlines in the United States conducted by the National Transportation Safety Board (NTSB). The ability of cross-cultural values to explain national differences in flight outcomes was examined. Cultural values were found to covary in a predicted way with national differences, but the absence of necessary data in the NTSB reports and limitations in the research method that was used prevented a clear understanding of the causal impact of cultural values. Moreover, individual differences such as personality traits were not examined in this study. Davis and Kuang (2001) report results of this second study. The research summarized in the current report extends this previous research by directly assessing cultural and individual differences among students from the United States and China who were trained to fly in a flight simulator using desktop computer workstations. The research design used in this study allowed delineation of the impact of national origin, cultural values, personality traits, cognitive style, shared mental model, and task workload on teamwork, error management and flight outcomes. We briefly review the literature that documents the importance of teamwork and error management and its impact on flight crew performance. We next examine teamwork and crew resource management training designed to improve teamwork. This is followed by discussion of the potential influence of national culture on teamwork and crew resource management. We then examine the influence of other individual and team differences, such as personality traits, cognitive style, shared mental model, and task workload. We provide a heuristic model that depicts the influence of national culture and individual differences on teamwork, error management and flight outcomes. The results demonstrate the usefulness of the model for future research.
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Content Validation and Evaluation of an Endovascular Teamwork Assessment Tool.
Hull, L; Bicknell, C; Patel, K; Vyas, R; Van Herzeele, I; Sevdalis, N; Rudarakanchana, N
2016-07-01
To modify, content validate, and evaluate a teamwork assessment tool for use in endovascular surgery. A multistage, multimethod study was conducted. Stage 1 included expert review and modification of the existing Observational Teamwork Assessment for Surgery (OTAS) tool. Stage 2 included identification of additional exemplar behaviours contributing to effective teamwork and enhanced patient safety in endovascular surgery (using real-time observation, focus groups, and semistructured interviews of multidisciplinary teams). Stage 3 included content validation of exemplar behaviours using expert consensus according to established psychometric recommendations and evaluation of structure, content, feasibility, and usability of the Endovascular Observational Teamwork Assessment Tool (Endo-OTAS) by an expert multidisciplinary panel. Stage 4 included final team expert review of exemplars. OTAS core team behaviours were maintained (communication, coordination, cooperation, leadership team monitoring). Of the 114 OTAS behavioural exemplars, 19 were modified, four removed, and 39 additional endovascular-specific behaviours identified. Content validation of these 153 exemplar behaviours showed that 113/153 (73.9%) reached the predetermined Item-Content Validity Index rating for teamwork and/or patient safety. After expert team review, 140/153 (91.5%) exemplars were deemed to warrant inclusion in the tool. More than 90% of the expert panel agreed that Endo-OTAS is an appropriate teamwork assessment tool with observable behaviours. Some concerns were noted about the time required to conduct observations and provide performance feedback. Endo-OTAS is a novel teamwork assessment tool, with evidence for content validity and relevance to endovascular teams. Endo-OTAS enables systematic objective assessment of the quality of team performance during endovascular procedures. Copyright © 2016. Published by Elsevier Ltd.
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2012-05-01
Alexandria, Virginia 22314. Orders will be expedited if placed through the librarian or other person designated to request documents from DTIC...an official Department of the Army position, policy, or decision, unless so designated by other official documentation. Citation of trade names in...teamwork and evaluate the effectiveness of team training methods (Baker and Salas, 1997). Additionally, good measures of team performance should aid the
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Kaji, Amy H; Langford, Vinette; Lewis, Roger J
2008-09-01
There is currently no validated method for assessing hospital disaster preparedness. We determine the degree of correlation between the results of 3 methods for assessing hospital disaster preparedness: administration of an on-site survey, drill observation using a structured evaluation tool, and video analysis of team performance in the hospital incident command center. This was a prospective, observational study conducted during a regional disaster drill, comparing the results from an on-site survey, a structured disaster drill evaluation tool, and a video analysis of teamwork, performed at 6 911-receiving hospitals in Los Angeles County, CA. The on-site survey was conducted separately from the drill and assessed hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity, decontamination capability, and pharmaceutical stockpiles. The drill evaluation tool, developed by Johns Hopkins University under contract from the Agency for Healthcare Research and Quality, was used to assess various aspects of drill performance, such as the availability of the hospital disaster plan, the geographic configuration of the incident command center, whether drill participants were identifiable, whether the noise level interfered with effective communication, and how often key information (eg, number of available staffed floor, intensive care, and isolation beds; number of arriving victims; expected triage level of victims; number of potential discharges) was received by the incident command center. Teamwork behaviors in the incident command center were quantitatively assessed, using the MedTeams analysis of the video recordings obtained during the disaster drill. Spearman rank correlations of the results between pair-wise groupings of the 3 assessment methods were calculated. The 3 evaluation methods demonstrated qualitatively different results with respect to each hospital's level of disaster preparedness. The Spearman rank correlation coefficient between the results of the on-site survey and the video analysis of teamwork was -0.34; between the results of the on-site survey and the structured drill evaluation tool, 0.15; and between the results of the video analysis and the drill evaluation tool, 0.82. The disparate results obtained from the 3 methods suggest that each measures distinct aspects of disaster preparedness, and perhaps no single method adequately characterizes overall hospital preparedness.
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Training managers for primary health care.
Kekki, P
1994-01-01
The University of Helsinki has devised a powerful in-service training course for managers of health centres. By working together at the University and their own centres on setting objectives, analysing data and solving problems, the participants greatly enhance their management and teamwork skills.
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Teamwork Skills Assessment for Cooperative Learning
ERIC Educational Resources Information Center
Strom, Paris S.; Strom, Robert D.
2011-01-01
Teamwork skills are required at work, but teacher efforts in many countries to track achievement within this context have been hindered by lack of assessment tools and input from students. The Teamwork Skills Inventory relies on peer and self-evaluation to establish accountability, identify competencies, and detect learning needs. Twenty-five…
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Hallin, Karin; Kiessling, Anna; Waldner, Annika; Henriksson, Peter
2009-02-01
Interprofessional competence can be defined as knowledge and understanding of their own and the other team members' professional roles, comprehension of communication and teamwork and collaboration in taking care of patients. To evaluate whether students perceived that they had achieved interprofessional competence after participating in clinical teamwork training. Six hundred and sixteen students from four undergraduate educational programs-medicine, nursing, physiotherapy and occupational therapy-participated in an interprofessional course at a clinical education ward. The students filled out pre and post questionnaires (96% response rate). All student groups increased their perceived interprofessional competence. Occupational therapy and medical students had the greatest achievements. All student groups perceived improved knowledge of the other three professions' work (p = 0.000000) and assessed that the course had contributed to the understanding of the importance of communication and teamwork to patient care (effect size 1.0; p = 0.00002). The medical students had the greatest gain (p = 0.00093). All student groups perceived that the clarity of their own professional role had increased significantly (p = 0.00003). Occupational therapy students had the greatest gain (p = 0.000014). Active patient based learning by working together in a real ward context seemed to be an effective means to increase collaborative and professional competence.
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A Qualitative Analysis of Narrative Preclerkship Assessment Data to Evaluate Teamwork Skills.
Dolan, Brigid M; O'Brien, Celia Laird; Cameron, Kenzie A; Green, Marianne M
2018-04-16
Construct: Students entering the health professions require competency in teamwork. Although many teamwork curricula and assessments exist, studies have not demonstrated robust longitudinal assessment of preclerkship students' teamwork skills and attitudes. Assessment portfolios may serve to fill this gap, but it is unknown how narrative comments within portfolios describe student teamwork behaviors. We performed a qualitative analysis of narrative data in 15 assessment portfolios. Student portfolios were randomly selected from 3 groups stratified by quantitative ratings of teamwork performance gathered from small-group and clinical preceptor assessment forms. Narrative data included peer and faculty feedback from these same forms. Data were coded for teamwork-related behaviors using a constant comparative approach combined with an identification of the valence of the coded statements as either "positive observation" or "suggestion for improvement." Eight codes related to teamwork emerged: attitude and demeanor, information facilitation, leadership, preparation and dependability, professionalism, team orientation, values team member contributions, and nonspecific teamwork comments. The frequency of codes and valence varied across the 3 performance groups, with students in the low-performing group receiving more suggestions for improvement across all teamwork codes. Narrative data from assessment portfolios included specific descriptions of teamwork behavior, with important contributions provided by both faculty and peers. A variety of teamwork domains were represented. Such feedback as collected in an assessment portfolio can be used for longitudinal assessment of preclerkship student teamwork skills and attitudes.
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Cooks training for Faith, Activity, and Nutrition project with AME churches in SC.
Condrasky, Margaret D; Baruth, Meghan; Wilcox, Sara; Carter, Chad; Jordan, Jeannette F
2013-04-01
This study describes the development and evaluation of a participatory training for cooks in African American churches. The 8-h training focused on providing healthy meals within the church food program. It enlisted cooks in hands-on "cooking with the chef" training and menu building exercises, and demonstrated development of flavor in foods through healthy ingredients. Cook ratings from pre- to post-training (possible range: 1-10) were evaluated with the Wilcoxon signed rank test. 114 cooks from 57 churches over the period from 7/21/07 to 3/21/11 participated in trainings. Self-rated cooking skill increased from pre- (6.5±SD) to post-training (7.9±SD), p=0.0001. Self-rated confidence in preparing meals also increased significantly (pre: 7.3±SD; post: 8.3±SD), p=0001. Qualitative feedback from the cooks' training has been positive. Two of the more frequently stated changes cooks report are using less salt and using more vegetables and fruits in menus. Lessons learned include: choosing the right church to host the training, teamwork as a key component, need for support system for church cooks, allocation of time for planning as well as shopping for healthy ingredients, and incorporation of flexibility into the training plan. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Cooks Training for Faith, Activity, and Nutrition project with AME churches in SC
Baruth, Meghan; Wilcox, Sara; Carter, Chad; Jordan, Jeannette F.
2012-01-01
Purpose This study describes the development and evaluation of a participatory training for cooks in African American churches. The 8-hour training focused on providing healthy meals within the church food program. It enlisted cooks in hands-on “cooking with the chef” training and menu building exercises, and demonstrated development of flavor in foods through healthy ingredients. Cook ratings from pre- to post-training (possible range: 1 to 10) were evaluated with the Wilcoxon signed rank test. Results 114 cooks from 57 churches over the period from 7/21/07 to 3/21/11 participated in trainings. Self-rated cooking skill increased from pre- (6.5 ± SD) to post- training (7.9 ± SD), p = .0001. Self-rated confidence in preparing meals also increased significantly (pre: 7.3 ± SD; post: 8.3 ± SD), p =.0001. Qualitative feedback from the cooks’ training has been positive. Two of the more frequently stated changes cooks report are using less salt and using more vegetables and fruits in menus. Lessons learned include: choosing the right church to host the training, teamwork as a key component, need for support system for church cooks, allocation of time for planning as well as shopping for healthy ingredients, and incorporation of flexibility into the training plan. PMID:23352927
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Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher
2014-09-01
Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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Teamwork: a study of Australian and US student speech-language pathologists.
Morrison, Susan C; Lincoln, Michelle A; Reed, Vicki A
2009-05-01
In the discipline of speech-language pathology little is known about the explicit and implicit team skills taught within university curricula. This study surveyed 281 speech-language pathology students to determine a baseline of their perceived ability to participate in interprofessional teams. The students were enrolled in programs in Australia and the USA and were surveyed about their perceptions of their attitudes, knowledge and skills in teamwork. MANCOVA analysis for main effects of age, university program and clinical experience showed that age was not significant, negating the perception that life experiences improve perceived team skills. Clinical experience was significant in that students with more clinical experience rated themselves more highly on their team abilities. Post Hoc analysis revealed that Australian students rated themselves higher than their US counterparts on their knowledge about working on teams, but lower on attitudes to teams; all students perceived that they had the skills to work on teams. These results provide insight about teamwork training components in current speech-language pathology curricula. Implications are discussed with reference to enhancing university training programs.
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Communication and teamwork in patient care: how much can we learn from aviation?
Lyndon, Audrey
2006-01-01
To identify evidence on the role of assertiveness and teamwork and the application of aviation industry techniques to improve patient safety for inpatient obstetric care. Studies limited to research with humans in English language retrieved from CINAHL, PubMed, Social Science Abstracts, and Social Sciences Citation Index, and references from reviewed articles. A total of 13 studies were reviewed, including 5 studies of teamwork, communication, and safety attitudes in aviation; 2 studies comparing these factors in aviation and health care; and 6 studies of assertive behavior and decision making by nurses. Studies lacking methodological rigor or focusing on medication errors and deviant behavior were excluded. Pilot attitudes regarding interpersonal interaction on the flight deck predicted effective performance and were amenable to behavior-based training to improve team performance. Nursing knowledge was inconsistently accessed in decision making. Findings regarding nurse assertiveness were mixed. Adaptation of training concepts and safety methods from other fields will have limited impact on perinatal safety without an examination of the contextual experiences of nurses and other health care providers in working to prevent patient harm.
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Cockpit Resource Management (CRM): A tool for improved flight safety (United Airlines CRM training)
NASA Technical Reports Server (NTRS)
Carroll, J. E.; Taggart, William R.
1987-01-01
The approach and methodology used in developing cockpit management skills is effective because of the following features: (1) A comparative method of learning is used enabling crewmembers to study different forms of teamwork. (2) The learning comes about as a result of crewmembers learning from one another instead of from an expert instructor. (3) Key elements of cockpit teamwork and effective management are studied so that crewmembers can determine how these elements can improve safety and problem solving. (4) Critique among the crewmembers themselves rather than from outsiders is used as a common focusing point for crews to provide feedback to one another on how each can be a more effective crewmember. (5) The training is continuous in the sense that it becomes part of recurrent, upgrade, and other forms of crewmember training and development. And (6) the training results in sound and genuine insights that come about through solid education as opposed to tutoring, coaching, or telling crewmembers how to behave more effectively.
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Identifying and training non-technical skills for teams in acute medicine
Flin, R; Maran, N
2004-01-01
The aviation domain provides a better analogy for the "temporary" teams that are found in acute medical specialities than industrial or military teamwork research based on established teams. Crew resource management (CRM) training, which emphasises portable skills (for whatever crew a pilot is rostered to on a given flight), has been recognised to have potential application in medicine, especially for teams in the operating theatre, intensive care unit, and emergency room. Drawing on research from aviation psychology that produced the behavioural marker system NOTECHS for rating European pilots' non-technical skills for teamwork on the flightdeck, this paper outlines the Anaesthetists Non-Technical Skills behavioural rating system for anaesthetists working in operating theatre teams. This taxonomy was used as the design basis for a training course, Crisis Avoidance Resource Management for Anaesthetists used to develop these skills, based in an operating theatre simulator. Further developments of this training programme for teams in emergency medicine are outlined. PMID:15465960
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Medical Team Training: Using Simulation as a Teaching Strategy for Group Work
ERIC Educational Resources Information Center
Moyer, Michael R.; Brown, Rhonda Douglas
2011-01-01
Described is an innovative approach currently being used to inspire group work, specifically a medical team training model, referred to as The Simulation Model, which includes as its major components: (1) Prior Training in Group Work of Medical Team Members; (2) Simulation in Teams or Groups; (3) Multidisciplinary Teamwork; (4) Team Leader…
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Weingart, Saul N; Yaghi, Omar; Wetherell, Matthew; Sweeney, Megan
2018-04-10
To examine the composition and concordance of existing instruments used to assess medical teams' performance. A trained observer joined 20 internal medicine housestaff teams for morning work rounds at Tufts Medical Center, a 415-bed Boston teaching hospital, from October through December 2015. The observer rated each team's performance using 9 teamwork observation instruments that examined domains including team structure, leadership, situation monitoring, mutual support, and communication. Observations recorded on paper forms were stored electronically. Scores were normalized from 1 (low) to 5 (high) to account for different rating scales. Overall mean scores were calculated and graphed; weighted scores adjusted for the number of items in each teamwork domain. Teamwork scores were analyzed using t-tests, pair-wise correlations, and the Kruskal-Wallis statistic, and team performance was compared across instruments by domain. The 9 tools incorporated 5 major domains, with 5-35 items per instrument for a total of 161 items per observation session. In weighted and unweighted analyses, the overall teamwork performance score for a given team on a given day varied by instrument. While all of the tools identified the same low outlier, high performers on some instruments were low performers on others. Inconsistent scores for a given team across instruments persisted in domain-level analyses. There was substantial variation in the rating of individual teams assessed concurrently by a single observer using multiple instruments. Since existing teamwork observation tools do not yield concordant assessments, researchers should create better tools for measuring teamwork performance.
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FY2015 Analysis of the Teamwork USA Program. Memorandum
ERIC Educational Resources Information Center
Howard, Mark
2015-01-01
The Department of Research and Evaluation (DRE) has completed an analysis of the performance of students who participated in the Teamwork USA Program, administered in FY2014 at three District schools. Teamwork USA hopes to improve student achievement at select Title I elementary schools via its Instrumental Music Program grant. This memorandum to…
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ERIC Educational Resources Information Center
Martinez-Fernandez, J. Reinaldo; Corcelles, Mariona; Cerrato-Lara, Maria
2011-01-01
In this study, we present the conceptions about teamwork questionnaire designed to evaluate the conceptions that secondary students have about teamwork. Participants were 309 students aged 15-16 from eight secondary schools, seven from Barcelona and one from Girona (Spain). The original 27-item questionnaire was reduced according to expert…
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Using Peer Assessment to Evaluate Teamwork from a Multidisciplinary Perspective
ERIC Educational Resources Information Center
Planas-Lladó, Anna; Feliu, Lidia; Castro, Francesc; Fraguell, Rosa Maria; Arbat, Gerard; Pujol, Joan; Suñol, Joan Josep; Daunis-i-Estadella, Pepus
2018-01-01
This article analyses the use of peer evaluation as a tool for evaluating teamwork and students' perceptions of this type of evaluation. A study was conducted of six subjects included on five degree courses at the University of Girona. In all of these subjects, students carried out a team activity, evaluated the performance of the team and the…
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McCulloch, Peter; Morgan, Lauren; New, Steve; Catchpole, Ken; Roberston, Eleanor; Hadi, Mohammed; Pickering, Sharon; Collins, Gary; Griffin, Damian
2017-01-01
Patient safety improvement interventions usually address either work systems or team culture. We do not know which is more effective, or whether combining approaches is beneficial. To compare improvement in surgical team performance after interventions addressing teamwork culture, work systems, or both. Suite of 5 identical controlled before-after intervention studies, with preplanned analysis of pooled data for indirect comparisons of strategies. Operating theatres in 5 UK hospitals performing elective orthopedic, plastic, or vascular surgery PARTICIPANTS:: All operating theatres staff, including surgeons, nurses, anaesthetists, and others INTERVENTIONS:: 4-month safety improvement interventions, using teamwork training (TT), systems redesign and standardization (SOP), Lean quality improvement, SOP + TT combination, or Lean + TT combination. Team technical and nontechnical performance and World Health Organization (WHO) checklist compliance, measured for 3 months before and after intervention using validated scales. Pooled data analysis of before-after change in active and control groups, comparing combined versus single and systems versus teamwork interventions, using 2-way ANOVA. We studied 453 operations, (255 intervention, 198 control). TT improved nontechnical skills and WHO compliance (P < 0.001), but not technical performance; systems interventions (Lean & SOP, 2 & 3) improved nontechnical skills and technical performance (P < 0.001) but improved WHO compliance less. Combined interventions (4 & 5) improved all performance measures except WHO time-out attempts, whereas single approaches (1 & 2 & 3) improved WHO compliance less (P < 0.001) and failed to improve technical performance. Safety interventions combining teamwork training and systems rationalization are more effective than those adopting either approach alone. This has important implications for safety improvement strategies in hospitals.
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Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N
2014-05-01
The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.
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Personality, relationship conflict, and teamwork-related mental models.
Vîrgă, Delia; Curşeu, Petru Lucian; CurŞeu, Petru Lucian; Maricuţoiu, Laurenţiu; Sava, Florin A; Macsinga, Irina; Măgurean, Silvia
2014-01-01
This study seeks to explore whether neuroticism, agreeableness, and conscientiousness moderate the influence of relationship conflict experienced in groups on changes in group members' evaluative cognitions related to teamwork quality (teamwork-related mental models). Data from 216 students, nested in 48 groups were analyzed using a multilevel modeling approach. Our results show that the experience of relationship conflict leads to a negative shift from the pre-task to the post-task teamwork-related mental models. Moreover, the results indicate that conscientiousness buffered the negative association between relationship conflict and the change in teamwork-related mental models. Our results did not support the hypothesized moderating effect of agreeableness and show that the detrimental effect of relationship conflict on the shift in teamwork-related mental models is accentuated for group members scoring low rather than high on neuroticism. These findings open new research venues for exploring the association between personality, coping styles and change in teamwork-related mental models.
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Personality, Relationship Conflict, and Teamwork-Related Mental Models
Vîrgă, Delia; CurŞeu, Petru Lucian; Maricuţoiu, Laurenţiu; Sava, Florin A.; Macsinga, Irina; Măgurean, Silvia
2014-01-01
This study seeks to explore whether neuroticism, agreeableness, and conscientiousness moderate the influence of relationship conflict experienced in groups on changes in group members' evaluative cognitions related to teamwork quality (teamwork-related mental models). Data from 216 students, nested in 48 groups were analyzed using a multilevel modeling approach. Our results show that the experience of relationship conflict leads to a negative shift from the pre-task to the post-task teamwork-related mental models. Moreover, the results indicate that conscientiousness buffered the negative association between relationship conflict and the change in teamwork-related mental models. Our results did not support the hypothesized moderating effect of agreeableness and show that the detrimental effect of relationship conflict on the shift in teamwork-related mental models is accentuated for group members scoring low rather than high on neuroticism. These findings open new research venues for exploring the association between personality, coping styles and change in teamwork-related mental models. PMID:25372143
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Measuring teamwork in health care settings: a review of survey instruments.
Valentine, Melissa A; Nembhard, Ingrid M; Edmondson, Amy C
2015-04-01
Teamwork in health care settings is widely recognized as an important factor in providing high-quality patient care. However, the behaviors that comprise effective teamwork, the organizational factors that support teamwork, and the relationship between teamwork and patient outcomes remain empirical questions in need of rigorous study. To identify and review survey instruments used to assess dimensions of teamwork so as to facilitate high-quality research on this topic. We conducted a systematic review of articles published before September 2012 to identify survey instruments used to measure teamwork and to assess their conceptual content, psychometric validity, and relationships to outcomes of interest. We searched the ISI Web of Knowledge database, and identified relevant articles using the search terms team, teamwork, or collaboration in combination with survey, scale, measure, or questionnaire. We found 39 surveys that measured teamwork. Surveys assessed different dimensions of teamwork. The most commonly assessed dimensions were communication, coordination, and respect. Of the 39 surveys, 10 met all of the criteria for psychometric validity, and 14 showed significant relationships to nonself-report outcomes. Evidence of psychometric validity is lacking for many teamwork survey instruments. However, several psychometrically valid instruments are available. Researchers aiming to advance research on teamwork in health care should consider using or adapting one of these instruments before creating a new one. Because instruments vary considerably in the behavioral processes and emergent states of teamwork that they capture, researchers must carefully evaluate the conceptual consistency between instrument, research question, and context.
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"Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach.
Ballangrud, Randi; Husebø, Sissel Eikeland; Aase, Karina; Aaberg, Oddveig Reiersdal; Vifladt, Anne; Berg, Geir Vegard; Hall-Lord, Marie Louise
2017-01-01
Effective teamwork and sufficient communication are critical components essential to patient safety in today's specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel's perception of teamwork in hospitals (Part 1). Further to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2). To address the aims, a descriptive, and explorative design (Part 1), and a quasi-experimental interventional design will be applied (Part 2). The study will be carried out in five different hospitals (A-E) in three hospital trusts in Norway. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, will be invited to respond to three Norwegian translated teamwork questionnaires (Part 1). An inter-professional teamwork intervention in line with the TeamSTEPPS recommend Model of Change will be implemented in a surgical ward at Hospital C. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) will be invited to to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit will be invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 month. Moreover, anonymous patient registry data from local registers and data from patients' medical records will be collected (Part 2). This study will help to understand the impact of an inter-professional teamwork intervention in a surgical ward and contribute to promote healthcare personnel's team competences with an opportunity to achieve changes in work processes and patient safety. Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date 30.05.2017.
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Tscholl, David W; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R; Noethiger, Christoph B
2015-10-01
An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P < 0.001), knowledge of critical information: 100% vs 90% (P < 0.001), perception of safety: 91% vs 84% (P < 0.001), perception of teamwork: 90% vs 86% (P = 0.028), and clinical performance: 93% vs 93% (P = 0.60). This study provides empirical evidence that the use of a preinduction checklist significantly improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.
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75 FR 23269 - Agency Information Collection Activities: Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2010-05-03
... training, knowledge, and skills to their organizations, local areas, regions, and states. This study is... Strategies and Tools for Enhancing Performance and Patient Safety) to provide an evidence-based suite of tools and strategies for training teamwork- based patient safety to health care professionals. In 2007...
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ERIC Educational Resources Information Center
Centre County Vocational-Technical School, Pleasant Gap, PA. CIU 10 Bi-County Development Center for Adults.
This document includes a final report and curriculum manual from a project to help adult educators teach team training by developing a curriculum for use in teaching teamwork skills in work force literacy programs and by providing two half-day seminars to assist adult educators with effectively using the curriculum. The manual for work force…
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The Surgical Safety Checklist and Teamwork Coaching Tools: a study of inter-rater reliability.
Huang, Lyen C; Conley, Dante; Lipsitz, Stu; Wright, Christopher C; Diller, Thomas W; Edmondson, Lizabeth; Berry, William R; Singer, Sara J
2014-08-01
To assess the inter-rater reliability (IRR) of two novel observation tools for measuring surgical safety checklist performance and teamwork. Data surgical safety checklists can promote adherence to standards of care and improve teamwork in the operating room. Their use has been associated with reductions in mortality and other postoperative complications. However, checklist effectiveness depends on how well they are performed. Authors from the Safe Surgery 2015 initiative developed a pair of novel observation tools through literature review, expert consultation and end-user testing. In one South Carolina hospital participating in the initiative, two observers jointly attended 50 surgical cases and independently rated surgical teams using both tools. We used descriptive statistics to measure checklist performance and teamwork at the hospital. We assessed IRR by measuring percent agreement, Cohen's κ, and weighted κ scores. The overall percent agreement and κ between the two observers was 93% and 0.74 (95% CI 0.66 to 0.79), respectively, for the Checklist Coaching Tool and 86% and 0.84 (95% CI 0.77 to 0.90) for the Surgical Teamwork Tool. Percent agreement for individual sections of both tools was 79% or higher. Additionally, κ scores for six of eight sections on the Checklist Coaching Tool and for two of five domains on the Surgical Teamwork Tool achieved the desired 0.7 threshold. However, teamwork scores were high and variation was limited. There were no significant changes in the percent agreement or κ scores between the first 10 and last 10 cases observed. Both tools demonstrated substantial IRR and required limited training to use. These instruments may be used to observe checklist performance and teamwork in the operating room. However, further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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Factors related to teamwork performance and stress of operating room nurses.
Sonoda, Yukio; Onozuka, Daisuke; Hagihara, Akihito
2018-01-01
To evaluate operating room nurses' perception of teamwork performance and their level of mental stress and to identify related factors. Little is known about the factors affecting teamwork and the mental stress of surgical nurses, although the performance of the surgical team is essential for patient safety. The questionnaire survey for operation room nurses consisted of simple questions about teamwork performance and mental stress. Multivariate analyses were used to identify factors causing a sense of teamwork performance or mental stress. A large number of surgical nurses had a sense of teamwork performance, but 30-40% of operation room nurses were mentally stressed during surgery. Neither the patient nor the operation factors were related to the sense of teamwork performance in both types of nurses. Among scrub nurses, endoscopic and abdominal surgery, body mass index, blood loss and the American Society of Anesthesiologists physical status class were related to their mental stress. Conversely, circulating nurses were stressed about teamwork performance. The factors related to teamwork performance and mental stress during surgery differed between scrub and circulating nurses. Increased support for operation room nurses is necessary. The increased support leads to safer surgical procedures and better patient outcomes. © 2017 John Wiley & Sons Ltd.
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Interprofessional Emergency Training Leads to Changes in the Workplace.
Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D; Exadaktylos, Aristomenis K; Machner, Mareen; Hautz, Wolf E
2018-01-01
Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one's roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants' "Commitment to Change." In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication , behavior , knowledge and attitude . Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., "acknowledge other professions' work"), and these were equally distributed among professions. At the two-month follow-up, 32 participants (50%) provided written feedback on their original commitments: 57 of 62 (91.9%) commitments were at least partly realized at the follow-up, and only five (8.1%) commitments lacked realization entirely. A structured simulation-enhanced intervention was successful in promoting change to the practice of emergency care, while training teamwork and communication skills jointly.
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Van Dijk-de Vries, Anneke N; Duimel-Peeters, Inge G P; Muris, Jean W; Wesseling, Geertjan J; Beusmans, George H M I; Vrijhoef, Hubertus J M
2016-04-08
Teamwork between healthcare providers is conditional for the delivery of integrated care. This study aimed to assess the usefulness of the conceptual framework Integrated Team Effectiveness Model for developing and testing of the Integrated Team Effectiveness Instrument. Focus groups with healthcare providers in an integrated care setting for people with chronic obstructive pulmonary disease (COPD) were conducted to examine the recognisability of the conceptual framework and to explore critical success factors for collaborative COPD practice out of this framework. The resulting items were transposed into a pilot instrument. This was reviewed by expert opinion and completed 153 times by healthcare providers. The underlying structure and internal consistency of the instrument were verified by factor analysis and Cronbach's alpha. The conceptual framework turned out to be comprehensible for discussing teamwork effectiveness. The pilot instrument measures 25 relevant aspects of teamwork in integrated COPD care. Factor analysis suggested three reliable components: teamwork effectiveness, team processes and team psychosocial traits (Cronbach's alpha between 0.76 and 0.81). The conceptual framework Integrated Team Effectiveness Model is relevant in developing a practical full-spectrum instrument to facilitate discussing teamwork effectiveness. The Integrated Team Effectiveness Instrument provides a well-founded basis to self-evaluate teamwork effectiveness in integrated COPD care by healthcare providers. Recommendations are provided for the improvement of the instrument.
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Simulation-based driver and vehicle crew training: applications, efficacy and future directions.
Goode, Natassia; Salmon, Paul M; Lenné, Michael G
2013-05-01
Simulation is widely used as a training tool in many domains, and more recently the use of vehicle simulation as a tool for driver and vehicle crew training has become popular (de Winter et al., 2009; Pradhan et al., 2009). This paper presents an overview of how vehicle simulations are currently used to train driving-related procedural and higher-order cognitive skills, and team-based procedural and non-technical teamwork skills for vehicle crews, and evaluates whether there is evidence these training programs are effective. Efficacy was evaluated in terms of whether training achieves learning objectives and whether the attainment of those objectives enhances real world performance on target tasks. It was concluded that while some higher-order cognitive skills training programs have been shown to be effective, in general the adoption of simulation technology has far outstripped the pace of empirical research in this area. The paper concludes with a discussion of the issues that require consideration when developing and evaluating vehicle simulations for training purposes - based not only on what is known from the vehicle domain, but what can be inferred from other domains in which simulation is an established training approach, such as aviation (e.g. Jentsch et al., 2011) and medicine (e.g. McGaghie et al., 2010). STATEMENT OF RELEVANCE: Simulation has become a popular tool for driver and vehicle crew training in civilian and military settings. This review considers whether there is evidence that this training method leads to learning and the transfer of skills to real world performance. Evidence from other domains, such as aviation and medicine, is drawn upon to inform the design and evaluation of future vehicle simulation training systems. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.
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Republished: Building a culture of safety through team training and engagement.
Thomas, Lily; Galla, Catherine
2013-07-01
Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.
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Building a culture of safety through team training and engagement.
Thomas, Lily; Galla, Catherine
2013-05-01
Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.
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Relationship Between Operating Room Teamwork, Contextual Factors, and Safety Checklist Performance.
Singer, Sara J; Molina, George; Li, Zhonghe; Jiang, Wei; Nurudeen, Suliat; Kite, Julia G; Edmondson, Lizabeth; Foster, Richard; Haynes, Alex B; Berry, William R
2016-10-01
Studies show that using surgical safety checklists (SSCs) reduces complications. Many believe SSCs accomplish this by enhancing teamwork, but evidence is limited. Our study sought to relate teamwork to checklist performance, understand how they relate, and determine conditions that affect this relationship. Using 2 validated tools for observing and coaching operating room teams, we evaluated the association between checklist performance with surgeon buy-in and 4 domains of surgical teamwork: clinical leadership, communication, coordination, and respect. Hospital staff in 10 South Carolina hospitals observed 207 procedures between April 2011 and January 2013. We calculated levels of checklist performance, buy-in, and measures of teamwork, and evaluated their relationship, controlling for patient and case characteristics. Few teams completed most or all SSC items. Teams more often completed items considered procedural "checks" than conversation "prompts." Surgeon buy-in, clinical leadership, communication, a summary measure of teamwork overall, and observers' teamwork ratings positively related to overall checklist completion (multivariable model estimates from 0.04, p < 0.05 for communication to 0.17, p < 0.01 for surgeon buy-in). All measures of teamwork and surgeon buy-in related positively to completing more conversation prompts; none related significantly to procedural checks (estimates from 0.10, p < 0.01 for communication to 0.27, p < 0.001 for surgeon buy-in). Patient age was significantly associated with completing the checklist and prompts (p < 0.05); only case duration was positively associated with performing more checks (p < 0.10). Surgeon buy-in and surgical teamwork characterized by shared clinical leadership, open communication, active coordination, and mutual respect were critical in prompting case-related conversations, but not in completing procedural checks. Findings highlight the importance of surgeon engagement and high-quality, consistent teamwork for promoting checklist use and ensuring a safe surgical environment. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
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Tactical Communications Training Environment for Unmanned Aircraft System Operators
2016-12-15
communication and teamwork skills. The Night Vision Tactical Trainer - Shadow (NVTT-Shadow) was developed as a game -based desktop solution to train...advanced individual training Soldiers and UAS course instructors. The usability testing demonstrated the feasibility of interactive gaming applied to MUM...T tactical communications. Ratings and comments from both students and instructors validated the need as well as mission context, game content, and
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Pemberton, Julia; Rambaran, Madan; Cameron, Brian H
2013-02-01
We evaluated the retention of trauma knowledge and skills after an interprofessional Trauma Team Training (TTT) course in Guyana and explored the course impact on participants. A mixed-methods design evaluated knowledge using a multiple-choice quiz test, skills and trauma moulage simulation with checklists, and course impact with qualitative interviews. Participants were evaluated at 3 time points; before, after, and 4 months after TTT. Forty-seven course participants included 20 physicians, 17 nurses, and 10 paramedical providers. All participants had improved multiple-choice quiz test scores after the course and retained knowledge after 4 months, with nonphysicians showing the most improved scores. Trauma skill and moulage scores declined slightly after 4 months, with the greatest decline observed in complex skills. Qualitatively, course participants self-reported impact of the TTT course included improved empowerment, knowledge, teamwork, and patient care. Interprofessional team-based training led to the retention of trauma knowledge and skills as well as the empowerment of nonphysicians. The decline in performance of some trauma skills indicates the need for a regular trauma update course. Copyright © 2013 Elsevier Inc. All rights reserved.
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Effects of Crew Resource Management Training on Medical Errors in a Simulated Prehospital Setting
ERIC Educational Resources Information Center
Carhart, Elliot D.
2012-01-01
This applied dissertation investigated the effect of crew resource management (CRM) training on medical errors in a simulated prehospital setting. Specific areas addressed by this program included situational awareness, decision making, task management, teamwork, and communication. This study is believed to be the first investigation of CRM…
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The Impact of Organisational Change on the Nature and Extent of Training in Australian Enterprises
ERIC Educational Resources Information Center
Smith, Andrew; Oczkowski, Edward; Noble, Charles; Macklin, Robert
2004-01-01
This article reports on a study investigating the relationship between the introduction of new management practices and the training provided by Australian enterprises for their employees. The new management practices investigated include teamworking, total quality management, lean production, business process re-engineering and the learning…
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Evaluation of TEAM dynamics before and after remote simulation training utilizing CERTAIN platform.
Pennington, Kelly M; Dong, Yue; Coville, Hongchuan H; Wang, Bo; Gajic, Ognjen; Kelm, Diana J
2018-12-01
The current study examines the feasibility and potential effects of long distance, remote simulation training on team dynamics. The study design was a prospective study evaluating team dynamics before and after remote simulation. Study subjects consisted of interdisciplinary teams (attending physicians, physicians in training, advanced care practitioners, and/or nurses). The study was conducted at nine training sites in eight countries. Study subjects completed 2-3 simulation scenarios of acute crises before and after training with the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN). Pre- and post-CERTAIN training simulations were evaluated by two independent reviewers utilizing the Team Emergency Assessment Measure (TEAM), which is a 11-item questionnaire that has been validated for assessing teamwork in the intensive care unit. Any discrepancies of greater than 1 point between the two reviewers on any question on the TEAM assessment were sent to a third reviewer to judge. The score that was deemed discordant by the third judge was eliminated. Pre- and post-CERTAIN training TEAM scores were averaged and compared. Of the nine teams evaluated, six teams demonstrated an overall improvement in global team performance following CERTAIN virtual training. For each of the 11 TEAM assessments, a trend toward improvement following CERTAIN training was noted; however, no assessment had universal improvement. 'Team composure and control' had the least absolute score improvement following CERTAIN training. The greatest improvement in the TEAM assessment scores was in the 'team's ability to complete tasks in a timely manner' and in the 'team leader's communication to the team'. The assessment of team dynamics using long distance, virtual simulation training appears to be feasible and may result in improved team performance during simulated patient crises; however, language and video quality were the two largest barriers noted during the review process.
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Peer social support training in UK prisons.
Stewart, Warren; Lovely, Rachel
2017-10-11
To undertake a service evaluation to assess the effect of peer social support training using two separate learning programmes, which were designed to assist prisoners to support older prisoners and prisoners with disabilities. The service evaluation used an action research approach to support planning, delivery and data collection. Eleven interviews with nine prisoners who had undertaken the peer social support training programmes and two members of prison staff (one nurse manager and one prison officer) were recorded and transcribed by the researchers. This data was coded and thematically analysed to evaluate the findings. Recommendations were made regarding the format and content of the training. The training was well received by the peer social support worker trainees and had several positive outcomes, including increased peer social support, improved relationships between peer social support workers and older prisoners and prisoners with disabilities, increased self-esteem, measured as 'social capital', among peer social support workers, and effective teamworking. The peer social support training programmes were considered to be a positive intervention and were effective in supporting peer social support roles. Recommendations for future training of prisoner peer support workers include involving existing peer social support workers in training and recruitment, and enhancing the role of peer social support workers in prisons by providing them with job descriptions. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
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Systematic review of methods for quantifying teamwork in the operating theatre
Marshall, D.; Sykes, M.; McCulloch, P.; Shalhoub, J.; Maruthappu, M.
2018-01-01
Background Teamwork in the operating theatre is becoming increasingly recognized as a major factor in clinical outcomes. Many tools have been developed to measure teamwork. Most fall into two categories: self‐assessment by theatre staff and assessment by observers. A critical and comparative analysis of the validity and reliability of these tools is lacking. Methods MEDLINE and Embase databases were searched following PRISMA guidelines. Content validity was assessed using measurements of inter‐rater agreement, predictive validity and multisite reliability, and interobserver reliability using statistical measures of inter‐rater agreement and reliability. Quantitative meta‐analysis was deemed unsuitable. Results Forty‐eight articles were selected for final inclusion; self‐assessment tools were used in 18 and observational tools in 28, and there were two qualitative studies. Self‐assessment of teamwork by profession varied with the profession of the assessor. The most robust self‐assessment tool was the Safety Attitudes Questionnaire (SAQ), although this failed to demonstrate multisite reliability. The most robust observational tool was the Non‐Technical Skills (NOTECHS) system, which demonstrated both test–retest reliability (P > 0·09) and interobserver reliability (Rwg = 0·96). Conclusion Self‐assessment of teamwork by the theatre team was influenced by professional differences. Observational tools, when used by trained observers, circumvented this.
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Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M; Ogińska, Halszka; Camerino, Donatella; Le Nézet, Olivier; Conway, Paul Maurice; Fry, Clementine; Hasselhorn, Hans-Martin
2007-10-01
Europe's nursing shortage calls for more effective ways to recruit and retain nurses. This contribution aims to clarify whether and how social work environment, teamwork characteristics, burnout, and personal factors are associated with nurses' intent to leave (ITL). Our sample comprises 28,561 hospital-based nurses from 10 European countries. Different occupational levels have been taken into account: qualified registered nurses (n = 18,594), specialized nurses (n = 3957), head nurses (n = 3256), and nursing aides and ancillary staff (n = 2754). Our outcomes indicate that ITL is quite prevalent across Europe, although we have found some differences across the countries depending on working conditions and economic situation. Quality of teamwork, interpersonal relationships, career development possibilities, uncertainty regarding treatment, and influence at work are associated with nurses' decision to leave the profession across Europe, notwithstanding some country-specific outcomes. A serious lack of quality of teamwork seems to be associated with a 5-fold risk of ITL in 7 countries. As far as personal factors are concerned, our data support the hypothesized importance of work-family conflicts, satisfaction with pay, and burnout. A high burnout score seems to be associated with 3 times the risk of ITL in 5 countries. To prevent premature leaving, it is important to expand nurses' expertise, to improve working processes through collaboration and multidisciplinary teamwork, and to develop team training approaches and ward design facilitating teamwork.
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Using Qualitative Methods to Evaluate a Family Behavioral Intervention for Type 1 Diabetes
Herbert, Linda Jones; Sweenie, Rachel; Kelly, Katherine Patterson; Holmes, Clarissa; Streisand, Randi
2013-01-01
Introduction The objectives of this study were to qualitatively evaluate a dyadic adolescent-parent type 1 diabetes (T1D) program developed to prevent deterioration in diabetes care among adolescents with T1D and provide recommendations for program refinement. Method Thirteen adolescent-parent dyads who participated in the larger RCT, the TeamWork Project, were interviewed regarding their perceptions of their participation in the program and current T1D challenges. Interviews were transcribed and coded to establish broad themes. Results Adolescents and parents thought the TeamWork Project sessions were helpful and taught them new information. Five themes catalog findings from the qualitative interviews: TeamWork content, TeamWork structure, transition of responsibility, current and future challenges, and future intervention considerations. Discussion Addressing T1D challenges as a parent-adolescent dyad via a behavioral clinic program is helpful to families during adolescence. Findings highlight the utility of qualitative evaluation to tailor interventions for the unique challenges related to pediatric chronic illness. PMID:24269281
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Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania
2013-01-01
Background A team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC. Methods Six focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed. Results The analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors. Conclusions The need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself. PMID:23945286
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A simulation-based curriculum to introduce key teamwork principles to entering medical students.
Banerjee, Arna; Slagle, Jason M; Mercaldo, Nathaniel D; Booker, Ray; Miller, Anne; France, Daniel J; Rawn, Lisa; Weinger, Matthew B
2016-11-16
Failures of teamwork and interpersonal communication have been cited as a major patient safety issue. Although healthcare is increasingly being provided in interdisciplinary teams, medical school curricula have traditionally not explicitly included the specific knowledge, skills, attitudes, and behaviors required to function effectively as part of such teams. As part of a new "Foundations" core course for beginning medical students that provided a two-week introduction to the most important themes in modern healthcare, a multidisciplinary team, in collaboration with the Center for Experiential Learning and Assessment, was asked to create an experiential introduction to teamwork and interpersonal communication. We designed and implemented a novel, all-day course to teach second-week medical students basic teamwork and interpersonal principles and skills using immersive simulation methods. Students' anonymous comprehensive course evaluations were collected at the end of the day. Through four years of iterative refinement based on students' course evaluations, faculty reflection, and debriefing, the course changed and matured. Four hundred twenty evaluations were collected. Course evaluations were positive with almost all questions having means and medians greater than 5 out of 7 across all 4 years. Sequential year comparisons were of greatest interest for examining the effects of year-to-year curricular improvements. Differences were not detected among any of the course evaluation questions between 2007 and 2008 except that more students in 2008 felt that the course further developed their "Decision Making Abilities" (OR 1.69, 95% CI 1.07-2.67). With extensive changes to the syllabus and debriefer selection/assignment, concomitant improvements were observed in these aspects between 2008 and 2009 (OR = 2.11, 95% CI: 1.28-3.50). Substantive improvements in specific exercises also yielded significant improvements in the evaluations of those exercises. This curriculum could be valuable to other medical schools seeking to inculcate teamwork foundations in their medical school's preclinical curricula. Moreover, this curriculum can be used to facilitate teamwork principles important to inter-disciplinary, as well as uni-disciplinary, collaboration.
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Creating a sustainable, interprofessional-team training program: initial results.
Riggall, Virginia K; Smith, Charlene M
2015-01-01
The purpose of this program evaluation was to explore whether incorporating deliberate learning concepts, through the use of simulated patient scenarios to teach interprofessional collaboration skills to a healthcare team on one acute-care hospital unit, would improve the resuscitation response in the first 5 minutes on that unit. This was a pilot program evaluation utilizing a unit-based, clinical nurse specialist in the deployment of an interprofessional educational program involving simulation on an acute medical floor in a large tertiary-care hospital. Eighty-four staff members participated in 17 simulations. The sample included first-year internal-medicine residents, registered nurses, respiratory therapists, and patient care technicians. This was a program evaluation that used the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) (Classroom slides: TeamSTEPPS essentials; http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/slessentials.html#s3) during the presimulation/postsimulation sessions to assess the participants' perceptions of teamwork. Expected intervention behaviors were collected through observations of participants in the simulations and compared with the American Heart Association guidelines (Circulation 2010;122:S685-S670, S235-S337). Common perceptions of participants regarding the experience were obtained through open-ended evaluation questions. Fifty-three participants completed the pre- and post-T-TPQ. Mean scores in the leadership category of T-TPQ decreased significantly (P = .003) from the pretest (median, 2.167) to the T-TPQ posttest (median, 2.566). Only 35% of the groups administered a defibrillation during the ventricular fibrillation simulation scenario, and only 1 group delivered this shock within the American Heart Association's recommended time frame of 2 minutes (Circulation 2010;122:S235-S337). A single resuscitation simulation was not enough interventional dosage for staff to improve the resuscitation process. A longitudinal study should be conducted to determine the effectiveness of the program after staff members have repeated the program multiple times. A unit-based quality-improvement simulation training program could help improve the first-5-minute response and resuscitation skills of staff by increasing the frequency of unit-based training overseen by the unit's clinical nurse specialist.
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Van Dijk-de Vries, Anneke N.; Duimel-Peeters, Inge G. P.; Muris, Jean W.; Wesseling, Geertjan J.; Beusmans, George H. M. I.
2016-01-01
Introduction: Teamwork between healthcare providers is conditional for the delivery of integrated care. This study aimed to assess the usefulness of the conceptual framework Integrated Team Effectiveness Model for developing and testing of the Integrated Team Effectiveness Instrument. Theory and methods: Focus groups with healthcare providers in an integrated care setting for people with chronic obstructive pulmonary disease (COPD) were conducted to examine the recognisability of the conceptual framework and to explore critical success factors for collaborative COPD practice out of this framework. The resulting items were transposed into a pilot instrument. This was reviewed by expert opinion and completed 153 times by healthcare providers. The underlying structure and internal consistency of the instrument were verified by factor analysis and Cronbach’s alpha. Results: The conceptual framework turned out to be comprehensible for discussing teamwork effectiveness. The pilot instrument measures 25 relevant aspects of teamwork in integrated COPD care. Factor analysis suggested three reliable components: teamwork effectiveness, team processes and team psychosocial traits (Cronbach’s alpha between 0.76 and 0.81). Conclusions and discussion: The conceptual framework Integrated Team Effectiveness Model is relevant in developing a practical full-spectrum instrument to facilitate discussing teamwork effectiveness. The Integrated Team Effectiveness Instrument provides a well-founded basis to self-evaluate teamwork effectiveness in integrated COPD care by healthcare providers. Recommendations are provided for the improvement of the instrument. PMID:27616953
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... natural tendency to find the most stable and energy-efficient way to walk. The physical therapist and prosthetist may try either or both of these strategies to get the best outcome. Communication and teamwork ...
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Badiyepeymaie Jahromi, Zohreh; Mosalanejad, Leili
2015-01-14
Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students' learning behaviors. In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according to Web Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient's treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet.Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. In view of Web Quest's positive impacts on students' learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended.
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Jahromi, Zohreh Badiyepeymaie; Mosalanejad, Leili
2015-01-01
Introduction: Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students’ learning behaviors. Materials and Methods: In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according toWeb Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient’s treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet. Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. Results: The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. Conclusions: In view of Web Quest’s positive impacts on students’ learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended. PMID:25946931
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ERIC Educational Resources Information Center
Hobson, Charles J.; Strupeck, David; Griffin, Andrea; Szostek, Jana; Rominger, Anna S.
2014-01-01
A comprehensive educational program for teaching behavioral teamwork and team leadership skills was rigorously evaluated with 148 MBA students enrolled at an urban regional campus of a Midwestern public university. Major program components included (1) videotaped student teams in leaderless group discussion (LGD) exercises at the course beginning…
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ERIC Educational Resources Information Center
Lehraus, Katia
2015-01-01
This study explored how to integrate cooperative skills training into learning tasks in the area of writing. Cooperative learning sessions, aimed at developing both cooperative and cognitive skills, were created and conducted in two elementary school classes (Grade 2, age 7-8). Pupils' teamwork interactions were videotaped and analysed.…
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ERIC Educational Resources Information Center
Association of Physical Plant Administrators of Universities and Colleges, Washington, DC.
This volume presents 30 conference papers: (1) "Empowering the Workforce to Improve Efficiency and Responsiveness" by Marilyn Lockhart and others; (2) "Teamwork: Leadership Not Pushership" by Polly Pinney; (3) "Training: A Continuing Process" by Thomas F. Vacha; (4) "Presupervisory Training: Less Talk, More…
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Jiehui Jiang; Yuting Zhang; Mi Zhou; Xiaosong Zheng; Zhuangzhi Yan
2017-07-01
Biomedical Engineering (BME) bachelor education aims to train qualified engineers who devote themselves to addressing biological and medical problems by integrating the technological, medical and biological knowledge. Design thinking and teamwork with other disciplines are necessary for biomedical engineers. In the current biomedical engineering education system of Shanghai University (SHU), however, such design thinking and teamwork through a practical project is lacking. This paper describes a creative "joint assignment" project in Shanghai University, China, which has provided BME bachelor students a two-year practical experience to work with students from multidisciplinary departments including sociology, mechanics, computer sciences, business and art, etc. To test the feasibility of this project, a twenty-month pilot project has been carried out from May 2015 to December 2016. The results showed that this pilot project obviously enhanced competitive power of BME students in Shanghai University, both in the capabilities of design thinking and teamwork.
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High-performance teams and the physician leader: an overview.
Majmudar, Aalap; Jain, Anshu K; Chaudry, Joseph; Schwartz, Richard W
2010-01-01
The complexity of health care delivery within the United States continues to escalate in an exponential fashion driven by an explosion of medical technology, an ever-expanding research enterprise, and a growing emphasis on evidence-based practices. The delivery of care occurs on a continuum that spans across multiple disciplines, now requiring complex coordination of care through the use of novel clinical teams. The use of teams permeates the health care industry and has done so for many years, but confusion about the structure and role of teams in many organizations contributes to limited effectiveness and suboptimal outcomes. Teams are an essential component of graduate medical education training programs. The health care industry's relative lack of focus regarding the fundamentals of teamwork theory has contributed to ineffective team leadership at the physician level. As a follow-up to our earlier manuscripts on teamwork, this article clarifies a model of teamwork and discusses its application to high-performance teams in health care organizations. Emphasized in this discussion is the role played by the physician leader in ensuring team effectiveness. By educating health care professionals on the fundamentals of high-performance teamwork, we hope to stimulate the development of future physician leaders who use proven teamwork principles to achieve the goals of trainee education and excellent patient care. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Joshi, Kavita; Hernandez, Jessica; Martinez, Joseph; AbdelFattah, Kareem; Gardner, Aimee K
2018-02-01
Although simulation is an effective method for enhancing team competencies, it is unclear how team familiarity impacts this process. We examined how team familiarity impacted team competencies. Trainees were assigned to stable or dynamic teams to participate in three simulated cases. Situation awareness (SA) data was collected through in-scenario freezes. The recorded performances were assessed for clinical effectiveness (ClinEff) and teamwork. All data are reported on a 1-100% (100% = perfect performance) scale. Forty-six trainees (23 General Surgery; 23 Emergency Medicine) were randomized by specialty into stable (N = 8) or dynamic (N = 7) groups. Overall changes from Sim 1 to Sim3 were 12.2% (p < 0.01), -1.1% (ns), and 7.1% (p < 0.01) for SA, ClinEff, and Teamwork, respectively. However, improvements differed by condition, with stable teams reflecting improvements in ClinEff (15.2%; p < 0.05), whereas dynamic team ClinEff improvement (8.7%) was not significant. Both groups demonstrated improvements in teamwork (stable = 9%, p < 0.05; dynamic = 4.9%, p < 0.05). Teams who continued to work together demonstrated increased improvements in clinical effectiveness and teamwork, while dynamic teams only demonstrated improvements in teamwork. Copyright © 2017 Elsevier Inc. All rights reserved.
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Design and evaluation of a prelicensure interprofessional course on improving care transitions.
Heflin, Mitchell T; Pinheiro, Sandro O; Konrad, Thomas R; Egerton, Emily O; Thornlow, Deirdre K; White, Heidi K; McConnell, Eleanor J
2014-01-01
Effective management of care transitions for older adults require the coordinated expertise of an interprofessional team. Unfortunately, different health care professions are rarely educated together or trained in teamwork skills. To address this issue, a team of professionally diverse faculty from the Duke University Geriatric Education Center designed an interprofessional course focused on improving transitions of care for older adults. This innovative prelicensure course provided interactive teaching sessions designed to promote critical thinking and foster effective communication among health care professionals, caregivers, and patients. Students were assessed by in-class and online participation, performance on individual assignments, and team-based proposals to improve care transitions for older patients with congestive heart failure. Twenty students representing six professions completed the course; 18 completed all self-efficacy and course evaluation surveys. Students rated their self-efficacy in several domains before and after the course and reported gains in teamwork skills (p < .001), transitions of care (p < .001), quality improvement (p < .001) and cultural competence (p < .001). Learner feedback emphasized the importance of enthusiastic and well-prepared faculty, interactive learning experiences, and engagement in relevant work. This course offers a promising approach to shifting the paradigm of health professions education to empower graduates to promote quality improvement through team-based care.
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Hastie, Carolyn; Fahy, Kathleen; Parratt, Jenny
2014-09-01
Poor teamwork is cited as one of the major root causes of adverse events in healthcare. Bullying, resulting in illness for staff, is an expression of poor teamwork skills. Despite this knowledge, poor teamwork persists in healthcare and teamwork skills are rarely the focus of teaching and assessment in undergraduate health courses. To develop and implement an assessment tool for use in facilitating midwifery students' learning of teamwork skills. This paper describes how the TeamUP rubric tool was developed. A review of the literature found no research reports on how to teach and assess health students' teamwork skills in standing teams. The literature, however, gives guidance about how university educators should evaluate individual students using peer assessment. The developmental processes of the rubric were grounded in the theoretical literature and feminist collaborative conversations. The rubric incorporates five domains of teamwork skills: Fostering a Team Climate; Project Planning; Facilitating Teams; Managing Conflict and Quality Individual Contribution. The process and outcomes of student and academic content validation are described. The TeamUP rubric is useful for articulating, teaching and assessing teamwork skills for health professional students. The TeamUP rubric is a robust, theoretically grounded model that defines and details effective teamwork skills and related behaviours. If these skills are mastered, we predict that graduates will be more effective in teams. Our assumption is that graduates, empowered by having these skills, are more likely to manage conflict effectively and less likely to engage in bullying behaviours. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
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Quality management and perceptions of teamwork and safety climate in European hospitals.
Kristensen, Solvejg; Hammer, Antje; Bartels, Paul; Suñol, Rosa; Groene, Oliver; Thompson, Caroline A; Arah, Onyebuchi A; Kutaj-Wasikowska, Halina; Michel, Philippe; Wagner, Cordula
2015-12-01
This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality management systems and perceived teamwork and safety climate. Our data analyses included descriptive and multilevel regression methods. Data on implementation of quality management system from seven European countries were evaluated including patient safety culture surveys from 3622 clinical leaders and 4903 frontline clinicians. Perceived teamwork and safety climate. Teamwork climate was reported as positive by 67% of clinical leaders and 43% of frontline clinicians. Safety climate was perceived as positive by 54% of clinical leaders and 32% of frontline clinicians. We found positive associations between implementation of quality management systems and teamwork and safety climate. Our findings, which should be placed in a broader clinical quality improvement context, point to the importance of quality management systems as a supportive structural feature for promoting teamwork and safety climate. To gain a deeper understanding of this association, further qualitative and quantitative studies using longitudinally collected data are recommended. The study also confirms that more clinical leaders than frontline clinicians have a positive perception of teamwork and safety climate. Such differences should be accounted for in daily clinical practice and when tailoring initiatives to improve teamwork and safety climate. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
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The work is never ending: uncovering teamwork sustainability using realistic evaluation.
Frykman, Mandus; von Thiele Schwarz, Ulrica; Muntlin Athlin, Åsa; Hasson, Henna; Mazzocato, Pamela
2017-03-20
Purpose The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork. Design/methodology/approach Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation. Non-participant observation and interview data were used. Findings The teamwork behaviors were not sustained. A substantial fallback in managerial activities in combination with a complex context contributed to reduced direction, opportunity, and motivation. Reduced direction made staff members unclear about how and why they should work in teams. Deterioration of opportunity was evident from the lack of problem-solving resources resulting in accumulated barriers to teamwork. Motivation in terms of management support and feedback was reduced. Practical implications The implementation of complex organizational changes in complex healthcare contexts requires continuous adaption and managerial activities well beyond the initial implementation period. Originality/value By integrating the DCOM® framework with realistic evaluation, this study responds to the call for theoretically based research on behavioral mechanisms that can explain how BCIs interact with context and how this interaction influences sustainability.
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Interprofessional Emergency Training Leads to Changes in the Workplace
Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D.; Exadaktylos, Aristomenis K.; Machner, Mareen; Hautz, Wolf E.
2018-01-01
Introduction Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. Methods We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one’s roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants’ “Commitment to Change.” In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. Results In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication, behavior, knowledge and attitude. Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., “acknowledge other professions’ work”), and these were equally distributed among professions. At the two-month follow-up, 32 participants (50%) provided written feedback on their original commitments: 57 of 62 (91.9%) commitments were at least partly realized at the follow-up, and only five (8.1%) commitments lacked realization entirely. Conclusion A structured simulation-enhanced intervention was successful in promoting change to the practice of emergency care, while training teamwork and communication skills jointly. PMID:29383079
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Djukic, Maja; Fulmer, Terry; Adams, Jennifer G; Lee, Sabrina; Triola, Marc M
2012-09-01
Interprofessional education is a critical precursor to effective teamwork and the collaboration of health care professionals in clinical settings. Numerous barriers have been identified that preclude scalable and sustainable interprofessional education (IPE) efforts. This article describes NYU3T: Teaching, Technology, Teamwork, a model that uses novel technologies such as Web-based learning, virtual patients, and high-fidelity simulation to overcome some of the common barriers and drive implementation of evidence-based teamwork curricula. It outlines the program's curricular components, implementation strategy, evaluation methods, and lessons learned from the first year of delivery and describes implications for future large-scale IPE initiatives. Copyright © 2012 Elsevier Inc. All rights reserved.
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A Multidisciplinary Approach to a Pediatric Difficult Airway Simulation Course.
Lind, Meredith Merz; Corridore, Marco; Sheehan, Cameron; Moore-Clingenpeel, Melissa; Maa, Tensing
2018-02-01
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork. Participants completed pre- and postworkshop questionnaires. Results Thirty-nine trainees participated over the 3-year study period. Compared with their precourse responses, participants' postcourse responses indicated either agreement or strong agreement that the multidisciplinary format (1) helped in the development of team communication skills and (2) was preferred over single-discipline training. Improvement in confidence in managing critical airway situations and in advanced airway management skills was significant ( P < .05). Eighty-one percent of participants had improved confidence in following the hospital's critical airway protocol, and 64% were better able to locate advanced airway management equipment. Discussion Multiple subspecialists manage pediatric respiratory failure, where successful care requires complex handoffs and teamwork. Multidisciplinary education to teach advanced airway management, teamwork, and communication skills is practical and preferred by learners and is possible to achieve despite differences in experience. Future study is required to better understand the impact of this course on patient care outcomes. Implications for Practice Implementation of a pediatric difficult airway course through simulation-based team training is feasible and preferred by learners among multiple disciplines. A multidisciplinary approach exposes previously unrecognized knowledge gaps and allows for better communication and collaboration among the fields.
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Improving Care Teams' Functioning: Recommendations from Team Science.
Fiscella, Kevin; Mauksch, Larry; Bodenheimer, Thomas; Salas, Eduardo
2017-07-01
Team science has been applied to many sectors including health care. Yet there has been relatively little attention paid to the application of team science to developing and sustaining primary care teams. Application of team science to primary care requires adaptation of core team elements to different types of primary care teams. Six elements of teams are particularly relevant to primary care: practice conditions that support or hinder effective teamwork; team cognition, including shared understanding of team goals, roles, and how members will work together as a team; leadership and coaching, including mutual feedback among members that promotes teamwork and moves the team closer to achieving its goals; cooperation supported by an emotionally safe climate that supports expression and resolution of conflict and builds team trust and cohesion; coordination, including adoption of processes that optimize efficient performance of interdependent activities among team members; and communication, particularly regular, recursive team cycles involving planning, action, and debriefing. These six core elements are adapted to three prototypical primary care teams: teamlets, health coaching, and complex care coordination. Implementation of effective team-based models in primary care requires adaptation of core team science elements coupled with relevant, practical training and organizational support, including adequate time to train, plan, and debrief. Training should be based on assessment of needs and tasks and the use of simulations and feedback, and it should extend to live action. Teamlets represent a potential launch point for team development and diffusion of teamwork principles within primary care practices. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.
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Is It Getting Chilly in Here? Men and Women at Work.
ERIC Educational Resources Information Center
Filipczak, Bob
1994-01-01
Discusses the problems that have arisen in the workplace because of the fear of sexual harassment charges. Describes the gender communication training needed to build a climate of understanding and allow teamwork to flourish. (JOW)
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Martin, Heather A; Ciurzynski, Susan M
2015-11-01
Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses. This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
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Midwifery students' evaluation of team-based academic assignments involving peer-marking.
Parratt, Jenny A; Fahy, Kathleen M; Hastie, Carolyn R
2014-03-01
Midwives should be skilled team workers in maternity units and in group practices. Poor teamwork skills are a significant cause of adverse maternity care outcomes. Despite Australian and International regulatory requirements that all midwifery graduates are competent in teamwork, the systematic teaching and assessment of teamwork skills is lacking in higher education. How do midwifery students evaluate participation in team-based academic assignments, which include giving and receiving peer feedback? First and third year Bachelor of Midwifery students who volunteered (24 of 56 students). Participatory Action Research with data collection via anonymous online surveys. There was general agreement that team based assignments; (i) should have peer-marking, (ii) help clarify what is meant by teamwork, (iii) develop communication skills, (iv) promote student-to-student learning. Third year students strongly agreed that teams: (i) are valuable preparation for teamwork in practice, (ii) help meet Australian midwifery competency 8, and (iii) were enjoyable. The majority of third year students agreed with statements that their teams were effectively coordinated and team members shared responsibility for work equally; first year students strongly disagreed with these statements. Students' qualitative comments substantiated and expanded on these findings. The majority of students valued teacher feedback on well-developed drafts of the team's assignment prior to marking. Based on these findings we changed practice and created more clearly structured team-based assignments with specific marking criteria. We are developing supporting lessons to teach specific teamwork skills: together these resources are called "TeamUP". TeamUP should be implemented in all pre-registration Midwifery courses to foster students' teamwork skills and readiness for practice. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva
2017-01-01
Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.
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Minehart, Rebecca D; Pian-Smith, May C M; Walzer, Toni B; Gardner, Roxane; Rudolph, Jenny W; Simon, Robert; Raemer, Daniel B
2012-06-01
Organizational behavior and management fields have long realized the importance of teamwork and team-building skills, but only recently has health care training focused on these critical elements. Communication styles and strategies are a common focus of team training but have not yet been consistently applied to medicine. We sought to determine whether such communication strategies, specifically "advocacy" and "inquiry," were used de novo by medical professionals in a simulation-based teamwork and crisis resource management course. Explicit expression of a jointly managed clinical plan between providers, a strategy shown to improve patient safety, was also evaluated. Forty-four of 54 videotaped performances of an ongoing team-building skills course were viewed and analyzed for presence of advocacy and/or inquiry that related to information or a plan; inclusion criteria were participation of a nonconfederate obstetrician and an anesthesiologist. Verbal statement of a jointly managed clinical plan was also recorded. Anesthesiologists advocated information in 100% of cases and advocated their plans in 93% of cases but inquired information in 30% of cases and inquired about the obstetricians' plans in 11% of cases. Obstetricians advocated information in 73% of cases, advocated their plans in 73% of cases, inquired information in 75% of cases, and inquired about the anesthesiologists' plans in 59% of cases. An explicitly stated joint team plan was formed in 45% of cases. Anesthesiologists advocated more frequently than obstetricians, while obstetricians inquired and advocated in more balanced proportions. However, fewer than half of the teams explicitly agreed on a joint plan. Increasing awareness of communication styles, and possibly incorporating these skills into medical training, may help teams arrive more efficiently at jointly managed clinical plans in crisis situations.
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Simulation and Shoulder Dystocia.
Shaddeau, Angela K; Deering, Shad
2016-12-01
Shoulder dystocia is an unpredictable obstetric emergency that requires prompt interventions to ensure optimal outcomes. Proper technique is important but difficult to train given the urgent and critical clinical situation. Simulation training for shoulder dystocia allows providers at all levels to practice technical and teamwork skills in a no-risk environment. Programs utilizing simulation training for this emergency have consistently demonstrated improved performance both during practice drills and in actual patients with significantly decreased risks of fetal injury. Given the evidence, simulation training for shoulder dystocia should be conducted at all institutions that provide delivery services.
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Teamwork in Task Analysis. Training Manual V
1975-11-01
Research Programs Psychological Sciences Division Office of Naval Research Contract No. N00014-74-A-0436-0001 NR 151-370 Approved for public...Corps (Code RD) And Monitored By Personnel and Training Research Programs Psychological Sciences Division Office of Naval Research Contract No...survival in the hidden warfare of the destructive psychological win-lose game. Win-lose behavior stems from individual attitudes and manage- ment climate
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Method matters: impact of in-scenario instruction on simulation-based teamwork training.
Escher, Cecilia; Rystedt, Hans; Creutzfeldt, Johan; Meurling, Lisbet; Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Nordahl Amorøe, Torben; Hult, Håkan; Felländer-Tsai, Li; Abrandt-Dahlgren, Madeleine
2017-01-01
The rationale for introducing full-scale patient simulators in training to improve patient safety is to recreate clinical situations in a realistic setting. Although high-fidelity simulators mimic a wide range of human features, simulators differ from the body of a sick patient. The gap between the simulator and the human body implies a need for facilitators to provide information to help participants understand scenarios. The authors aimed at describing different methods that facilitators in our dataset used to provide such extra scenario information and how the different methods to convey information affected how scenarios played out. A descriptive qualitative study was conducted to examine the variation of methods to deliver extra scenario information to participants. A multistage approach was employed. The authors selected film clips from a shared database of 31 scenarios from three participating simulation centers. A multidisciplinary research team performed a collaborative analysis of representative film clips focusing on the interplay between participants, facilitators, and the physical environment. After that, the entire material was revisited to further examine and elaborate the initial findings. The material displayed four distinct methods for facilitators to convey information to participants in simulation-based teamwork training. The choice of method had impact on the participating teams regarding flow of work, pace, and team communication. Facilitators' close access to the teams' activities when present in the simulation suite, either embodied or disembodied in the simulation, facilitated the timing for providing information, which was critical for maintaining the flow of activities in the scenario. The mediation of information by a loudspeaker or an earpiece from the adjacent operator room could be disturbing for team communication. In-scenario instruction is an essential component of simulation-based teamwork training that has been largely overlooked in previous research. The ways in which facilitators convey information about the simulated patient have the potential to shape the simulation activities and thereby serve different learning goals. Although immediate timing to maintain an adequate pace is necessary for professionals to engage in training of medical emergencies, novices may gain from a slower tempo to train complex clinical team tasks systematically.
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Interprofessional teamwork and team interventions in chronic care: A systematic review.
Körner, Mirjam; Bütof, Sarah; Müller, Christian; Zimmermann, Linda; Becker, Sonja; Bengel, Jürgen
2016-01-01
To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.
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A rater training protocol to assess team performance.
Eppich, Walter; Nannicelli, Anna P; Seivert, Nicholas P; Sohn, Min-Woong; Rozenfeld, Ranna; Woods, Donna M; Holl, Jane L
2015-01-01
Simulation-based methodologies are increasingly used to assess teamwork and communication skills and provide team training. Formative feedback regarding team performance is an essential component. While effective use of simulation for assessment or training requires accurate rating of team performance, examples of rater-training programs in health care are scarce. We describe our rater training program and report interrater reliability during phases of training and independent rating. We selected an assessment tool shown to yield valid and reliable results and developed a rater training protocol with an accompanying rater training handbook. The rater training program was modeled after previously described high-stakes assessments in the setting of 3 facilitated training sessions. Adjacent agreement was used to measure interrater reliability between raters. Nine raters with a background in health care and/or patient safety evaluated team performance of 42 in-situ simulations using post-hoc video review. Adjacent agreement increased from the second training session (83.6%) to the third training session (85.6%) when evaluating the same video segments. Adjacent agreement for the rating of overall team performance was 78.3%, which was added for the third training session. Adjacent agreement was 97% 4 weeks posttraining and 90.6% at the end of independent rating of all simulation videos. Rater training is an important element in team performance assessment, and providing examples of rater training programs is essential. Articulating key rating anchors promotes adequate interrater reliability. In addition, using adjacent agreement as a measure allows differentiation between high- and low-performing teams on video review. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.
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White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J; Hoogenboom, Gabie; McGready, Rose
2016-01-01
To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70-89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010-2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to ensure evidence-based care of women and their families.
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White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M.; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J.; Hoogenboom, Gabie; McGready, Rose
2016-01-01
Background To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. Methods and Findings All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Results Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70–89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010–2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. Conclusions We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care. Education needs to be tailored to local needs to ensure evidence-based care of women and their families. PMID:27711144
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Teamwork Evaluation by Middle Grade Students in Inclusive Classrooms
ERIC Educational Resources Information Center
Strom, Paris S.; Thompson, MaryEllen; Strom, Robert D.
2013-01-01
Teamwork skills are considered essential in a work environment characterized by diversity and interdependence. Consequently, middle grade teachers arrange cooperative learning so students can acquire experience with solving problems in groups. Teachers also acknowledge that they are frustrated because appropriate instruments are lacking to track…
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Wang, Carolyn L; Chinnugounder, Sankar; Hippe, Daniel S; Zaidi, Sadaf; O'Malley, Ryan B; Bhargava, Puneet; Bush, William H
2017-01-01
To assess the performance of interprofessional teams of radiologists, technologists, and nurses trained with high-fidelity hands-on (HO) simulation and computer-based (CB) simulation training for contrast reaction management (CR) and teamwork skills (TS). Nurses, technologists, and radiology residents were randomized into 11 teams of three (one of each). Six teams underwent HO training and five underwent CB training for CR and TS. Participants took written tests before and after training and were further tested using a high-fidelity simulation scenario. HO and CB groups scored similarly on all written tests and each showed improvement after training (P = .002 and P = .018, respectively). During the final scenario test, HO teams tended to receive higher grades than CB teams on CR (95% versus 81%, P = .17) and made fewer errors in epinephrine administration (0/6 versus 2/5, P = .18). HO and CB teams scored similarly on TS (51% versus 52%, P = .66), but overall scores were lower for TS than for CR skills in both the HO (P = .03) and CB teams (P = .06). HO training was more highly rated than CB as an effective educational tool (P = .01) and for effectiveness at teaching CR and team communication skills (P = .02). High-fidelity simulation can be used to both train and test interprofessional teams of radiologists, technologists, and nurses for both CR and TS and is more highly rated as an effective educational tool by participants than similar CB training. However, a single session of either type of training may be inadequate for mastering TS. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
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The Outdoor Leisure Industry and the Environment.
ERIC Educational Resources Information Center
Beard, Colin
1998-01-01
Many services and products of the outdoor leisure industry are becoming more environmentally aware. Approaches include turning environmental work into recreational activities; introducing environmental problems and projects into outdoor management development programs that train workers in management, leadership, and teamworking skills; and…
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A comparison of the teamwork attitudes and knowledge of Irish surgeons and U.S Naval aviators.
O'Connor, Paul; Ryan, Stephen; Keogh, Ivan
2012-10-01
Poor teamwork skills are contributors to poor performance and mishaps in high risk work settings, including the operating theatre. A questionnaire was used to assess the attitudes towards, and knowledge of, Irish surgeons (n = 72) towards the human factors that contribute to mishaps and poor teamwork in high risk environments. The responses were compared to those obtained from U.S. Naval aviators (n = 552 for the attitude questions, and n = 172 for the knowledge test). U.S. Naval aviators were found to be significantly more knowledgeable, and held attitudes that were significantly more positive towards effective teamworking than the surgeons. Moreover, 78.9% of Senior House Officers and Registrars stated that junior personnel were frequently afraid to speak-up (compared with 31.3% of Consultants). Only 7.3% of surgeons stated that an adequate pre-operative brief team brief was frequently conducted, and only 15% stated that an adequate post-operative team brief was frequently conducted. It is suggested that the human factors training currently provided to surgeons in Ireland is a positive first step. However, there is a need to stress the importance of assertiveness in juniors, listening in seniors, and more reinforcement of good teamworking behaviours in the operating theatre. Copyright © 2011 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.
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Evaluating the Usage of Cloud-Based Collaboration Services through Teamwork
ERIC Educational Resources Information Center
Qin, Li; Hsu, Jeffrey; Stern, Mel
2016-01-01
With the proliferation of cloud computing for both organizational and educational use, cloud-based collaboration services are transforming how people work in teams. The authors investigated the determinants of the usage of cloud-based collaboration services including teamwork quality, computer self-efficacy, and prior experience, as well as its…
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Reframing implementation as an organisational behaviour problem.
Clay-Williams, Robyn; Braithwaite, Jeffrey
2015-01-01
The purpose of this paper is to report on a process evaluation of a randomised controlled trial (RCT) intervention study that tested the effectiveness of classroom- and simulation-based crew resource management courses, alone and in combination, and identifies organisational barriers and facilitators to implementation of team training programmes in healthcare. The RCT design consisted of a before and after study with a team training intervention. Quantitative data were gathered on utility and affective reactions to training, and on teamwork knowledge, attitudes, and behaviours of the learners. A sample of participants was interviewed at the conclusion of the study. Interview responses were analysed, alongside qualitative elements of the classroom course critique, to search for evidence, context, and facilitation clues to the implementation process. The RCT method provided scientifically robust data that supported the benefits of classroom training. Qualitative data identified a number of facilitators to implementation of team training, and shed light on some of the ways that learning was diffused throughout the organisation. Barriers to successful implementation were also identified, including hospital time and resource constraints and poor organisational communication. Quantitative randomised methods have intermittently been used to evaluate team training interventions in healthcare. Despite two decades of team training trials, however, the authors do not know as well as the authors would like what goes on inside the "black box" of such RCTs. While results are usually centred on outcomes, this study also provides insight into the context and mechanisms associated with those outcomes and identifies barriers and facilitators to successful intervention implementation.
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An Introductory Interprofessional Exercise for Healthcare Students
Rege, Saumitra V.; Misto, Kara; Dollase, Richard; George, Paul
2012-01-01
Objective. To evaluate healthcare students’ perceptions of an introductory interprofessional exercise and their team dynamics. Design. A workshop was developed, combining second-year medical students, fourth-year nursing students, and third-year pharmacy students to work as an interdisciplinary team. The teams alternated between working together on patient cases focusing on chronic obstructive pulmonary disease and asthma, and on the evaluation of standardized pneumonia patients. Teams were given the patients' health information and no other instructions. A faculty member and the standardized patient evaluated the students using a teamwork global rating scale. Assessment. Student survey results showed a positive response to interprofessional teamwork. The faculty members and standardized patients reported that the students worked as a cohesive unit and demonstrated good team communication. Conclusions. This introductory interprofessional experience had a positive impact on the students’ understanding of collaboration and teamwork. This type of experience will help students foster future collaborations as healthcare providers. PMID:23129853
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Copson, Sean; Calvert, Katrina; Raman, Puvaneswary; Nathan, Elizabeth; Epee, Mathias
2017-06-01
Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval. We also aimed to investigate if an improvement in perinatal outcomes could be demonstrated. A retrospective cohort study was performed. All cases of cord prolapse in the designated time period were identified and reviewed and a comparison of outcome measures pre- and post-training was undertaken. Thirty-one cases were identified in the pre-training period, and compared to 64 cases post-training. Documentation improved significantly post-training. There were non-significant improvements in use of spinal anaesthetic, and in the length of stay in the special care neonatal unit. There was a significant increase in the number of babies with Apgar scores less than seven at 5 min. There were no differences in the diagnosis to delivery interval, or in perinatal mortality rates. Obstetric emergency training was associated with improved teamwork, as evidenced by the improved documentation post-training in this study, but not with improved diagnosis to delivery interval. Long-term follow-up studies are required to ascertain whether training has an impact on longer-term paediatric outcomes, such as cerebral palsy rates. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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Guzmán, Azucena; Wenborn, Jennifer; Ledgerd, Ritchard; Orrell, Martin
2017-03-01
There is a recognised need to improve staff training in care homes. The aim of this study was to conduct a qualitative evaluation of the Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP), a staff training programme aimed at enhancing staff-resident communication. Focus groups were conducted with residents able to provide consent; staff and relatives and managers were interviewed in two care homes. A theoretical framework was developed to interpret the impact of CCSEP using Framework Analysis. Residents noted that the programme appeared to result in staff interacting more with them, as well as enjoying working together as a team. Staff reported an improved sense of teamwork, developing more positive attitudes towards residents, as well as their concerns about using theatrical techniques in the care setting. Relatives identified care home organisational aspects as being barriers to implementation, and some regarded CCSEP simply as 'entertainment' rather than 'creative care'. This study provides an insight into the potential of this staff training programme to improve staff-resident interactions. However, participants' varying views of CCSEP highlight the need to brief staff, residents and relatives before implementation so as to enable full understanding of the aim. © 2016 John Wiley & Sons Ltd.
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Developing Trust in Virtual Teams
ERIC Educational Resources Information Center
Germain, Marie-Line
2011-01-01
Rapid globalization, advances in technology, flatter organizational structures, synergistic cooperation among firms, and a shift to knowledge work environments have led to the increasing use of virtual teams in organizations. Selecting, training, and socializing employees in virtual teamwork has therefore become an important human resource…
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NASA Technical Reports Server (NTRS)
Helmreich, Robert L.
1996-01-01
This research addressed a number of issues relevant to the performance of teams in demanding environments. Initial work, conducted in the aviation analog environment, focused on developing new measures of performance related attitudes and behaviors. The attitude measures were used to assess acceptance of concepts related to effective teamwork and personal capabilities under stress. The behavioral measures were used to evaluate the effectiveness of flight crews operating in commercial aviation. Assessment of team issues in aviation led further to the evaluation and development of training to enhance team performance. Much of the work addressed evaluation of the effectiveness of such training, which has become known as Crew Resource Management (CRM). A second line of investigation was into personality characteristics that predict performance in challenging environments such as aviation and space. A third line of investigation of team performance grew out of the study of flight crews in different organizations. This led to the development of a theoretical model of crew performance that included not only individual attributes such as personality and ability, but also organizational and national culture. A final line of investigation involved beginning to assess whether the methodologies and measures developed for the aviation analog could be applied to another domain -- the performance of medical teams working in the operating room.
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Jones, Katherine J; Skinner, Anne M; High, Robin; Reiter-Palmon, Roni
2013-05-01
Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture-reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks. We used two quasi-experimental designs: a cross-sectional comparison of hospital survey on patient safety culture (HSOPS) results from an intervention group of 24 hospitals to a static group of 13 hospitals and a pre-post comparison of HSOPS results within intervention hospitals. Dependent variables were HSOPS items representing the four components of safety culture; independent variables were derived from items added to the HSOPS that measured the extent of team training, learning and transfer. We used a generalised linear mixed model approach to account for the correlated nature of the data. 59% of 2137 respondents from the intervention group reported receiving team training. Intervention group HSOPS scores were significantly higher than static group scores in three dimensions assessing the flexible and learning components of safety culture. The distribution of the adoption of team behaviours (transfer) varied in the intervention group from 2.8% to 31.0%. Adoption of team behaviours was significantly associated with odds of an individual reacting more positively at reassessment than baseline to nine items reflecting all four components of safety culture. Team training can result in transformational change in safety culture when the work environment supports the transfer of learning to new behaviour.
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Allan, Catherine K; Thiagarajan, Ravi R; Beke, Dorothy; Imprescia, Annette; Kappus, Liana J; Garden, Alexander; Hayes, Gavin; Laussen, Peter C; Bacha, Emile; Weinstock, Peter H
2010-09-01
Resuscitation of pediatric cardiac patients involves unique and complex physiology, requiring multidisciplinary collaboration and teamwork. To optimize team performance, we created a multidisciplinary Crisis Resource Management training course that addressed both teamwork and technical skill needs for the pediatric cardiac intensive care unit. We sought to determine whether participation improved caregiver comfort and confidence levels regarding future resuscitation events. We developed a simulation-based, in situ Crisis Resource Management curriculum using pediatric cardiac intensive care unit scenarios and unit-specific resuscitation equipment, including an extracorporeal membrane oxygenation circuit. Participants replicated the composition of a clinical team. Extensive video-based debriefing followed each scenario, focusing on teamwork principles and technical resuscitation skills. Pre- and postparticipation questionnaires were used to determine the effects on participants' comfort and confidence regarding participation in future resuscitations. A total of 182 providers (127 nurses, 50 physicians, 2 respiratory therapists, 3 nurse practitioners) participated in the course. All participants scored the usefulness of the program and scenarios as 4 of 5 or higher (5 = most useful). There was significant improvement in participants' perceived ability to function as a code team member and confidence in a code (P < .001). Participants reported they were significantly more likely to raise concerns about inappropriate management to the code leader (P < .001). We developed a Crisis Resource Management training program in a pediatric cardiac intensive care unit to teach technical resuscitation skills and improve team function. Participants found the experience useful and reported improved ability to function in a code. Further work is needed to determine whether participation in the Crisis Resource Management program objectively improves team function during real resuscitations. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
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Hope, Joanie Mayer; Lugassy, Daniel; Meyer, Rina; Jeanty, Freida; Myers, Stephanie; Jones, Sadie; Bradley, Joann; Mitchell, Rena; Cramer, Eva
2005-01-01
To evaluate the impact of the Downstate Team-Building Initiative (DTBI), a model multicultural and interdisciplinary health care team-building program for health professions students. A total of 65 students representing seven health disciplines participated in DTBI's first three years (one cohort per year since implementation). During the 18-session curriculum, students self-evaluated their group's progress through Tuckman's four team-development stages (FORMING, STORMING, NORMING, PERFORMING) on an 11-point scale. Students completed matched pre- and postintervention program evaluations assessing five variables: interdisciplinary understanding, interdisciplinary attitudes, teamwork skills, multicultural skills, and team atmosphere. After participation, students completed narrative follow-up questionnaires investigating impact one and two years after program completion. Each year's team development curve followed a similar logarithmic trajectory. Cohort 1 remained in team development stage 3 (NORMING) while Cohorts 2 and 3 advanced into the final stage-PERFORMING. A total of 34 matched pre- and postintervention evaluations showed significant change in all major variables: Team atmosphere and group teamwork skills improved most (48% and 44%, respectively). Interdisciplinary understanding improved 42%. Individual multicultural skills (defined by ability to address racism, homophobia, and sexism) started at the highest baseline and improved the least (13%). Group multicultural skills improved 36%. Of 23 responses to the follow-up surveys, 22 (96%) stated DTBI was a meaningful educational experience applicable to their current clinical surroundings. DTBI successfully united students across health discipline, ethnicity, socioeconomic class, gender, and sexual orientation into functioning teams. The model represents an effective approach to teaching health care team building and demonstrates benefits in both preclinical and clinical years of training.
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Murphy, Margaret; Curtis, Kate; McCloughen, Andrea
2016-02-01
In hospital emergencies require a structured team approach to facilitate simultaneous input into immediate resuscitation, stabilisation and prioritisation of care. Efforts to improve teamwork in the health care context include multidisciplinary simulation-based resuscitation team training, yet there is limited evidence demonstrating the value of these programmes.(1) We aimed to determine the current state of knowledge about the key components and impacts of multidisciplinary simulation-based resuscitation team training by conducting an integrative review of the literature. A systematic search using electronic (three databases) and hand searching methods for primary research published between 1980 and 2014 was undertaken; followed by a rigorous screening and quality appraisal process. The included articles were assessed for similarities and differences; the content was grouped and synthesised to form three main categories of findings. Eleven primary research articles representing a variety of simulation-based resuscitation team training were included. Five studies involved trauma teams; two described resuscitation teams in the context of intensive care and operating theatres and one focused on the anaesthetic team. Simulation is an effective method to train resuscitation teams in the management of crisis scenarios and has the potential to improve team performance in the areas of communication, teamwork and leadership. Team training improves the performance of the resuscitation team in simulated emergency scenarios. However, the transferability of educational outcomes to the clinical setting needs to be more clearly demonstrated. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.
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Torrecilla-Abril, Maravillas; Crespo-Mateos, Ana Patricia; Cartagena-Martínez, Esther; Oyarzabal-Arocena, Milagros; Pérez-Ortiz, Clara Isabel
2018-05-30
To determine the interest of nursing residents in the training areas of Family and Community Nursing (EFyC) at the beginning of their training, to evaluate community activities in health centres and to determine satisfaction with the training received and activities carried out. We present the experience of training in the public and community health competencies of EFyC Nursing from 2014 to 2017 in a multiprofessional teaching unit. The training was divided into 3theoretical modules. The training was completed with 2activities: the design and development of a health education programme and an asset mapping in the basic health area. A questionnaire was completed on satisfaction with the course and the activities carried out. During this period, 27 residents received training. As part of the training process, 26 health education programmes and 17 asset mappings were conducted in accredited health centres. The areas of intervention addressed were: lifestyles, life transitions and health problems. The overall satisfaction with the course was 4.5 ±.1 out of 5. The results show a high degree of interest in this area, as well as high evaluation of the activities carried out and the training received. Training in community health and health education during the period of residence is essential to include these competencies in the professional role. The dedication and involvement of the multiprofessional teaching units is essential in the development of these competences, training the residents through the integration of a biopsychosocial approach, community health and teamwork in primary care. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
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Teamwork: an essential for leading and launching innovation.
Davis, Patricia D; Marshall, David R
2014-01-01
Teamwork and innovation require a merging of special skills sets to produce the best outcomes. Collaboration and innovation have become core competencies for effectiveness in every industry. The capacity to collaborate and innovate has never been more important, especially in health care, with the regulatory and quality mandates to evaluate every aspect of service to ensure that we add value for patients and families. The examination of teamwork and innovation, which are inextricably linked, are described and discussed. The art of building teams, steps for leading change, and an approach to innovation in health care are described. The University of Texas Medical Branch in Galveston, Texas, shares one approach and experience called Innovation Forerunners-nurses from all levels and areas-to embed the tools and concepts of teamwork and innovation across patient care areas.
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[Burnout and teamwork in primary care teams].
Vilà Falgueras, Maite; Cruzate Muñoz, Carlota; Orfila Pernas, Francesc; Creixell Sureda, Joan; González López, María Pilar; Davins Miralles, Josep
2015-01-01
To estimate the prevalence of burnout and the perception of teamwork in Primary Care teams from Barcelona. Multicenter cross-sectional. Primary Health Care Teams from Barcelona. Institut Català de la Salut. All permanent employees or temporary professionals of all categories from 51 teams (N=2398). A total of 879 responses (36.7%) were obtained. The Maslach Burnout Inventory questionnaire, with 3 dimensions, was sent by emotional exhaustion (AE), depersonalization (DP), and personal accomplishment (RP). Burnout is considered present when two or more dimensions scored high marks. Perception of teamwork and evaluation of leaders was evaluated using an ad hoc questionnaire. The prevalence of burnout was17.2% (two or more dimensions affected), and 46.2% had at least one of the three dimensions with a high level. A high level of AE was found in 38.2%, of DP in 23.8%, and 7.7% had low RP. Almost half (49.2%) believe that teamwork is encouraged in their workplace. Social workers overall, have a higher average of dimensions affected at a high level, followed by administrative personnel, dentists, doctors and nurses (p<0.001). Permanent staff have a greater degree of emotional exhaustion (p<0.002). Those who rated their leaders worst and least rated teamwork had more emotional exhaustion, depersonalization and higher level of burnout in general (p<0.001). The level of burnout among professionals is considerable, with differences existing between occupational categories. Teamwork and appreciating their leaders protect from burnout. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.
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Neville, Timothy J; Salmon, Paul M; Read, Gemma J M
2018-02-01
Intra-team communication plays an important role in team effectiveness in various domains including sport. As such, it is a key consideration when introducing new tools within systems that utilise teams. The difference in intra-team communication of Australian Rules Football (AFL) umpiring teams was studied when umpiring with or without radio communications technology. A cross-sectional observational study was conducted to analyse the verbal communication of seven umpiring teams (20 participants) grouped according to their experience with radio communication. The results identified that radio communication technology increased the frequency and altered the structure of intra-team communication. Examination of the content of the intra-team communication identified impacts on the 'Big Five' teamwork behaviours and associated coordinating mechanisms. Analysis revealed that the communications utilised did not align with the closed-loop form of communication described in the Big Five model. Implications for teamwork models, coaching and training of AFL umpires are discussed. Practitioner Summary: Assessing the impact of technology on performance is of interest to ergonomics practitioners. The impact of radio communications on teamwork is explored in the highly dynamic domain of AFL umpiring. When given radio technology, intra-team communication increased which supported teamwork behaviours, such as backup behaviour and mutual performance monitoring.
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Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M
2013-01-01
Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P < .003). Follow-up in situ scenarios 10-12 months later demonstrated retention of skills training at both clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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ERIC Educational Resources Information Center
Stupans, Ieva
2013-01-01
The Internet has emerged as a mainstream communication medium, resulting in the development of new educational opportunities for teaching and learning. This article describes and evaluates a learning opportunity which used a Wiki technology to support an aligned assessment activity which was focused around teamwork and students construction of…
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ERIC Educational Resources Information Center
Heiner, Jeremy S.
2013-01-01
Student registered nurse anesthetists are an important part of an operating room team, yet little research has investigated how they perceive teamwork or approach team related issues specific to the operating room. This mixed methods study evaluated junior and senior student registered nurse anesthetists' attitudes toward and perceptions of…
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An Evaluation Framework for Selecting Collaboration Systems for Student Teamwork
ERIC Educational Resources Information Center
Shen, Yide; Li, Lei; Zheng, Guangzhi; Guo, Rong
2017-01-01
Collaboration technologies play an increasingly important role in student teamwork in universities. With the proliferation of collaboration systems on the market and the wide range of features they offer, choosing an appropriate system can be an overwhelming task for college students. In this paper, the authors present an empirical study that…
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A patient-centred team-coaching concept for medical rehabilitation.
Körner, M; Becker, S; Dinius, J; Müller, C; Zimmermann, L; Rundel, M
2018-01-01
Team coaching enhances teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional teamwork is regarded as a crucial factor in medical rehabilitation, to date no evaluated team-coaching approaches are available for improving interprofessional teamwork in medical rehabilitation in Germany. Based on a systematic literature search and interviews with staff, managers, and patients of rehabilitation clinics, we developed a team-coaching approach that is standardized in its process but based on the individual needs and requests of each clinic. It takes a systemic perspective and is goal-oriented and solution-focused. The approach mainly serves to provide impulses to make use of resources within the team and to support a self-directed organisational learning process. It is manualized and can, therefore, be used by professionals aiming to improve interprofessional teamwork in their clinic. A multi-centre, cluster-randomized controlled study that was conducted to evaluate the team-coaching approach showed positive results. Team organization, knowledge integration, and responsibility can be improved, and, therefore, the implementation of the patient-centred team-coaching approach in interprofessional rehabilitation teams can be recommended.
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Assessing team effectiveness and affective learning in a datathon.
Piza, Felipe Maia de Toledo; Celi, Leo Anthony; Deliberato, Rodrigo Octavio; Bulgarelli, Lucas; de Carvalho, Fabricio Rodrigues Torres; Filho, Roberto Rabello; de La Hoz, Miguel Angel Armengol; Kesselheim, Jennifer Cohn
2018-04-01
Datathons are increasingly organized in the healthcare field. The goal is to assemble people with different backgrounds to work together as a team and engage in clinically relevant research or develop algorithms using health-related datasets. Criteria to assess the return of investment on such events have traditionally included publications produced, patents for prediction, classification, image recognition and other types of software, and start-up companies around the application of machine learning in healthcare. Previous studies have not evaluated whether a datathon can promote affective learning and effective teamwork. Fifty participants of a health datathon event in São Paulo, Brazil at Hospital Israelita Albert Einstein (HIAE) were divided into 8 groups. A survey with 25 questions, using the Affective Learning Scale and Team-Review Questionnaire, was administered to assess team effectiveness and affective learning during the event. Multivariate regression models and Pearson's correlation tests were performed to evaluate the effect of affective learning on teamwork. Majority of the participants were male 76% (37/49); 32% (16/49) were physicians. The mean score for learning (scale from 1 to 10) was 8.38, while that for relevance of the perceived teamwork was 1.20 (scale from 1 to 5; "1" means most relevant). Pearson's correlation between the learning score and perception of teamwork showed moderate association (r = 0.36, p = 0.009). Five learning and 10 teamwork variables were on average positively graded in the event. The final regression model includes all learning and teamwork variables. Effective leadership was strongly correlated with affective learning (β = -0.27, p < 0.01, R 2 = 75%). Effective leadership, team accomplishment, criticism, individual development and creativity were the variables significantly associated with higher levels of affective learning. It is feasible to enhance affective knowledge and the skill to work in a team during a datathon. We found that teamwork is associated with higher affective learning from participants' perspectives. Effective leadership is essential for teamwork and is a significant predictor of learning. Copyright © 2018 Elsevier B.V. All rights reserved.
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Organizational and Teamwork Factors of Tele-Intensive Care Units.
Wilkes, Michael S; Marcin, James P; Ritter, Lois A; Pruitt, Sherilyn
2016-09-01
Use of tele-intensive care involves organizational and teamwork factors across geographic locations. This situation adds to the complexity of collaboration in providing quality patient-centered care. To evaluate cross-agency teamwork of health care professionals caring for patients in tele-intensive care units in rural and urban regions. A national qualitative study was conducted in 3 US geographic regions with tele-intensive care programs. Discussions and interviews were held with key participants during site visits at 3 hub sites (specialist services location) and 8 rural spoke sites (patient location). The effects of communication and culture between the hub team and the spoke team on use of the services and effectiveness of care were evaluated. A total of 34 participants were interviewed. Specific organizational and teamwork factors significantly affect the functionality of a tele-intensive care unit. Key operational and cultural barriers that limit the benefits of the units include unrealistic expectations about operational capabilities, lack of trust, poorly defined leadership, and a lack of communication policies. Potential solutions include education on spoke facility resources, clearly defined expectations and role reversal education, team-building activities, and feedback mechanisms to share concerns, successes, and suggestions. Proper administration and attention to important cultural and teamwork factors are essential to making tele-intensive care units effective, practical, and sustainable. ©2016 American Association of Critical-Care Nurses.
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Hollingsworth, John M; Funk, Russell J; Garrison, Spencer A; Owen-Smith, Jason; Kaufman, Samuel A; Pagani, Francis D; Nallamothu, Brahmajee K
2016-11-01
Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether teamwork (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system's teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (SD for the bipartite clustering coefficient was 0.09). Although health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (eg, physician staff size and surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality. Health systems with physicians who tend to work together in tightly-knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care. © 2016 American Heart Association, Inc.
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Weller, Jennifer; Henderson, Robert; Webster, Craig S; Shulruf, Boaz; Torrie, Jane; Davies, Elaine; Henderson, Kaylene; Frampton, Chris; Merry, Alan F
2014-01-01
Effective teamwork is important for patient safety, and verbal communication underpins many dimensions of teamwork. The validity of the simulated environment would be supported if it elicited similar verbal communications to the real setting. The authors hypothesized that anesthesiologists would exhibit similar verbal communication patterns in routine operating room (OR) cases and routine simulated cases. The authors further hypothesized that anesthesiologists would exhibit different communication patterns in routine cases (real or simulated) and simulated cases involving a crisis. Key communications relevant to teamwork were coded from video recordings of anesthesiologists in the OR, routine simulation and crisis simulation and percentages were compared. The authors recorded comparable videos of 20 anesthesiologists in the two simulations, and 17 of these anesthesiologists in the OR, generating 400 coded events in the OR, 683 in the routine simulation, and 1,419 in the crisis simulation. The authors found no significant differences in communication patterns in the OR and the routine simulations. The authors did find significant differences in communication patterns between the crisis simulation and both the OR and the routine simulations. Participants rated team communication as realistic and considered their communications occurred with a similar frequency in the simulations as in comparable cases in the OR. The similarity of teamwork-related communications elicited from anesthesiologists in simulated cases and the real setting lends support for the ecological validity of the simulation environment and its value in teamwork training. Different communication patterns and frequencies under the challenge of a crisis support the use of simulation to assess crisis management skills.
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Curran, Vernon; Fleet, Lisa; White, Susan; Bessell, Clare; Deshpandey, Akhil; Drover, Anne; Hayward, Mark; Valcour, James
2015-03-01
The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin simulators are used. There is limited research that has compared the effect of low and high-fidelity manikin simulators for NRP learning outcomes, and more specifically on teamwork performance and confidence. The purpose of this study was to examine the effect of using low versus high-fidelity manikin simulators in NRP instruction. A randomized posttest-only control group study design was conducted. Third year undergraduate medical students participated in NRP instruction and were assigned to an experimental group (high-fidelity manikin simulator) or control group (low-fidelity manikin simulator). Integrated skills station (megacode) performance, participant satisfaction, confidence and teamwork behaviour scores were compared between the study groups. Participants in the high-fidelity manikin simulator instructional group reported significantly higher total scores in overall satisfaction (p = 0.001) and confidence (p = 0.001). There were no significant differences in teamwork behaviour scores, as observed by two independent raters, nor differences on mandatory integrated skills station performance items at the p < 0.05 level. Medical students' reported greater satisfaction and confidence with high-fidelity manikin simulators, but did not demonstrate overall significantly improved teamwork or integrated skills station performance. Low and high-fidelity manikin simulators facilitate similar levels of objectively measured NRP outcomes for integrated skills station and teamwork performance.
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Patients' views of teamwork in the emergency department offer insights about team performance.
Henry, Beverly W; McCarthy, Danielle M; Nannicelli, Anna P; Seivert, Nicholas P; Vozenilek, John A
2016-06-01
Research into efforts to engage patients in the assessment of health-care teams is limited. To explore, through qualitative methods, patient awareness of teamwork-related behaviours observed during an emergency department (ED) visit. Researchers used semi-structured question guides for audio-recorded interviews and analysed their verbatim transcripts. Researchers conducted individual phone interviews with 6 teamwork subject matter experts (SMEs) and held 5 face-to-face group interviews with patients and caregivers (n = 25) about 2 weeks after discharge from the emergency department (ED). SMEs suggested that a range of factors influence patient perspectives of teams. Many patients perceived the health-care team within the context of their expectations of an ED visit and their treatment plan. Four themes emerged: (i) patient-centred views highlight gaps in coordination and communication; (ii) team processes do concern patients; (iii) patients are critical observers of ways that team members present their team roles; (iv) patients' observations of team members relate to patients' views of team effectiveness. Analysis also indicated that patients viewed health-care team members' interactions with each other as proxy for how team members actually felt about patients. Results from both sets of interviews (SME and patient) indicated that patient observations of teamwork could add to assessment of team processes/frameworks. Patients' understanding about teamwork organization seemed helpful and witnessed interteam communication appeared to influence patient confidence in the team. Patients perspectives are an important part of assessment in health care and suggest potential areas for improvement through team training. © 2013 John Wiley & Sons Ltd.
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Essentials of Pediatric Emergency Medicine Fellowship: Part 4: Beyond Clinical Education.
Wolff, Margaret; Carney, Michele; Eldridge, Charles; Zaveri, Pavan; Kou, Maybelle
2016-08-01
This article is the third in a 7-part series that aims to comprehensively describe the current state and future directions of pediatric emergency medicine fellowship training from the essential requirements to considerations for successfully administering and managing a program to the careers that may be anticipated upon program completion. This article focuses on the skills beyond clinical training required of pediatric emergency medicine physicians including teaching, leadership, teamwork, and communication.
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Erickson, Jeanne M; Blackhall, Leslie; Brashers, Valentina; Varhegyi, Nikole
2015-12-01
Interprofessional care is critical for patients at the end of life (EOL), but programs to teach communication skills to medical and nursing students are rare. The aims of this study were to determine whether an interprofessional workshop improves (1) student attitudes toward teamwork and (2) self-efficacy for communicating in difficult situations. Nursing and medical students attended a workshop with collaborative role play of an EOL conversation. Before the workshop, students showed different attitudes toward teamwork and collaboration and varying levels of confidence about communication skills. After the workshop, both groups reported more positive attitudes toward teamwork but a mixed picture of confidence in communication. Experiential interprofessional education workshops enhance perceptions about the benefits of teamwork, but further teaching and evaluation methods are needed to maximize the effectiveness. © The Author(s) 2014.
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Transforming Schools through Total Quality Education.
ERIC Educational Resources Information Center
Schmoker, Mike; Wilson, Richard B.
1993-01-01
Deming's work emphasizes advantages of teamwork, investment in ongoing training for all employees to increase their value to the company, and insistence that research and employee-gathered data guide and inform every decision and improvement effort. The parallel between psychologist Mihaly Csikszenmihalyi's work and Deming's shows that Total…
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Alcatel Telecom Transforms Technicians into Managers
ERIC Educational Resources Information Center
Education & Training, 2002
2002-01-01
Investigates the ways in which Alcatel Telecom attempts to smooth the transition of its employees from technical to business manager. Focuses on the Alcatel centre at Antwerp University, Belgium, which provides training in entrepreneurship, leadership, teamwork, the Alcatel culture and strategy, the dynamics of the telecommunications market,…
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A Phenomenological Study of Teamwork in Online and Face-to-Face Student Teams
ERIC Educational Resources Information Center
Saghafian, Marzieh; O'Neill, D. Kevin
2018-01-01
Team-based projects are widely used in both traditional face-to-face and online programs in higher education. To date, the teamwork experiences of students in each modality have been documented primarily through evaluative research conducted over short spans of time and limited by a priori frameworks. The literature also reflects a lack of…
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ERIC Educational Resources Information Center
McIntyre, Joseph S.
2011-01-01
The effectiveness of three case studies and associated teamwork to stimulate interest of college freshman in engineering was investigated by observing students. Case studies were assigned as laboratory team exercises in an introduction to engineering course at Auburn University. Student interest in the case studies was evaluated qualitatively…
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Saving lives: A meta-analysis of team training in healthcare.
Hughes, Ashley M; Gregory, Megan E; Joseph, Dana L; Sonesh, Shirley C; Marlow, Shannon L; Lacerenza, Christina N; Benishek, Lauren E; King, Heidi B; Salas, Eduardo
2016-09-01
As the nature of work becomes more complex, teams have become necessary to ensure effective functioning within organizations. The healthcare industry is no exception. As such, the prevalence of training interventions designed to optimize teamwork in this industry has increased substantially over the last 10 years (Weaver, Dy, & Rosen, 2014). Using Kirkpatrick's (1956, 1996) training evaluation framework, we conducted a meta-analytic examination of healthcare team training to quantify its effectiveness and understand the conditions under which it is most successful. Results demonstrate that healthcare team training improves each of Kirkpatrick's criteria (reactions, learning, transfer, results; d = .37 to .89). Second, findings indicate that healthcare team training is largely robust to trainee composition, training strategy, and characteristics of the work environment, with the only exception being the reduced effectiveness of team training programs that involve feedback. As a tertiary goal, we proposed and found empirical support for a sequential model of healthcare team training where team training affects results via learning, which leads to transfer, which increases results. We find support for this sequential model in the healthcare industry (i.e., the current meta-analysis) and in training across all industries (i.e., using meta-analytic estimates from Arthur, Bennett, Edens, & Bell, 2003), suggesting the sequential benefits of training are not unique to medical teams. Ultimately, this meta-analysis supports the expanded use of team training and points toward recommendations for optimizing its effectiveness within healthcare settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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The Impact of Operating Room Distractions on Stress, Workload, and Teamwork.
Wheelock, Ana; Suliman, Amna; Wharton, Rupert; Babu, E D; Hull, Louise; Vincent, Charles; Sevdalis, Nick; Arora, Sonal
2015-06-01
To investigate whether distractions in the operating room (OR) are associated with higher mental workload and stress, and poorer teamwork among OR personnel. Engaging in multiple tasks can affect performance. There is little research on the effect of distractions on surgical team members' behavior and cognitive processes. Ninety general surgery cases were observed in real time. Cases were assessed by a surgeon and a behavioral scientist using 4 validated tools: OR Distractions Assessment Form, the Observational Teamwork Assessment for Surgery tool, NASA-Task Load Index, and short form of the State Trait Anxiety Inventory. Analysis of variance was performed to evaluate significant differences between teamwork, workload, and stress level among team members. Correlations (Pearson r) were computed to evaluate associations between variables. The most prevalent distractions were those initiated by external staff, followed by case-irrelevant conversations. Case-irrelevant conversations were associated with poorer team performance. Irrelevant conversations initiated by surgeons were associated with lower teamwork in surgeons (across team skills: r = -0.44 to -0.58, P < 0.05 to 0.01) and anesthesiologists (r = -0.38 and r = -0.40, for coordination and leadership; P < 0.05). Equipment-related distractions correlated with higher stress (r = 0.48, P < 0.05) and lower teamwork (across team skills: r = -0.42 to -0.50, P < 0.05) in nurses. Acoustic distractions correlated with higher stress in surgeons (r = 0.32, P < 0.05) and higher workload in anesthesiologists (r = 0.30, P < 0.05). Although some distractions may be inevitable in the OR, they can also be detrimental to the team. A deeper understanding of the effect of distractions on teams and their outcomes can lead to targeted quality improvement.
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Liaw, Sok Ying; Zhou, Wen Tao; Lau, Tang Ching; Siau, Chiang; Chan, Sally Wai-Chi
2014-02-01
Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. The aim of the study is to describe the development, implementation and evaluation of a simulation-based interprofessional educational (Sim-IPE) program, using a presage-process-product (3P) model, for improving medical and nursing students' communication skills in caring of a patient with physiological deterioration. The program was conducted using full-scale simulation and communication strategies adapted from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). 127 medical and nursing students participated in a 3-hour small group interprofessional learning that incorporated simulation scenarios of deteriorating patients. Pre and post-tests were conducted to assess the students' self-confidence in interprofessional communication and perception in interprofessional learning. After the training, the students completed a satisfaction questionnaire. Both medicine and nursing groups demonstrated a significant improvement on post-test score from pre-test score for self-confidence (p<.0001) and perception (p<.0001) with no significant differences detected between the two groups. The participants were highly satisfied with their simulation learning. The Sim-IPE has better prepared the medical and nursing students in communicating with one another in providing safe care for deteriorating patient. In addition, it has improved their perception towards interprofessional learning. This pre-registration interprofessional education could prepare them for more comprehensive interprofessional team learning at post-registration level. Copyright © 2014 Elsevier Ltd. All rights reserved.
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Leadership survey. An evaluation of health care executives' challenges.
Thrall, T H; Hoppszallern, S
2001-01-01
Locating and keeping employees represents one of the greatest challenges facing health care leaders today. This is a key finding of the third Leadership Survey of executives in physician practices, managed care organizations and hospitals. The survey is sponsored by the Medical Group Management Association and Hospitals & Health Networks magazine. Other significant results: Practices put the most emphasis on teamwork, training and staff development as methods to combat labor shortages; practice executives count adequacy of reimbursements and physician productivity as top leadership challenges, along with the availability of qualified workers; practices choose print advertising and the addition of new products and services as the best ways for them to build market share.
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Mitropoulos, Panagiotis Takis; Cupido, Gerardo
2009-01-01
In construction, the challenge for researchers and practitioners is to develop work systems (production processes and teams) that can achieve high productivity and high safety at the same time. However, construction accident causation models ignore the role of work practices and teamwork. This study investigates the mechanisms by which production and teamwork practices affect the likelihood of accidents. The paper synthesizes a new model for construction safety based on the cognitive perspective (Fuller's Task-Demand-Capability Interface model, 2005) and then presents an exploratory case study. The case study investigates and compares the work practices of two residential framing crews: a 'High Reliability Crew' (HRC)--that is, a crew with exceptional productivity and safety over several years, and an average performing crew from the same company. The model explains how the production and teamwork practices generate the work situations that workers face (the task demands) and affect the workers ability to cope (capabilities). The case study indicates that the work practices of the HRC directly influence the task demands and match them with the applied capabilities. These practices were guided by the 'principle' of avoiding errors and rework and included work planning and preparation, work distribution, managing the production pressures, and quality and behavior monitoring. The Task Demand-Capability model links construction research to a cognitive model of accident causation and provides a new way to conceptualize safety as an emergent property of the production practices and teamwork processes. The empirical evidence indicates that the crews' work practices and team processes strongly affect the task demands, the applied capabilities, and the match between demands and capabilities. The proposed model and the exploratory case study will guide further discovery of work practices and teamwork processes that can increase both productivity and safety in construction operations. Such understanding will enable training of construction foremen and crews in these practices to systematically develop high reliability crews.
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Interprofessional education in anatomy: Learning together in medical and nursing training.
Herrmann, Gudrun; Woermann, Ulrich; Schlegel, Claudia
2015-01-01
Teamwork and the interprofessional collaboration of all health professions are a guarantee of patient safety and highly qualified treatment in patient care. In the daily clinical routine, physicians and nurses must work together, but the education of the different health professions occurs separately in various places, mostly without interrelated contact. Such training abets mutual misunderstanding and cements professional protectionism, which is why interprofessional education can play an important role in dismantling such barriers to future cooperation. In this article, a pilot project in interprofessional education involving both medical and nursing students is presented, and the concept and the course of training are described in detail. The report illustrates how nursing topics and anatomy lectures can be combined for interprofessional learning in an early phase of training. Evaluation of the course showed that the students were highly satisfied with the collaborative training and believed interprofessional education (IPE) to be an important experience for their future profession and understanding of other health professionals. The results show that the IPE teaching concept, which combines anatomy and nursing topics, provides an optimal setting for learning together and helps nurses and doctors in training to gain knowledge about other health professionals' roles, thus evolving mutual understanding. © 2014 American Association of Anatomists.
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Shamim Khan, Mohammad; Ahmed, Kamran; Gavazzi, Andrea; Gohil, Rishma; Thomas, Libby; Poulsen, Johan; Ahmed, Munir; Jaye, Peter; Dasgupta, Prokar
2013-03-01
WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: A competent urologist should not only have effective technical skills, but also other attributes that would make him/her a complete surgeon. These include team-working, communication and decision-making skills. Although evidence for effectiveness of simulation exists for individual simulators, there is a paucity of evidence for utility and effectiveness of these simulators in training programmes that aims to combine technical and non-technical skills training. This article explains the process of development and validation of a centrally coordinated simulation program (Participants - South-East Region Specialist Registrars) under the umbrella of the British Association for Urological Surgeons (BAUS) and the London Deanery. This program incorporated training of both technical (synthetic, animal and virtual reality models) and non-technical skills (simulated operating theatres). To establish the feasibility and acceptability of a centralized, simulation-based training-programme. Simulation is increasingly establishing its role in urological training, with two areas that are relevant to urologists: (i) technical skills and (ii) non-technical skills. For this London Deanery supported pilot Simulation and Technology enhanced Learning Initiative (STeLI) project, we developed a structured multimodal simulation training programme. The programme incorporated: (i) technical skills training using virtual-reality simulators (Uro-mentor and Perc-mentor [Symbionix, Cleveland, OH, USA], Procedicus MIST-Nephrectomy [Mentice, Gothenburg, Sweden] and SEP Robotic simulator [Sim Surgery, Oslo, Norway]); bench-top models (synthetic models for cystocopy, transurethral resection of the prostate, transurethral resection of bladder tumour, ureteroscopy); and a European (Aalborg, Denmark) wet-lab training facility; as well as (ii) non-technical skills/crisis resource management (CRM), using SimMan (Laerdal Medical Ltd, Orpington, UK) to teach team-working, decision-making and communication skills. The feasibility, acceptability and construct validity of these training modules were assessed using validated questionnaires, as well as global and procedure/task-specific rating scales. In total 33, three specialist registrars of different grades and five urological nurses participated in the present study. Construct-validity between junior and senior trainees was significant. Of the participants, 90% rated the training models as being realistic and easy to use. In total 95% of the participants recommended the use of simulation during surgical training, 95% approved the format of the teaching by the faculty and 90% rated the sessions as well organized. A significant number of trainees (60%) would like to have easy access to a simulation facility to allow more practice and enhancement of their skills. A centralized simulation programme that provides training in both technical and non-technical skills is feasible. It is expected to improve the performance of future surgeons in a simulated environment and thus improve patient safety. © 2012 BJU International.
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An integrative framework for sensor-based measurement of teamwork in healthcare
Rosen, Michael A; Dietz, Aaron S; Yang, Ting; Priebe, Carey E; Pronovost, Peter J
2015-01-01
There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies. PMID:25053579
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75 FR 38107 - Agency Information Collection Activities: Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-01
... TeamSTEPPS[supreg] (aka Team Strategies and Tools for Enhancing Performance and Patient Safety) to provide an evidence-based suite of tools and strategies for training teamwork- based patient safety to... TeamSTEPPS and are afforded the opportunity to observe the tools and strategies provided in the program...
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78 FR 52927 - Agency Information Collection Activities: Proposed Collection; Comment Request
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-27
... TeamSTEPPS[supreg] (aka Team Strategies and Tools for Enhancing Performance and Patient Safety) to provide an evidence-based suite of tools and strategies for training teamwork- based patient safety to... strategies provided in the program in action. In addition to developing Master Trainers, AHRQ has also...
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A School-Based Quality Improvement Program.
ERIC Educational Resources Information Center
Rappaport, Lewis A.
1993-01-01
As one Brooklyn high school discovered, quality improvement begins with administrator commitment and participants' immersion in the literature. Other key elements include ongoing training of personnel involved in the quality-improvement process, tools such as the Deming Cycle (plan-do-check-act), voluntary and goal-oriented teamwork, and a worthy…
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Learning Organisations and Child Protection Agencies: Post-Fordist Techniques?
ERIC Educational Resources Information Center
Reich, Ann
2002-01-01
A study of child protection agencies in New South Wales shows how reforms involving a neoliberal interpretation of the learning organization, rather than encouraging teamwork and employee participation, are used to govern and control. Such new "technologies of training" demand changes in the character and identity of workers. (SK)
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How to Teach Emotional Intelligence Skills in IT Project Management
ERIC Educational Resources Information Center
Connolly, Amy J.; Reinicke, Bryan
2017-01-01
High emotional intelligence ("EQ") is considered one of the greatest strengths of an alpha project manager, yet undergraduate project management students are not directly trained in EQ soft skills such as communication, politics and teamwork. This article describes examples of active learning exercises implemented in an undergraduate IT…
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ERIC Educational Resources Information Center
Roffe, Ian
1999-01-01
A literature review identified principles for supporting innovation and creativity in organizations: integrated approach, the right climate, and appropriate incentives. Staff development should focus on such skills as teamwork, communication, vision, change management, and leadership. Internet and intranet communications are beginning to be…
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Millennials Need Training Too: Using Communication Technology to Facilitate Teamwork
ERIC Educational Resources Information Center
Charsky, Dennis; Kish, Mary L.; Briskin, Jessica; Hathaway, Sarah; Walsh, Kira; Barajas, Nicolas
2009-01-01
Human Communication in Organizations (HCO) is an introductory college course at Ithaca College, typically taken in the freshman year, in which students from a wide variety of majors examine the basic concepts, issues, and uses of organizational communication including communication theory, superior-subordinate and peer relationships, leadership,…
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Total Quality Management in the Defense Fuel Supply Center: Issues and Observations.
ERIC Educational Resources Information Center
Matysek, Eugene F., Jr.
1993-01-01
Examines the Total Quality Management (TQM) activities at a federal government agency (i.e., the Defense Fuel Supply Center) using the following criteria established by the Federal Quality Institute: top management leadership and support; strategic quality planning; customer focus; training and recognition; employee empowerment and teamwork; and…
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Personal Skills. Facilitator's Skill Packets 1-7. Social Skills Training.
ERIC Educational Resources Information Center
Model Classrooms, Bellevue, WA.
This document contains the following seven facilitators' skill packets on personal skills: (1) personal hygiene; (2) personal appearance; (3) locker hygiene; (4) dorm cleanliness; (5) punctuality and attendance; (6) responding to supervision; and (7) teamwork. Each packet contains the following sections: definition of personal skills; objective;…
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25 Years of Teamwork for Adult Education in Iowa.
ERIC Educational Resources Information Center
Stacy, W. H.
This silver anniversary report reviews the history of the Iowa Adult Education Association (IAEA) since its founding on April 7, 1945. IAEA conferences, meetings, workshops, and publications are covered year by year, with particular reference to such activities and concerns as leadership training, professional continuing education, educational…
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Hybrid simulation: bringing motivation to the art of teamwork training in the operating room.
Kjellin, A; Hedman, L; Escher, C; Felländer-Tsai, L
2014-12-01
Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence. © The Finnish Surgical Society 2014.
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A multicenter trial of aviation-style training for surgical teams.
Catchpole, Ken R; Dale, Trevor J; Hirst, D Guy; Smith, J Phillip; Giddings, Tony A E B
2010-09-01
This study measured the effect of aviation-style team training on 3 surgical teams from different specialties. It focused on team working and communication, particularly briefing, time-out, and debriefing, and sought to understand how improvements in team skills could be implemented in a broad range of naturalistic surgical environments to improve safety, quality, and efficiency. Surgical teams performing maxillofacial, vascular, and neurosurgery were studied during 112 operations: 51 before and 61 after intervention. Human factors experts delivered the training of up to 2 days in the classroom followed by 6 days of coaching in theater for each team. Trained observers measured teamwork using the Oxford NOTECHS and the frequency of preoperative briefings, pre-incision time-outs, and postoperative debriefings. The Safety Attitudes Questionnaire and ethnographic observations were used to provide contextual details. There were significantly more time-outs (chi = 18.17, P < 0.001), briefings (chi = 8.62, P = 0.004), and debriefings (chi = 8.58, P = 0.004) after the intervention. The NOTECHS scores showed an interaction between site and intervention (F2,106 = 7.57, P = 0.001). The Safety Attitudes Questionnaire and ethnographic observations helped understand these differences. Aviation-style teamwork training can increase compliance and team performance, but this was influenced by the attitude and collaboration of key individuals, and the effect was reduced by significant latent failures. This study demonstrates the need to improve organizational and personal management factors in the National Health Service if training in patient safety is to be effective and sustained. It also shows the influence of working conditions on clinical studies of quality improvement.
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Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center.
Peters, V Kristen; Harvey, Ellen M; Wright, Andi; Bath, Jennifer; Freeman, Dan; Collier, Bryan
2018-01-01
Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
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Ginsburg, Liane; Bain, Lorna
2017-03-01
Communication failure is a leading cause of error and is often due to inhibition of individuals to speak up in interprofessional healthcare environments. The present study sought to evaluate the impact of a multifaceted intervention designed to promote speaking up on teamwork climate in one clinical department of a large community hospital based in Canada. The multifaceted intervention included a role-playing simulation workshop, teamwork climate data feedback and facilitated discussion with the interprofessional team (discussion briefings), and other department-led initiatives to promote trust, teamwork, and speaking up among interprofessional team members. A quasi-experiment (pretest-posttest control group design, using two posttests several months apart) was used to evaluate the impact of the complete intervention on individual teamwork climate perceptions. The intervention was implemented with an intact interprofessional team (the Emergency Department-ED) in 2014. The intensive care unit (ICU) was used as the control unit. Survey response rates were the highest at time 1 (83/102 = 81% for the ED and 29/31 = 94% for the ICU) and the lowest at time 3 (38/105 = 36% for the ED and 14/30 = 47% for the ICU). The results obtained from paired and unpaired analyses suggest that this type of multifaceted approach can improve staff perceptions of teamwork climate. The teamwork climate score in the ED was significantly higher at follow-up (Mt2 = 3.42, SD = 0.66) compared to baseline (Mt1 = 3.13, SD = 0.72), (F(1, 34) = 12.2, p = .001, eta 2 p = .263), while baseline and follow-up scores were not significantly different between baseline and follow-up for the ICU group (Mt1 = 4.12, SD = 0.60; Mt2 = 4.15, SD = 0.56; F(1, 34) = 0.06, p = .806, eta 2 p = .002). Sustaining high levels of participation in interprofessional initiatives and engaging physicians remain challenging when interventions are used in context. Improving team communication is a broad and challenging area that continues to require attention.
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Team Training and Institutional Protocols to Prevent Shoulder Dystocia Complications.
Smith, Samuel
2016-12-01
Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance.
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[Organize quality assurance as in aviation; improve patient safety in Dutch hospitals].
Haerkens, Marck H T M; Beekmann, Roland T A; van den Elzen, Guus J P; Lansbergen, Michael D I; Berlijn, Dick L
2009-01-01
Failing teamwork is a major cause of adverse events in hospitals in the Netherlands. Training team-skills can improve the safety standards in clinical heath care. An adapted version of Crew Resource Management (CRM) training is proving to be a usable format in the hospital environment. We emphasize that paying attention to the subject of safety has to start early in medical education in order to incorporate non-technical skills into the hospital culture.
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Improving patient safety in the radiation oncology setting through crew resource management.
Sundararaman, Srinath; Babbo, Angela E; Brown, John A; Doss, Richard
2014-01-01
This paper demonstrates how the communication patterns and protocol rigors of a methodology called crew resource management (CRM) can be adapted to a radiation oncology environment to create a culture of patient safety. CRM training was introduced to our comprehensive radiation oncology department in the autumn of 2009. With 34 full-time equivalent staff, we see 100-125 patients daily on 2 hospital campuses. We were assisted by a consulting group with considerable experience in helping hospitals incorporate CRM principles and practices. Implementation steps included developing change initiative skills for key leaders, providing training in teamwork and communications, creating site-specific tools for safety and efficiency, and collecting data to document results. Our goals were to improve patient safety, teamwork, communication, and efficiency through the use of tools we developed that emphasized teamwork and communication, cross-checking, and routinizing specific protocols. Our CRM plan relies on the following 4 pillars: patient identification methods; "pause for the cause"; enabling all staff to halt treatment and question decisions; and daily morning meetings. We discuss some of the hurdles to change we encountered. Our safety record has improved. Our near-miss rate before CRM implementation averaged 11 per month; our near-miss rate currently averages 1.2 per month. In the 5 years prior to CRM implementation, we experienced 1 treatment deviation per year, although none rose to the level of "mis-administration." Since implementing CRM, our current patient treatment setup and delivery process has eliminated all treatment deviations. Our practices have identified situations where ambiguity or conflicting documentation could have resulted in inappropriate treatment or treatment inefficiencies. Our staff members have developed an extraordinary sense of teamwork combined with a high degree of personal responsibility to assure patient safety and have spoken up when they considered something potentially unsafe. We have increased our efficiency (and profitability); in 2012, our units of service were up 11.3% over 2009 levels with the same staffing level. The rigor and standardization introduced into our practice, combined with the increase in communication and teamwork have improved both safety and efficiency while improving both staff and patient satisfaction. CRM principles are highly adaptable and applicable to the radiation oncology setting. © 2014. Published by Elsevier Inc. All rights reserved.
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Managing patient deterioration: assessing teamwork and individual performance.
Cooper, Simon; Cant, Robyn; Porter, Jo; Missen, Karen; Sparkes, Louise; McConnell-Henry, Tracy; Endacott, Ruth
2013-05-01
To assess the ability of rural Australian nurse teams to manage deteriorating patients. This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Knowledge in relation to patient deterioration management varied (mean 63%, range 27-100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17-83%, SD 14.03) with significantly higher levels in younger participants (r=-0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.
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Learning-by-Doing Teamwork KSA: The Role of Strategic Management Simulation
ERIC Educational Resources Information Center
Martín-Pérez, Víctor; Martín-Cruz, Natalia; Pérez-Santana, Pilar
2012-01-01
The objective of this paper is to evaluate the effectiveness of strategic management simulations as a learning-by-doing tool so that university students can learn to work in a team, that is, they can enhance their knowledge, skills, and abilities (KSA) for effective teamwork. The authors have carried out an analysis of the effect of strategic…
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Curran, Vernon R; Mugford, J Gerry; Law, Rebecca M T; MacDonald, Sandra
2005-03-01
An evaluation study of an undergraduate HIV/AIDS interprofessional education program for medical, nursing and pharmacy students was undertaken to assess changes in role perception, attitudes towards collaboration, self-reported teamwork skills and satisfaction with a shared learning experience. A combined one group pretest-posttest and time-series study design was used. Several survey instruments and observation checklists were completed by students and tutors before, during and after the educational program. Students reported greater awareness of roles and the continuous exposure to interprofessional learning led to improved attitudes towards teamwork. Standardized patients were effective in fostering an experience of realism and motivating collaboration between students. A problem-based learning approach combined with standardized patients was effective in enhancing HIV/AIDS interprofessional role perception, enhancing attitudes towards collaboration and interprofessional approaches to HIV/AIDS care and fostering confidence in teamwork skills among pre-licensure health sciences students.
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Expert validation of a teamwork assessment rubric: A modified Delphi study.
Parratt, Jenny A; Fahy, Kathleen M; Hutchinson, Marie; Lohmann, Gui; Hastie, Carolyn R; Chaseling, Marilyn; O'Brien, Kylie
2016-01-01
Teamwork is a 'soft skill' employability competence desired by employers. Poor teamwork skills in healthcare have an impact on adverse outcomes. Teamwork skills are rarely the focus of teaching and assessment in undergraduate courses. The TeamUP Rubric is a tool used to teach and evaluate undergraduate students' teamwork skills. Students also use the rubric to give anonymised peer feedback during team-based academic assignments. The rubric's five domains focus on planning, environment, facilitation, conflict management and individual contribution; each domain is grounded in relevant theory. Students earn marks for their teamwork skills; validity of the assessment rubric is critical. To what extent do experts agree that the TeamUP Rubric is a valid assessment of 'teamwork skills'? Modified Delphi technique incorporating Feminist Collaborative Conversations. A heterogeneous panel of 35 professionals with recognised expertise in communications and/or teamwork. Three Delphi rounds using a survey that included the rubric were conducted either face-to-face, by telephone or online. Quantitative analysis yielded item content validity indices (I-CVI); minimum consensus was pre-set at 70%. An average of the I-CVI also yielded sub-scale (domain) (D-CVI/Ave) and scale content validity indices (S-CVI/Ave). After each Delphi round, qualitative data were analysed and interpreted; Feminist Collaborative Conversations by the research team aimed to clarify and confirm consensus about the wording of items on the rubric. Consensus (at 70%) was obtained for all but one behavioural descriptor of the rubric. We modified that descriptor to address expert concerns. The TeamUP Rubric (Version 4) can be considered to be well validated at that level of consensus. The final rubric reflects underpinning theory, with no areas of conceptual overlap between rubric domains. The final TeamUP Rubric arising from this study validly measures individual student teamwork skills and can be used with confidence in the university setting. Copyright © 2015 Elsevier Ltd. All rights reserved.
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[Novelities in resuscitation training methods].
López-Messa, J B; Martín-Hernández, H; Pérez-Vela, J L; Molina-Latorre, R; Herrero-Ansola, P
2011-10-01
The importance of cardiac arrest as a health problem makes training in resuscitation a topic of great interest. It is necessary to enhance resuscitation training for all citizens, starting in schools and institutes, targeting teachers and nurses for training, to in turn become future trainers. The model of short courses with video-instruction and the use of mannequins is useful for the dissemination of resuscitation techniques. Liberalization of the use of automated external defibrillators (AED) and reduction of the training requirements in basic life support and AED for those non-health professionals who can use them, seems appropriate. Training must be improved in schools of medicine and nursing schools at undergraduate level. Health professionals should be trained according to their needs, with emphasis on non-technical skills such as leadership and teamwork. The model based on the use of trainers and low-fidelity mannequins remains a basic and fundamental element in training. Training through performance evaluation is a technique that should be implemented in all areas where cases of cardiac arrest are seen and the healthcare team has intervened. Simulation appears to be defined as the current and future modality for training in various medical areas, including of course the important field of resuscitation. Lastly, research in resuscitation training should be considered an example of translational science, where rigorous studies of skill acquisition with outcome measures serve to transfer the results to the clinical environment for analysis of their impact upon patient care. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.
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Learning Bridge Tool to Improve Student Learning, Preceptor Training, and Faculty Teamwork
Cawley, Pauline; Arendt, Cassandra S.
2011-01-01
Objectives To implement a Learning Bridge tool to improve educational outcomes for pharmacy students as well as for preceptors and faculty members. Design Pharmacy faculty members collaborated to write 9 case-based assignments that first-year pharmacy (P1) students worked with preceptors to complete while at experiential sites. Assessment Students, faculty members, and preceptors were surveyed about their perceptions of the Learning Bridge process. As in our pilot study,1 the Learning Bridge process promoted student learning. Additionally, the Learning Bridge assignments familiarized preceptors with the school's P1 curriculum and its content. Faculty teamwork also was increased through collaborating on the assignments. Conclusions The Learning Bridge assignments provided a compelling learning environment and benefited students, preceptors, and faculty members. PMID:21655400
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Learning bridge tool to improve student learning, preceptor training, and faculty teamwork.
Karimi, Reza; Cawley, Pauline; Arendt, Cassandra S
2011-04-11
To implement a Learning Bridge tool to improve educational outcomes for pharmacy students as well as for preceptors and faculty members. Pharmacy faculty members collaborated to write 9 case-based assignments that first-year pharmacy (P1) students worked with preceptors to complete while at experiential sites. Students, faculty members, and preceptors were surveyed about their perceptions of the Learning Bridge process. As in our pilot study,(1) the Learning Bridge process promoted student learning. Additionally, the Learning Bridge assignments familiarized preceptors with the school's P1 curriculum and its content. Faculty teamwork also was increased through collaborating on the assignments. The Learning Bridge assignments provided a compelling learning environment and benefited students, preceptors, and faculty members.
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TEAM ATTITUDE EVALUATION: AN EVALUATION IN HOSPITAL COMMITTEES.
Hekmat, Somayeh Noori; Dehnavieh, Reza; Rahimisadegh, Rohaneh; Kohpeima, Vahid; Jahromi, Jahromi Kohpeima
2015-12-01
Patients' health and safety is not only a function of complex treatments and advanced therapeutic technologies but also a function of a degree based on which health care professionals fulfill their duties effectively as a team. The aim of this study was to determine the attitude of hospital committee members about teamwork in Kerman hospitals. This study was conducted in 2014 on 171 members of clinical teams and committees of four educational hospitals in Kerman University of Medical Sciences. To collect data, the standard "team attitude evaluation" questionnaire was used. This questionnaire consisted of five domains which evaluated the team attitude in areas related to the team structure, leadership, situation monitoring, mutual support, and communication in the form of a 5-point Likert type scale. To analyze data, descriptive statistical tests, T-test, ANOVA, and linear regression were used. The average score of team attitude for hospital committee members was 3.9 out of 5. The findings showed that leadership had the highest score among the subscales of team work attitude, while mutual support had the lowest score. We could also observe that responsibility was an important factor in participants' team work attitude (β = -0.184, p = 0.024). Comparing data in different subgroups revealed that employment, marital status, and responsibility were the variables affecting the participants' attitudes in the team structure domain. Marital status played a role in leadership; responsibility had a role in situation monitoring; and work experience played a role in domains of communication and mutual support. Hospital committee members had a positive attitude towards teamwork. Training hospital staff and paying particular attention to key elements of effectiveness in a health care team can have a pivotal role in promoting the team culture.
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MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L
2009-01-01
Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.
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STORC safety initiative: a multicentre survey on preparedness & confidence in obstetric emergencies.
Guise, Jeanne-Marie; Segel, Sally Y; Larison, Kristine; M Jump, Sarah; Constable, Marion; Li, Hong; Osterweil, Patricia; Dieter Zimmer
2010-12-01
Patient safety is a national and international priority. The purpose of this study was to understand clinicians' perceptions of teamwork during obstetric emergencies in clinical practice, to examine factors associated with confidence in responding to obstetric emergencies and to evaluate perceptions about the value of team training to improve preparedness. An anonymous survey was administered to all clinical staff members who respond to obstetric emergencies in seven Oregon hospitals from June 2006 to August 2006. 614 clinical staff (74.5%) responded. While over 90% felt confident that the appropriate clinical staff would respond to emergencies, more than half reported that other clinical staff members were confused about their role during emergencies. Over 84% were confident that emergency drills or simulation-based team training would improve performance. Clinical staff who respond to obstetric emergencies in their practice reported feeling confident that the qualified personnel would respond to an emergency; however, they were less confident that the responders would perform well as a team. They reported that simulation and team training may improve their preparedness and confidence in responding to emergencies.
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Leadership training in health care action teams: a systematic review.
Rosenman, Elizabeth D; Shandro, Jamie R; Ilgen, Jonathan S; Harper, Amy L; Fernandez, Rosemarie
2014-09-01
To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations. The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI). Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9). Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.
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Whitmore, Susan C.; Grefsheim, Suzanne F.; Rankin, Jocelyn A.
2008-01-01
Background The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. Purpose This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. Brief description The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. Results/outcomes NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. Evaluation method High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training, and service components. Anecdotal evidence has also indicated a favorable response to the programme. PMID:18494648
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Simulation-based learning: Just like the real thing
Lateef, Fatimah
2010-01-01
Simulation is a technique for practice and learning that can be applied to many different disciplines and trainees. It is a technique (not a technology) to replace and amplify real experiences with guided ones, often “immersive” in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Simulation-based learning can be the way to develop health professionals’ knowledge, skills, and attitudes, whilst protecting patients from unnecessary risks. Simulation-based medical education can be a platform which provides a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas. Simulation-based training techniques, tools, and strategies can be applied in designing structured learning experiences, as well as be used as a measurement tool linked to targeted teamwork competencies and learning objectives. It has been widely applied in fields such aviation and the military. In medicine, simulation offers good scope for training of interdisciplinary medical teams. The realistic scenarios and equipment allows for retraining and practice till one can master the procedure or skill. An increasing number of health care institutions and medical schools are now turning to simulation-based learning. Teamwork training conducted in the simulated environment may offer an additive benefit to the traditional didactic instruction, enhance performance, and possibly also help reduce errors. PMID:21063557
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Simulation-based learning: Just like the real thing.
Lateef, Fatimah
2010-10-01
Simulation is a technique for practice and learning that can be applied to many different disciplines and trainees. It is a technique (not a technology) to replace and amplify real experiences with guided ones, often "immersive" in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion. Simulation-based learning can be the way to develop health professionals' knowledge, skills, and attitudes, whilst protecting patients from unnecessary risks. Simulation-based medical education can be a platform which provides a valuable tool in learning to mitigate ethical tensions and resolve practical dilemmas. Simulation-based training techniques, tools, and strategies can be applied in designing structured learning experiences, as well as be used as a measurement tool linked to targeted teamwork competencies and learning objectives. It has been widely applied in fields such aviation and the military. In medicine, simulation offers good scope for training of interdisciplinary medical teams. The realistic scenarios and equipment allows for retraining and practice till one can master the procedure or skill. An increasing number of health care institutions and medical schools are now turning to simulation-based learning. Teamwork training conducted in the simulated environment may offer an additive benefit to the traditional didactic instruction, enhance performance, and possibly also help reduce errors.
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Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Breivik, Marit; Engeberg, Janecke Merethe; Brattebø, Guttorm
2016-11-01
Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.
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Fyffe, Chris; McCubbery, Jeffrey; Reid, Katharine J
2008-09-01
Active support (AS) has been shown to increase the amount of time that residents in shared residential settings are involved in purposeful activities. The organisational processes required to implement AS have been less well researched. Staff in community houses answered questions about the occurrence of organisational activities and processes thought to assist AS implementation (e.g., training and teamwork), their understanding of engagement, and their experience of changes in staff practice consistent with AS (including implementation problems). Non-house-based managers were also interviewed about their role in AS implementation. Reported occurrence of organisational activities and processes (e.g., training and teamwork) and understanding of engagement were associated with more reports of changes in staff practice and fewer staff reports of implementation problems. Staff reports on the role of non-house-based managers were not associated with reports of changes in staff practice or with reports of fewer AS implementation problems. Non-house-based managers' reports overestimated their role in AS implementation when compared with reports from house-based staff groups. While there are limitations in the research design (including the reliance on staff reports), the findings support the importance of wider organisational factors (beyond training programs for direct support staff) as integral to the implementation of AS. There is a need for further research on AS implementation.
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Hollingsworth, John M.; Funk, Russell J.; Garrison, Spencer A.; Owen-Smith, Jason; Kaufman, Samuel A.; Pagani, Francis D.; Nallamothu, Brahmajee K.
2017-01-01
Background Patients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether “teamwork” (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. Methods and Results Among Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system’s teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (standard deviation for the bipartite clustering coefficient was 0.09). While health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (e.g., physician staff size, surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality. Conclusions Health systems with physicians who tend to work together in tightly knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care. PMID:28263939
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Xyrichis, Andreas; Ream, Emma
2008-01-01
This paper is a report of an analysis of the concept of teamwork. Teamwork is seen as an important facilitator in delivering quality healthcare services internationally. However, research studies of teamwork in health care are criticized for lacking a basic conceptual understanding of what this concept represents. A universal definition for healthcare settings and professionals is missing from published literature. Walker and Avant's approach was used to guide this concept analysis. Literature searches used bibliographic databases (Medline, CINAHL, Web of Science, Proquest CSA), internet search engines (GoogleScholar), and hand searches. Literature published between 1976 and 2006 was reviewed but only material in English was included. Based on the analysis undertaken, teamwork is proposed as a dynamic process involving two or more healthcare professionals with complementary backgrounds and skills, sharing common health goals and exercising concerted physical and mental effort in assessing, planning, or evaluating patient care. This is accomplished through interdependent collaboration, open communication and shared decision-making, and generates value-added patient, organizational and staff outcomes. Praising the value of teamwork without a common understanding of what this concept represents endangers both research into this way of working and its effective utilization in practice. The proposed definition helps reconcile discrepancies between how this concept is understood by nurses and doctors, as well as allied health professionals. A common understanding can facilitate communication in educational, research and clinical settings and is imperative for improving clarity and validity of future research.
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Team Development Manual. Family Nurse Practitioner/Physician Assistant Program.
ERIC Educational Resources Information Center
Dostal, Lori
A manual is presented to help incorporate team development into training programs for nurse practitioners, physician assistants, and primary care physicians. It is also directed to practitioners who wish to improve teamwork and is designed to improve the utilization of the nurse practitioners and physician assistants. A group of one or more…
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Developing Self-Management and Teamwork Using Digital Games in 3D Simulations
ERIC Educational Resources Information Center
Cela-Ranilla, Jose M.; Esteve-Mon, Francesc M.; Esteve-González, Vanessa; Gisbert-Cervera, Merce
2014-01-01
Emerging technologies are providing opportunities for designing new learning environments, especially environments in which students can learn by putting their skills into practice. Knowledge about the development of these experiences needs to be accumulated and processed so that they can be integrated effectively into training programmes. In this…
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The Scope of Cooperative Work in the Classroom from the Viewpoint of Primary School Teachers
ERIC Educational Resources Information Center
Fernandez-Lozano, M P.; Gonzalez-Ballesteros, M.; De-Juanas, A.
2012-01-01
Introduction: Different international organisms, including UNESCO, insist on the importance of collaborative teamwork to face today's challenges. This skill should be fostered from the early stages of education, and consequently, it is particularly important that Primary School teacher training institutions draw up proposals and implement new…
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Teamwork: The Name of the Game in Recruitment.
ERIC Educational Resources Information Center
Bennett, Linda L.
This manual offers hints, guidelines, and suggestions for reaching prospective students for vocational training. Its main premise centers around alerting, encouraging, and assisting the student. A team effort is promoted; each staff member must be a part of the whole recruitment team. A section on advance planning focuses on analysis of the school…
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Interprofessional Education in Anatomy: Learning Together in Medical and Nursing Training
ERIC Educational Resources Information Center
Herrmann, Gudrun; Woermann, Ulrich; Schlegel, Claudia
2015-01-01
Teamwork and the interprofessional collaboration of all health professions are a guarantee of patient safety and highly qualified treatment in patient care. In the daily clinical routine, physicians and nurses must work together, but the education of the different health professions occurs separately in various places, mostly without interrelated…
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ERIC Educational Resources Information Center
Ong, Caroline C.; Dodds, Agnes; Nestel, Debra
2016-01-01
Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…
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RUPS: Research Utilizing Problem Solving. Classroom Version. Leader's Manual.
ERIC Educational Resources Information Center
Jung, Charles; And Others
This training manual is for teachers participating in the Research Utilizing Problem Solving (RUPS) workshops. The workshops last for four and one-half days and are designed to improve the school setting and to increase teamwork skills. The teachers participate in simulation exercises in which they help a fictitious teacher or principal solve a…
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León-Del-Barco, Benito; Mendo-Lázaro, Santiago; Felipe-Castaño, Elena; Fajardo-Bullón, Fernando; Iglesias-Gallego, Damián
2018-01-01
Cooperative learning are being used increasingly in the university classroom, in order to promote teamwork among students, improve performance and develop interpersonal competences. Responsibility and cooperation are two fundamental pillars of cooperative learning. Team members' responsibility is a necessary condition for the team's success in the assigned tasks. Students must be aware that they depend on each other and should make their maximum effort. On the other hand, in efficient groups, the members cooperate and pool their efforts to achieve the proposed goals. In this research, we propose to create a Questionnaire of Group Responsibility and Cooperation in Learning Teams (CRCG) . Participants in this work were 375 students from the Faculty of Teacher Training of the University of Extremadura (Spain). The CRCG has very acceptable psychometric characteristics, good internal consistency, and temporal reliability. Moreover, structural equation analysis allowed us to verify that the latent variables in the two factors found are well defined and, therefore, their assessment is adequate. Besides, we found high significant correlations between the Learning Team Potency Questionnaire (CPEA) and the total score and the factors of the CRCG. This tool will evaluate cooperative skills and offer faculty information in order to prepare students for teamwork and conflict resolution.
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León-del-Barco, Benito; Mendo-Lázaro, Santiago; Felipe-Castaño, Elena; Fajardo-Bullón, Fernando; Iglesias-Gallego, Damián
2018-01-01
Cooperative learning are being used increasingly in the university classroom, in order to promote teamwork among students, improve performance and develop interpersonal competences. Responsibility and cooperation are two fundamental pillars of cooperative learning. Team members’ responsibility is a necessary condition for the team’s success in the assigned tasks. Students must be aware that they depend on each other and should make their maximum effort. On the other hand, in efficient groups, the members cooperate and pool their efforts to achieve the proposed goals. In this research, we propose to create a Questionnaire of Group Responsibility and Cooperation in Learning Teams (CRCG). Participants in this work were 375 students from the Faculty of Teacher Training of the University of Extremadura (Spain). The CRCG has very acceptable psychometric characteristics, good internal consistency, and temporal reliability. Moreover, structural equation analysis allowed us to verify that the latent variables in the two factors found are well defined and, therefore, their assessment is adequate. Besides, we found high significant correlations between the Learning Team Potency Questionnaire (CPEA) and the total score and the factors of the CRCG. This tool will evaluate cooperative skills and offer faculty information in order to prepare students for teamwork and conflict resolution. PMID:29593622
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Porter, Joanne E; Cant, Robyn P; Cooper, Simon J
2018-05-01
Non-technical skills (NTS) teamwork training can enhance clinicians' understanding of roles and improve communication. We evaluated a quality improvement project rating teams' NTS performance to determine the value of formal rating and debriefing processes. In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Main themes were: 'Team composition' (allocation of resuscitation team roles), 'Resuscitation leadership' (including both nursing and medical leadership roles) and 'TEAM™ ratings promote reflective practice' (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Farver, Carol F; Smalling, Susan; Stoller, James K
2016-10-01
Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence. This paper describes our five-year experience with the CRs leadership program. Since inception, 105 CRs took the course; 81 (77%) completed before-and-after evaluations. Participants indicated that they had relatively little prior knowledge of the concepts that were presented and that the workshop greatly enhanced their familiarity with leadership competencies. Qualitative analysis of open-ended responses indicated that attendees valued the training, especially in conflict resolution and teamwork, and indicated specific action plans for applying these skills. Furthermore, the workshop spurred some participants to express plans to learn more about leadership competencies. This study extends prior experience in offering an emotional intelligence-based leadership workshop for CRs. Though the program is novel, further research is needed to more fully understand the impact of leadership training for CRs and for the institutions and patients they serve. © The Royal Australian and New Zealand College of Psychiatrists 2016.
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Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott
2017-12-01
Few scales currently exist to assess the quality of interprofessional teamwork through team members' perceptions of working together in mental health settings. The purpose of this study was to revise and validate an interprofessional scale to assess the quality of teamwork in inpatient psychiatric units and to use it multi-nationally. A literature review was undertaken to identify evaluative teamwork tools and develop an additional 12 items to ensure a broad global focus. Focus group discussions considered adaptation to different care systems using subjective judgements from 11 participants in a pre-test of items. Data quality, construct validity, reproducibility, and internal consistency were investigated in the survey using an international comparative design. Exploratory factor analysis yielded five factors with 21 items: 'patient/community centred care', 'collaborative communication', 'interprofessional conflict', 'role clarification', and 'environment'. High overall internal consistency, reproducibility, adequate face validity, and reasonable construct validity were shown in the USA and Japan. The revised Collaborative Practice Assessment Tool (CPAT) is a valid measure to assess the quality of interprofessional teamwork in psychiatry and identifies the best strategies to improve team performance. Furthermore, the revised scale will generate more rigorous evidence for collaborative practice in psychiatry internationally.
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O'Connor, Bonnie B; Eisenberg, David M; Buring, Julie E; Liang, Catherine L; Osypiuk, Kamila; Levy, Donald B; Wayne, Peter M
2015-03-01
Nonspecific chronic low back pain (CLBP) is a highly prevalent and costly public health problem with few treatment options that provide consistent and greater than modest benefits. Treatment of CLBP is shifting from unimodal to multimodal and multidisciplinary approaches, including biopsychosocially-based complementary and integrative care. Multidisciplinary approaches require unique levels of communication and coordination amongst clinicians; however, to date few studies have evaluated patterns of communication and decision making amongst clinicians collaborating in the care of challenging patients with CLBP. As part of an observational study evaluating the effectiveness and cost-effectiveness of an integrative, team-based care model for the treatment of CLBP, we used multiple qualitative research methods to characterize within-team cross-referral and communication amongst jointly-trained practitioners representing diverse biomedical and complementary disciplines. Patterns of communication and coordinated care are summarized for 3 cases of CLBP treated by multiple members (≥3) of an integrative medical team embedded within an academic hospital. Patients were aged from 36 to 88 years with varied comorbidities. Qualitative content analysis revealed 5 emergent themes regarding integrative patient care and treatment decision in this clinic: (1) the fundamental importance of the clinic's formal teamwork training; (2) the critical communicative and collaborative function of regular team meetings; (3) the importance to patient care goals of having the varied disciplines practicing "under one roof"; (4) a universal commitment to understanding and treating patients as whole persons; and (5) a shared philosophy of helping patients to help themselves. These key themes are all interconnected and form the foundation of the clinic's culture. Our qualitative findings provide context for current trends in enhancing patient-centered, coordinated, and team-based care; efforts towards better understanding interprofessional communication; overcoming barriers to successful collaboration; and identifying best practices for fostering clinical teamwork and a strong team identity. Our findings also support the need for further qualitative research, in combination with quantitative research, for evaluating the effectiveness and cost-effectiveness of resource-intensive integrative models for the treatment of chronic conditions.
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Wheeler, Derek S; Geis, Gary; Mack, Elizabeth H; LeMaster, Tom; Patterson, Mary D
2013-06-01
In situ simulation training is a team-based training technique conducted on actual patient care units using equipment and resources from that unit, and involving actual members of the healthcare team. We describe our experience with in situ simulation training in a major children's medical centre. In situ simulations were conducted using standardised scenarios approximately twice per month on inpatient hospital units on a rotating basis. Simulations were scheduled so that each unit participated in at least two in situ simulations per year. Simulations were conducted on a revolving schedule alternating on the day and night shifts and were unannounced. Scenarios were preselected to maximise the educational experience, and frequently involved clinical deterioration to cardiopulmonary arrest. We performed 64 of the scheduled 112 (57%) in situ simulations on all shifts and all units over 21 months. We identified 134 latent safety threats and knowledge gaps during these in situ simulations, which we categorised as medication, equipment, and/or resource/system threats. Identification of these errors resulted in modification of systems to reduce the risk of error. In situ simulations also provided a method to reinforce teamwork behaviours, such as the use of assertive statements, role clarity, performance of frequent updating, development of a shared mental model, performance of independent double checks of high-risk medicines, and overcoming authority gradients between team members. Participants stated that the training programme was effective and did not disrupt patient care. In situ simulations can identify latent safety threats, identify knowledge gaps, and reinforce teamwork behaviours when used as part of an organisation-wide safety programme.
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The design and delivery of crew resource management training: exploiting available resources.
Salas, E; Rhodenizer, L; Bowers, C A
2000-01-01
Despite widespread acceptance throughout commercial and military settings, crew resource management (CRM) training programs have not escaped doubts about their effectiveness. The current state of CRM training is an example of how an entire body of pertinent research and development has not had the impact on practice that it could. In this paper we outline additional resources (i.e., principles, information, findings, and guidelines) from the team training and training effectiveness research literatures that can be used to improve the design and delivery of CRM training. Some of the resources discussed include knowledge about training effectiveness, training teamwork-related skills, scenario design, and performance measurement. We conclude with a discussion of emerging resources as well as those that need to be developed. The purpose of this paper is to provide the CRM training developer with better access to resources that can be applied to the design and delivery of CRM training programs.
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Cooperative learning effects on teamwork attitudes in clinical laboratory science students.
Laatsch, Linda; Britton, Lynda; Keating, Susan; Kirchner, Phyllis; Lehman, Don; Madsen-Myers, Karen; Milson, Linda; Otto, Catherine; Spence, Libby
2005-01-01
To evaluate clinical laboratory science (CLS) student attitudes toward teamwork when using cooperative learning (CL) as compared to individual learning (IL) in a course and to determine if learning method affects student attitudes toward the course itself. This was a multi-institutional study involving eight classrooms in seven states. The effects of CL and IL on student attitudes were compared for 216 student participants. One group of students learned the course material through a CL approach while a second group of students learned via a traditional IL approach. For each course, the instructor, class material, and examination content was identical for the CL and IL students; the only variable was learning method. Student attitudes toward teamwork and toward the course were evaluated with a 35-item Attitude Questionnaire administered as a posttest. Mean scores for the CL and IL groups were compared using the Student t-test for independent samples. No significant difference was seen between the CL and IL students when assessing the first 30 questions on student attitudes toward teamwork (means = 98.42 and 98.22, respectively) when all institutions were combined. Comparable results were seen for each of the eight institutions. For the five questions comparing attitudes toward the course itself, there usually was no significant difference in attitude between CL and IL students. The only classrooms where CL students had more positive attitudes were those with instructors who had more than 10 years experience with CL. Results suggest that CL produces similar student attitudes toward teamwork and toward a CLS course as does IL.
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NASA Technical Reports Server (NTRS)
1989-01-01
The discovery that human error has caused many more airline crashes than mechanical malfunctions led to an increased emphasis on teamwork and coordination in airline flight training programs. Human factors research at Ames Research Center has produced two crew training programs directed toward more effective operations. Cockpit Resource Management (CRM) defines areas like decision making, workload distribution, communication skills, etc. as essential in addressing human error problems. In 1979, a workshop led to the implementation of the CRM program by United Airlines, and later other airlines. In Line Oriented Flight Training (LOFT), crews fly missions in realistic simulators while instructors induce emergency situations requiring crew coordination. This is followed by a self critique. Ames Research Center continues its involvement with these programs.
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Teaching Epidemiology at the Undergraduate Level: Considerations and Approaches.
Goldmann, Emily; Stark, James H; Kapadia, Farzana; McQueen, Matthew B
2018-06-01
The rapid growth in undergraduate public health education has offered training in epidemiology to an increasing number of undergraduate students. Epidemiology courses introduce undergraduate students to a population health perspective and provide opportunities for these students to build essential skills and competencies such as ethical reasoning, teamwork, comprehension of scientific methods, critical thinking, quantitative and information literacy, ability to analyze public health information, and effective writing and oral communication. Taking a varied approach and incorporating active learning and assessment strategies can help engage students in the material, improve comprehension of key concepts, and further develop key competencies. In this commentary, we present examples of how epidemiology may be taught in the undergraduate setting. Evaluation of these approaches and others would be a valuable next step.
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Non-technical skills of the operating theatre scrub nurse: literature review.
Mitchell, Lucy; Flin, Rhona
2008-07-01
This paper is a report of a review to identify the non-technical (cognitive and social) skills used by scrub nurses. Recognition that failures in non-technical skills contributed to accidents in high-risk industries led to the development of research programmes to study the role of cognition and social interactions in operational safety. Recently, psychological research in operating theatres has revealed the importance of non-technical skills in safe and efficient performance. Most of the studies to date have focused on anaesthetists and surgeons. On-line sources and university library catalogues, publications of the Association for Perioperative Practice, National Association of Theatre Nurses and Association of Peri-Operative Registered Nurses were searched in 2007. Studies were included in the review if they presented data from scrub nurses on one or more of their non-technical skills. These findings were examined in relation to an existing medical non-technical skills framework with categories of communication, teamwork, leadership, situation awareness and decision-making. Of 424 publications retrieved, 13 were reviewed in detail. Ten concerned communication and eight of those also had data on teamwork. In 11 papers teamwork was examined, and one focused on nurses' situation awareness, teamwork and communication. None of the papers we reviewed examined leadership or decision-making by scrub nurses. Further work is needed to identify formally the non-technical skills which are important to the role of scrub nurse and then to design training in the identified non-technical skills during the education and development of scrub nurses.
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Clinical leadership training: an evaluation of the Welsh Fellowship programme.
Phillips, Suzanne; Bullock, Alison
2018-05-08
Purpose UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation. Design/methodology/approach Focused on the participants ( n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities. The authors adopted a qualitative approach, collecting data from four focus groups, 20 individual face-to-face or telephone interviews with fellows and project supervisors and observation of Academi Wales training days. Findings Although from diverse specialties and stages in training, all participants reported that the Fellowship met expectations. Fellows learned leadership theory, developing understanding of leadership and teamwork in complex organisations. Through workplace projects, they applied their knowledge, learning from both success and failure. The quality of communication with fellows distinguished the better supervisors and impacted on project success. Research limitations/implications Small participant numbers limit generalisability. The authors did not evaluate longer-term impact. Practical implications Doctors are required to be both clinically proficient and influence service delivery and improve patient care. The WCLF programme addresses both the need for leadership theory (through the Academi Wales training) and the application of learning through the performance of leadership roles in the projects. Originality/value This work represents an evaluation of the only leadership programme in Wales, and outcomes have led to improvements.
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Fortugno, Mariella; Chandra, Smriti; Espin, Sherry; Gucciardi, Enza
2013-07-01
This exploratory case study examined an interprofessional placement of undergraduate students from nutrition, nursing, early childhood education, and child and youth care who collaborated to develop and deliver four healthy-living modules to secondary school students in Canada. An inductive thematic analysis was used to describe the teamwork that occurred between students. Data collected included focus groups with undergraduate students and preceptors, undergraduate students' reflections and secondary school students' evaluations of the modules delivered. Two major themes that emerged from all data sources were "team functioning" and "shift in perspectives". The undergraduate students identified several ways that facilitated their successful and positive teamwork with one another and also expressed how the placement experience improved their interprofessional skills. Findings from this study are discussed in relation to contact theory (Allport, 1954) and self-presentation theory (Goffman, 1963). This study suggests that providing undergraduate students with interprofessional placements in an educational setting can enhance interprofessional teamwork opportunities for students of various disciplines.
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Measuring teamwork and conflict among emergency medical technician personnel.
Patterson, P Daniel; Weaver, Matthew D; Weaver, Sallie J; Rosen, Michael A; Todorova, Gergana; Weingart, Laurie R; Krackhardt, David; Lave, Judith R; Arnold, Robert M; Yealy, Donald M; Salas, Eduardo
2012-01-01
We sought to develop a reliable and valid tool for measuring teamwork among emergency medical technician (EMT) partnerships. We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool (EMT-TEAMWORK). We performed a series of exploratory factor analyses (EFAs) and confirmatory factor analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. We received 687 completed surveys. The EFAs identified a nine-factor solution. We labeled these factors 1) Team Orientation, 2) Team Structure & Leadership, 3) Partner Communication, Team Support, & Monitoring, 4) Partner Trust and Shared Mental Models, 5) Partner Adaptability & Back-Up Behavior, 6) Process Conflict, 7) Strong Task Conflict, 8) Mild Task Conflict, and 9) Interpersonal Conflict. We tested a short-form (30-item SF) and long-form (45-item LF) version. The CFAs determined that both the SF and the LF possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties, with a mean Cronbach's alpha coefficient ≥0.70 across all nine factors (mean = 0.84; minimum = 0.78, maximum = 0.94). The mean Cronbach's alpha coefficient for the EMT-TEAMWORK-LF was 0.87 (minimum = 0.79, maximum = 0.94). There was wide variation in weighted scores across all nine factors and the global score for the SF and LF. Mean scores were lowest for the Team Orientation factor (48.1, standard deviation [SD] 21.5, SF; 49.3, SD 19.8, LF) and highest (more positive) for the Interpersonal Conflict factor (87.7, SD 18.1, for both SF and LF). We developed a reliable and valid survey to evaluate teamwork between EMT partners.
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Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R
2017-01-01
Objectives Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. Design A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. Setting 4 DAPs at 2 teaching and 2 community hospitals in Canada. Participants 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Results Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural–remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. Conclusions This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. PMID:28235969
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An integrative framework for sensor-based measurement of teamwork in healthcare.
Rosen, Michael A; Dietz, Aaron S; Yang, Ting; Priebe, Carey E; Pronovost, Peter J
2015-01-01
There is a strong link between teamwork and patient safety. Emerging evidence supports the efficacy of teamwork improvement interventions. However, the availability of reliable, valid, and practical measurement tools and strategies is commonly cited as a barrier to long-term sustainment and spread of these teamwork interventions. This article describes the potential value of sensor-based technology as a methodology to measure and evaluate teamwork in healthcare. The article summarizes the teamwork literature within healthcare, including team improvement interventions and measurement. Current applications of sensor-based measurement of teamwork are reviewed to assess the feasibility of employing this approach in healthcare. The article concludes with a discussion highlighting current application needs and gaps and relevant analytical techniques to overcome the challenges to implementation. Compelling studies exist documenting the feasibility of capturing a broad array of team input, process, and output variables with sensor-based methods. Implications of this research are summarized in a framework for development of multi-method team performance measurement systems. Sensor-based measurement within healthcare can unobtrusively capture information related to social networks, conversational patterns, physical activity, and an array of other meaningful information without having to directly observe or periodically survey clinicians. However, trust and privacy concerns present challenges that need to be overcome through engagement of end users in healthcare. Initial evidence exists to support the feasibility of sensor-based measurement to drive feedback and learning across individual, team, unit, and organizational levels. Future research is needed to refine methods, technologies, theory, and analytical strategies. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.
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Rixon, Andrew; Rixon, Sascha; Addae-Bosomprah, Hansel; Ding, Mingshuang; Bell, Anthony
2016-08-01
The objective of the present study is to develop and pilot a communication and influencing skills training programme that meets ED health professionals' needs at an urban district hospital. Qualitative methods within a participatory action research framework were utilised. An interdisciplinary team guided the programme's design and development. A training needs analysis saw team meetings, interviews, focus groups and observations conducted across the ED. Thematic analysis of the data identified health professionals' communication and influencing challenges. The training needs analysis informed the training programme curriculum's development. The pilot programme involved an interdisciplinary group of seven health professionals across 5 × 2 h sessions over 3 months, followed by a post-training survey. Five themes of communication and influencing challenges were identified: participating in effective handovers, involving patients in bedside handovers, effectively communicating with interdepartmental colleagues, asking ED colleagues to do tasks and understanding ED colleagues' roles, expectations and assumptions. Based on these challenges, the formulated RESPECT model (which stands for Relationships, Expectations, Styles, Partnerships, Enquiry, Coaching and Teamwork) informed the training curriculum. The peer coaching model used in the training programme was highly regarded by participants. Communication and Influencing for ED Professionals™ (Babel Fish Group Pty Ltd, Melbourne, Victoria, Australia) addresses a gap for communication programmes developed in the ED for the ED. Future research will evaluate the programme's impact in this ED. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
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Conflict management: difficult conversations with difficult people.
Overton, Amy R; Lowry, Ann C
2013-12-01
Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed.
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Teamwork--Teach Me, Teach Me Not: A Case Study of Three Australian Preservice Teachers
ERIC Educational Resources Information Center
Main, Katherine
2010-01-01
Explicit training in teaming skills (both preservice and inservice) has been identified as a key means of facilitating the effective functioning of teaching teams (Main, 2007). This case study explored how groupwork tasks within university coursework can prepare preservice education students to work effectively in teaching teams. Three students in…
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ERIC Educational Resources Information Center
Ancel, Gulsum
2016-01-01
Problem Statement: Problem-Solving (PS) skills have been determined to be an internationally useful strategy for better nursing. That is why PS skills underlie all nursing practice, teamwork, and health care management, and are a main topic in undergraduate nursing education. Thus, there is a need to develop effective methods to teach…
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Teaching Practices and Beliefs about Inclusion of General and Special Needs Teachers in Austria
ERIC Educational Resources Information Center
Schwab, Susanne; Holzinger, Andrea; Krammer, Mathias; Gebhardt, Markus; Hessels, Marco G. P.
2015-01-01
Self-reports of primary and secondary school teachers who teach in general and special education classrooms in Austria were examined in terms of their engagement in teamwork (between special and general education teachers), instructional methods that they use, factors that positively influence inclusive education, and their needs for training. The…
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The Use of Pre-Group Instruction to Improve Student Collaboration
ERIC Educational Resources Information Center
Snyder, Lisa Gueldenzoph
2010-01-01
The emphasis on the importance of collaborative skill is evident at nearly all levels of education. In higher education, teamwork and group skills are critical elements in a business student's training. To be successful in the business world, students must be able to work well in teams. Group work can be a successful learning experience if…
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The influence of personality and ability on undergraduate teamwork and team performance.
Rhee, Jinny; Parent, David; Basu, Anuradha
2013-12-01
The ability to work effectively on a team is highly valued by employers, and collaboration among students can lead to intrinsic motivation, increased persistence, and greater transferability of skills. Moreover, innovation often arises from multidisciplinary teamwork. The influence of personality and ability on undergraduate teamwork and performance is not comprehensively understood. An investigation was undertaken to explore correlations between team outcomes, personality measures and ability in an undergraduate population. Team outcomes included various self-, peer- and instructor ratings of skills, performance, and experience. Personality measures and ability involved the Five-Factor Model personality traits and GPA. Personality, GPA, and teamwork survey data, as well as instructor evaluations were collected from upper division team project courses in engineering, business, political science, and industrial design at a large public university. Characteristics of a multidisciplinary student team project were briefly examined. Personality, in terms of extraversion scores, was positively correlated with instructors' assessment of team performance in terms of oral and written presentation scores, which is consistent with prior research. Other correlations to instructor-, students' self- and peer-ratings were revealed and merit further study. The findings in this study can be used to understand important influences on successful teamwork, teamwork instruction and intervention and to understand the design of effective curricula in this area moving forward. The online version of this article (doi:10.1186/2193-1801-2-16) contains supplementary material, which is available to authorized users.
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Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian
2017-01-01
Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.
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Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian
2017-01-01
Purpose Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. Method A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. Results In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. Conclusion The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention. PMID:28704377
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Nurses' supervisors, learning options and organisational commitment: Australia, Brazil and England.
Brunetto, Yvonne; Shacklock, Kate; Teo, Stephen; Farr-Wharton, Rod; Nelson, Silvia
2015-11-01
To examine the relationships between leader-member exchange (LMX), workplace learning options (teamwork, training and development), empowerment and organisational commitment, for nurses in Australia, England and Brazil. The supervisor-employee relationship is fundamental to management theory and practice within the work context of Organisation for Economic Cooperation and Development (OECD) countries. Survey-based, self-report data were collected from 1350 nurses in 23 acute-care hospitals during 2011. Significant relationships were found between key Social Exchange Theory antecedents (LMX and teamwork) and outcomes (organisational commitment) for nurses in Australia and England, but not in Brazil. As expected, the path between teamwork and organisational commitment was significant in the three countries. The findings affirm the importance of LMX as a management tool affecting employee outcomes in OECD countries. In contrast, LMX cannot be assumed to play an important role within a context that operates a dual employment structure coupled with a culture accepting of 'Jeitinho' workplace relationships. Informal workplace relationships - 'Jeitinho' (similar to the Chinese 'guanxi') may be worthy of examination within BRICS (Brazil, Russia, India, China and South Africa) countries such as Brazil. © 2014 John Wiley & Sons Ltd.
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Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J.
2016-01-01
There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality. PMID:28970407
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Space Flight Resource Management for ISS Operations
NASA Technical Reports Server (NTRS)
Schmidt, Lacey L.; Slack, Kelley; Holland, Albert; Huning, Therese; O'Keefe, William; Sipes, Walter E.
2010-01-01
Although the astronaut training flow for the International Space Station (ISS) spans 2 years, each astronaut or cosmonaut often spends most of their training alone. Rarely is it operationally feasible for all six ISS crewmembers to train together, even more unlikely that crewmembers can practice living together before launch. Likewise, ISS Flight Controller training spans 18 months of learning to manage incredibly complex systems remotely in plug-and-play ground teams that have little to no exposure to crewmembers before a mission. How then do all of these people quickly become a team - a team that must respond flexibly yet decisively to a variety of situations? The answer implemented at NASA is Space Flight Resource Management (SFRM), the so-called "soft skills" or team performance skills. Based on Crew Resource Management, SFRM was developed first for shuttle astronauts and focused on managing human errors during time-critical events (Rogers, et al. 2002). Given the nature of life on ISS, the scope of SFRM for ISS broadened to include teamwork during prolonged and routine operations (O'Keefe, 2008). The ISS SFRM model resembles a star with one competency for each point: Communication, Cross-Culture, Teamwork, Decision Making, Team Care, Leadership/Followership, Conflict Management, and Situation Awareness. These eight competencies were developed with international participation by the Human Behavior and Performance Training Working Group. Over the last two years, these competencies have been used to build a multi-modal SFRM training flow for astronaut candidates and flight controllers that integrates team performance skills into the practice of technical skills. Preliminary results show trainee skill increases as the flow progresses; and participants find the training invaluable to performing well and staying healthy during ISS operations. Future development of SFRM training will aim to help support indirect handovers as ISS operations evolve further with the retirement of the Space Shuttle Program.
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[Innovation in healthcare processes and patient safety using clinical simulation].
Rojo, E; Maestre, J M; Díaz-Mendi, A R; Ansorena, L; Del Moral, I
2016-01-01
Many excellent ideas are never implemented or generalised by healthcare organisations. There are two related paradigms: thinking that individuals primarily change through accumulating knowledge, and believing that the dissemination of that knowledge within the organisation is the key element to facilitate change. As an alternative, a description and evaluation of a simulation-based inter-professional team training program conducted in a Regional Health Service to promote and facilitate change is presented. The Department of Continuing Education completed the needs assessment using the proposals presented by clinical units and management. Skills and behaviors that could be learned using simulation were selected, and all personnel from the units participating were included. Experiential learning principles based on clinical simulation and debriefing, were used for the instructional design. The Kirkpatrick model was used to evaluate the program. Objectives included: a) decision-making and teamwork skills training in high prevalence diseases with a high rate of preventable complications; b) care processes reorganisation to improve efficiency, while maintaining patient safety; and, c) implementation of new complex techniques with a long learning curve, and high preventable complications rate. Thirty clinical units organised 39 training programs in the 3 public hospitals, and primary care of the Regional Health Service during 2013-2014. Over 1,559 healthcare professionals participated, including nursing assistants, nurses and physicians. Simulation in healthcare to train inter-professional teams can promote and facilitate change in patient care, and organisational re-engineering. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
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Lutgendorf, Monica A; Spalding, Carmen; Drake, Elizabeth; Spence, Dennis; Heaton, Jason O; Morocco, Kristina V
2017-03-01
Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
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Whitmore, Susan C; Grefsheim, Suzanne F; Rankin, Jocelyn A
2008-06-01
The informationist programme at the Library of the National Institutes of Health (NIH) in Bethesda, MD, USA has grown to 14 informationists working with 40 clinical and basic science research teams. This case report, intended to contribute to the literature on informationist programmes, describes the NIH informationist programme, including implementation experiences, the informationists' training programme, their job responsibilities and programme outcomes. The NIH informationist programme was designed to enhance the library's service capacity. Over time, the steps for introducing the service to new groups were formalized to ensure support by leadership, the team being served and the library. Job responsibilities also evolved from traditional library roles to a wide range of knowledge management activities. The commitment by the informationist, the team and the library to continuous learning is critical to the programme's success. RESULTS / OUTCOMES: NIH scientists reported that informationists saved them time and contributed to teamwork with expert searching and point-of-need instruction. Process evaluation helped refine the programme. High-level, preliminary outcomes were identified from a survey of scientists receiving informationist services, along with key informant interviews. Process evaluation examined service implementation, informationists' training and service components. Anecdotal evidence has also indicated a favourable response to the programme.
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Curran, Vernon R; Sharpe, Dennis; Flynn, Kate; Button, Pam
2010-01-01
There has been limited research on the effect of interprofessional education (IPE) over time on the attitudes of undergraduate health and human service professional students. Previous research in this area has suggested that students from different professions report differing attitudes towards IPE and interprofessional teamwork, and such attitudes may also be influenced by other background characteristics of the students themselves (e.g., gender, age). The purpose of this study was to evaluate the longitudinal effect of the introduction of an IPE curriculum on students' attitudes towards IPE and teamwork. A time series study design was conducted to assess the attitudes of undergraduate health and human service professional students towards IPE and teamwork, and students were also asked to complete satisfaction surveys after IPE curriculum activities. Significant differences in the attitudes of students from different professions and their satisfaction with participation in IPE were reported over the duration of the study. Overall, student satisfaction with IPE participation was relatively positive; however the introduction of IPE curriculum during their undergraduate education did not appear to have a significant longitudinal effect on attitudes towards IPE or interprofessional teamwork. The findings have implications for the design and integration of IPE curriculum within existing uni-professional curriculum.
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Medicine as It Should Be: Teaching Team and Teamwork during a Palliative Care Clerkship.
Head, Barbara A; Furman, Christian Davis; Lally, Andrew M; Leake, Kimberly; Pfeifer, Mark
2018-05-01
Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills. Our objective was to assess the learning of senior medical students during a palliative care rotation. A constant comparison method based on grounded theory was used in this qualitative study. Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship. Sixty randomly selected reflective writings were analyzed. The reflective writings were analyzed to evaluate the student's experiences. Dominant themes identified were related to teams and teamwork. Eight specific themes were identified: value of IDT for team members; value of IDT for patient/family; importance of each team member; reliance on other team members; roles of team members; how teams work; team communication; and interdisciplinary assessment and care planning. Students described exposure to novel experiences and planned to incorporate newly learned behaviors in their future practice. By participating in palliative care IDTs, medical students consistently learned about teamwork within healthcare. Additionally, they learned the importance of such teamwork to patients and the team itself. Rotations with palliative care IDTs have a significant role to play in IPE and preparing medical students to practice on teams.
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Flight Operations . [Zero Knowledge to Mission Complete
NASA Technical Reports Server (NTRS)
Forest, Greg; Apyan, Alex; Hillin, Andrew
2016-01-01
Outline the process that takes new hires with zero knowledge all the way to the point of completing missions in Flight Operations. Audience members should be able to outline the attributes of a flight controller and instructor, outline the training flow for flight controllers and instructors, and identify how the flight controller and instructor attributes are necessary to ensure operational excellence in mission prep and execution. Identify how the simulation environment is used to develop crisis management, communication, teamwork, and leadership skills for SGT employees beyond what can be provided by classroom training.
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Interprofessional resuscitation rounds: a teamwork approach to ACLS education.
Dagnone, Jeffrey Damon; McGraw, Robert C; Pulling, Cheryl A; Patteson, Ann K
2008-01-01
We developed and implemented a series of interprofessional resuscitation rounds targeting fourth year nursing and medical students, and junior residents from a variety of specialty programs. Each two hour session was conducted in our patient simulation lab, and was held weekly during the academic year. Students were given specific instruction on the roles and responsibilities of resuscitation team members, and then teams of five worked through pre-defined Advanced Cardiac Life Support (ACLS) scenarios on a high fidelity patient simulator. At the end of each session students completed an anonymous evaluation of the program via a standardized questionnaire using Likert rating scales. A total of 222 evaluations (101 nursing students, 42 medical students, and 79 junior residents) were submitted from October 2005 to April 2006. Mean scores reflected a strong consensus that these rounds were valuable for their training, provided a vehicle for understanding team roles in resuscitation, and that these rounds should be mandatory for all medical and nursing trainees. Participants also expressed a desire for additional interprofessional training. Despite challenges inherent in teaching a diverse group of learners, these interprofessional resuscitation rounds were rated highly by nursing and medical trainees as valuable learning experiences.
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Are Nursing Students Appropriate Partners for the Interdisciplinary Training of Surgery Residents?
Stefanidis, Dimitrios; Ingram, Katherine M; Williams, Kristy H; Bencken, Crystal L; Swiderski, Dawn
2015-01-01
Interdisciplinary team training in a simulation center recreates clinical team interactions and holds promise in improving teamwork of clinicians by breaking down educational silos. The objective of our study was to assess the appropriateness of interdisciplinary training with general surgery residents and nursing students. Over 2 consecutive academic years (2012-2013 and 2013-2014), general surgery residents participated in interdisciplinary team-training simulation-based sessions with senior nursing students. Scenario objectives included demonstration of appropriate teamwork and communication, and clinical decision making; sessions incorporated interdisciplinary debriefing of the scenarios. Participants were asked to assess their team-training experience and the appropriateness of their team-training partner. Responses were compared. A total of 16 team-training sessions were conducted during the study period. Overall, 12 surgery residents (67%) and 44 nursing students (63%) who had participated in at least 1 session responded to the survey. Although both residents and nursing students indicated that the knowledge and team skills acquired during these sessions were useful to them in clinical practice (73% vs 86%, respectively; p = not significant), residents rated their educational value lower (3.3 vs 4.3 on a 5-point scale, respectively; p < 0.01) and only 18% of the residents felt that these sessions should be continued compared with 90% of nursing students (p < 0.05). Most useful components of the sessions were participation in the scenario (73%) and debriefing (54%) for residents and for the nursing students, debriefing (91%), observation of others (68%), and interaction with resident physicians (66%) ranked highest; 48% of student nurses preferred residents as team-training partners whereas 100% residents preferred practicing nurses and 0% with nursing students owing to their limited clinical experience. Interdisciplinary team training and debriefing of surgery residents with nursing students is feasible and highly valued by nursing students. Nevertheless, our experience indicates that residents do not prefer nursing students as team-training partners owing to their limited clinical experience and would rather train with experienced nurses. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
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Fernandez, Rosemarie; Parker, Dennis; Kalus, James S; Miller, Douglas; Compton, Scott
2007-06-15
To determine the effectiveness and student acceptance of using a human patient simulation (HPS) training module focused on interdisciplinary teamwork skills. During their second-professional year, all pharmacy students were in enrolled in Principles of Pharmacotherapy 4: Cardiovascular Diseases and Patient Care Lab IV, a problem-based learning course. As part of the patient care laboratory, students participated in a simulated case of an acutely ill patient with a hypertensive emergency. During the simulation, students performed a history and physical examination. They then worked as a team to make treatment recommendations to the nursing and physician staff members. Following the exercise, a facilitated debriefing session was conducted. Students completed satisfaction surveys to assess the quality and effectiveness of the session. Over 98% of students agreed or strongly agreed that they learned material relevant to their current studies. When compared to student lectures, 90% of students felt that they learned clinical patient care better when using a HPS mannequin in simulated patient scenarios. HPS-based learning offers a realistic training experience through which clinical knowledge and interpersonal teamwork skills can be taught. Students enjoy the experience and find it relevant to their future practice. Simulation-based training may teach certain topics better than traditional lecture formats and as such could help to fill gaps in the current pharmacy curriculum.
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Workforce development to provide person-centered care
Austrom, Mary Guerriero; Carvell, Carly A.; Alder, Catherine A.; Gao, Sujuan; Boustani, Malaz; LaMantia, Michael
2018-01-01
Objectives Describe the development of a competent workforce committed to providing patient-centered care to persons with dementia and/or depression and their caregivers; to report on qualitative analyses of our workforce’s case reports about their experiences; and to present lessons learned about developing and implementing a collaborative care community-based model using our new workforce that we call care coordinator assistants (CCAs). Method Sixteen CCAs were recruited and trained in person-centered care, use of mobile office, electronic medical record system, community resources, and team member support. CCAs wrote case reports quarterly that were analyzed for patient-centered care themes. Results Qualitative analysis of 73 cases using NVivo software identified six patient-centered care themes: (1) patient familiarity/understanding; (2) patient interest/engagement encouraged; (3) flexibility and continuity of care; (4) caregiver support/engagement; (5) effective utilization/integration of training; and (6) teamwork. Most frequently reported themes were patient familiarity – 91.8% of case reports included reference to patient familiarity, 67.1% included references to teamwork and 61.6% of case reports included the theme flexibility/continuity of care. CCAs made a mean number of 15.7 (SD = 15.6) visits, with most visits for coordination of care services, followed by home visits and phone visits to over 1200 patients in 12 months. Discussion Person-centered care can be effectively implemented by well-trained CCAs in the community. PMID:26666358
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Revisioning the Process: A Case Study in Feminist Program Evaluation.
ERIC Educational Resources Information Center
Beardsley, Rebecca M.; Miller, Michelle Hughes
2002-01-01
Conducted a case study of the evaluation of a women's substance abuse prevention program and identified three key aspects of negotiated evaluation. Discusses the processes involved in feminist evaluation, including collaborative agenda setting and cooperative teamwork. (SLD)
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Teamwork education improves trauma team performance in undergraduate health professional students.
Baker, Valerie O'Toole; Cuzzola, Ronald; Knox, Carolyn; Liotta, Cynthia; Cornfield, Charles S; Tarkowski, Robert D; Masters, Carolynn; McCarthy, Michael; Sturdivant, Suzanne; Carlson, Jestin N
2015-01-01
Effective trauma resuscitation requires efficient and coordinated care from a team of providers; however, providers are rarely instructed on how to be effective members of trauma teams. Team-based learning using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been shown to improve team dynamics among practicing professionals, including physicians and nurses. The impact of TeamSTEPPS on students being trained in trauma management in an undergraduate health professional program is currently unknown. We sought to determine the impact of TeamSTEPPS on team dynamics among undergraduate students being trained in trauma resuscitation. We enrolled teams of undergraduate health professional students from four programs: nursing, physician assistant, radiologic science, and respiratory care. After completing an online training on trauma resuscitation principles, the participants completed a trauma resuscitation scenario. The participants then received teamwork training using TeamSTEPPS and completed a second trauma resuscitation scenario identical to the first. All resuscitations were recorded and scored offline by two blinded research assistants using both the Team Emergency Assessment Measure (TEAM) and Trauma Team Performance Observation Tool (TPOT) scoring systems. Pre-test and post-test TEAM and TPOT scores were compared. We enrolled a total of 48 students in 12 teams. Team leadership, situational monitoring, and overall communication improved with TeamSTEPPS training (P=0.04, P=0.02, and P=0.03, respectively), as assessed by the TPOT scoring system. TeamSTEPPS also improved the team's ability to prioritize tasks and work together to complete tasks in a rapid manner (P<0.01 and P=0.02, respectively) as measured by TEAM. Incorporating TeamSTEPPS into trauma team education leads to improved TEAM and TPOT scores among undergraduate health professionals.
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Amery, Justin; Lapwood, Susie
2004-12-01
To identify and explore the educational needs of children's hospice doctors in England. A descriptive quantitative and qualitative survey. Children's hospices in England. All children's hospice doctors (n =55) in England were approached, and 35 (65%) consented. A questionnaire designed to survey doctors' self-assessed educational competencies (confidence and perceived need for training) in subject areas derived from analysis of existing children's palliative care literature. Educational diaries used prospectively in practice to identify areas of unmet educational need. Self-perceived confidence and usefulness scores for each subject area. An analysis of support, education and training needs deriving from educational diaries and one-to-one interviews. Confidence and usefulness scores suggest that respondents would most value support, education and training in the management of emergencies, symptoms and physical disease. Educational diary analysis revealed that respondents would most value support, education and training in communication skills, team-working skills, and personal coping strategies. There is a disparity between educational needs as derived from self-rated competencies and from educational diary keeping; suggesting that children's hospice doctors may not be fully aware of their own educational, support and training needs. Self-rated competencies emphasise the value of education in craft or clinical skills; whereas personal diary keeping emphasises the value of education in intrapersonal and interpersonal skills such as communication, team-working and personal coping skills. The current curricula and educational resources need to acknowledge that interpersonal and intrapersonal competencies are as important as clinical competencies. While the study looks particularly at the educational needs of children's hospice doctors, readers may feel that the findings are of relevance to all specialities and disciplines.
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Casado-Mejía, Rosa; Brea-Ruiz, Ma Teresa; Torres-Enamorado, Dolores; Albar-Marín, Ma Jesús; Botello-Hermosa, Alicia; Santos-Casado, María; Casado-Rojas, Irene
2016-01-01
The Hospital Universitario Virgen del Rocío (HUVR) of Seville was chosen as the reference Andalusian site to treat possible cases of Ebola. After the health alert (WHO, 2014), a voluntary group of healthcare and non-healthcare professionals was set up, which, after being trained, treated a possible case. In this light, the aim is to understand the motivations and emotional experiences of this group and to identify the facilitators of and obstacles to its operation. Qualitative, interpretative and phenomenological study. Observation unit: professional team of the HUVR trained to treat Ebola cases. Analysis units: teamwork, motivations and emotions. Three interviews with key informants were conducted, as well as three discussion groups involving 23 of the 60 team members (2014-2016). A content analysis of the motivations, emotions and elements affecting the team's operation was conducted with QSRNUDISTVivo10. data sources, techniques and disciplinary perspectives were triangulated. The results were presented to the team, which duly agreed with the findings. Training, professional responsibility, professional self-esteem, risk appetite or loyalty to the leader stood out as motivations to voluntarily join the team. Emotional experiences evolved from fear and stress to self-pressure control, while essential elements for the team's operation were found to be calmness and confidence based on training and teamwork. Family, source department, resources, communication media and emotional management were facilitators of or obstacles to the team's success. An understanding of the key motivational and influential factors may be important in the management of effective and successful multidisciplinary teams during health alerts. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
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Dynes, Michelle M; Stephenson, Rob; Hadley, Craig; Sibley, Lynn M
2014-01-01
Worldwide, a shortage of skilled health workers has prompted a shift toward community-based health workers taking on greater responsibility in the provision of select maternal and newborn health services. Research in mid- and high-income settings suggests that coworker collaboration increases productivity and performance. A major gap in this research, however, is the exploration of factors that influence teamwork among diverse community health worker cadres in rural, low-resource settings. The purpose of this study is to examine how sociodemographic and structural factors shape teamwork among community-based maternal and newborn health workers in Ethiopia. A cross-sectional survey was conducted with health extension workers, community health development agents, and traditional birth attendants in 3 districts of the West Gojam Zone in the Amhara region of Ethiopia. Communities were randomly selected from Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) sites; health worker participants were recruited using a snowball sampling strategy. Fractional logit modeling and average marginal effects analyses were carried out to identify the influential factors for frequency of work interactions with each cadre. One hundred and ninety-four health workers participated in the study. A core set of factors-trust in coworkers, gender, and cadre-were influential for teamwork across groups. Greater geographic distance and perception of self-interested motivations were barriers to interactions with health extension workers, while greater food insecurity (a proxy for wealth) was associated with increased interactions with traditional birth attendants. Interventions that promote trust and gender sensitivity and improve perceptions of health worker motivations may help bridge the gap in health services delivery between low- and high-resource settings. Inter-cadre training may be one mechanism to increase trust and respect among diverse health workers, thereby increasing collaboration. Large-scale, longitudinal research is needed to understand how changes in trust, gender norms, and perceptions of motivations influence teamwork over time. © 2014 by the American College of Nurse-Midwives.
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Conflict Management: Difficult Conversations with Difficult People
Overton, Amy R.; Lowry, Ann C.
2013-01-01
Conflict occurs frequently in any workplace; health care is not an exception. The negative consequences include dysfunctional team work, decreased patient satisfaction, and increased employee turnover. Research demonstrates that training in conflict resolution skills can result in improved teamwork, productivity, and patient and employee satisfaction. Strategies to address a disruptive physician, a particularly difficult conflict situation in healthcare, are addressed. PMID:24436688
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International Disability Educational Alliance (IDEAnet)
2011-12-01
engineer ing projects , capacity- building education programs, interactive online tools, and advocacy on disability rights. Initially, the CIR focused...lead to a long-term project for data collection in Kenya and other parts of the world where similar studies are underway. D1: Design and...of 206 and to f acilitate multi- and in ter-disciplinary teamwork between rehabilitation professionals The course/training includes both
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Multiprofessional education to stimulate collaboration: a circular argument and its consequences.
Roodbol, Petrie F
2010-01-01
The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance.
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Boosting productivity: a framework for professional/amateur collaborative teamwork
NASA Astrophysics Data System (ADS)
Al-Shedhani, Saleh S.
2002-11-01
As technology advances, remote operation of telescopes has paved the way for joint observational projects between Astronomy clubs. Equipped with a small telescope, a standard CCD, and a networked computer, the observatory can be set up to carry out several photometric studies. However, most club members lack the basic training and background required for such tasks. A collaborative network between professionals and amateurs is proposed to utilize professional know-how and amateurs' readiness for continuous observations. Working as a team, various long-term observational projects can be carried out using small telescopes. Professionals can play an important role in raising the standards of astronomy clubs via specialized training programs for members on how to use the available technology to search/observe certain events (e.g. supernovae, comets, etc.). Professionals in return can accumulate a research-relevant database and can set up an early notification scheme based on comparative analyses of the recently-added images in an online archive. Here we present a framework for the above collaborative teamwork that uses web-based communication tools to establish remote/robotic operation of the telescope, and an online archive and discussion forum, to maximize the interactions between professionals and amateurs and to boost the productivity of small telescope observatories.
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Management Commitment to Safety, Teamwork, and Hospital Worker Injuries.
McGonagle, Alyssa K; Essenmacher, Lynnette; Hamblin, Lydia; Luborsky, Mark; Upfal, Mark; Arnetz, Judith
2016-01-01
Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organizational records of worker injuries and survey responses regarding management commitment to safety and teamwork from 446 hospital workers within 42 work units in a multi-site hospital system were examined. Results underscored the particular importance of teamwork on worker injuries as well as the importance of management commitment to safety as relating to teamwork. To improve worker safety, organizational leaders and unit managers should work to maintain environments wherein teamwork can thrive.
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Management Commitment to Safety, Teamwork, and Hospital Worker Injuries
McGonagle, Alyssa K.; Essenmacher, Lynnette; Hamblin, Lydia; Luborsky, Mark; Upfal, Mark; Arnetz, Judith
2016-01-01
Although many studies link teamwork in health care settings to patient safety, evidence linking teamwork to hospital worker safety is lacking. This study addresses this gap by providing evidence linking teamwork perceptions in hospital workers to worker injuries, and further, finds a linkage between manager commitment to safety and teamwork. Organizational records of worker injuries and survey responses regarding management commitment to safety and teamwork from 446 hospital workers within 42 work units in a multi-site hospital system were examined. Results underscored the particular importance of teamwork on worker injuries as well as the importance of management commitment to safety as relating to teamwork. To improve worker safety, organizational leaders and unit managers should work to maintain environments wherein teamwork can thrive. PMID:27867448
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Brewer, Margo L; Stewart-Wynne, Edward G
2013-11-01
Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process. An interprofessional practice program was established with six beds within a general medical ward. This provided the setting for 2- to 3-week clinical placements for students from medicine, nursing, physiotherapy, occupational therapy, social work, pharmacy, dietetics and medical imaging. Following an initial trial, the training ward began with 79 students completing a placement. An interprofessional capability framework focused on the delivery of high quality client care and effective teamwork underpins this learning experience. Quantitative outcome data showed not only an improvement in students' attitudes towards interprofessional collaboration but also acquisition of a high level of interprofessional practice capabilities. Qualitative outcome data from students and clients was overwhelmingly positive. Suggestions for improvement were identified. This innovative learning environment facilitated the development of the students' knowledge, skills and attitudes required for interprofessional, client centred collaborative practice. Staff reported a high level of compliance with clinical safety and quality.
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Calvert, Katrina L; McGurgan, Paul M; Debenham, Edward M; Gratwick, Frances J; Maouris, Panos
2013-12-01
Obstetric emergencies contribute significantly to maternal morbidity and mortality. Current training in the management of obstetric emergencies in Australia and internationally focusses on utilising a multidisciplinary simulation-based model. Arguments for and against this type of training exist, using both economic and clinical reasoning. To identify the evidence base for the clinical impact of simulation training in obstetric emergencies and to address some of the concerns regarding appropriate delivery of obstetric emergency training in the Australian setting. A literature search was performed to identify research undertaken in the area of obstetric emergency training. The initial literature search using broad search terms identified 887 articles which were then reviewed and considered for inclusion if they provided original research with a specific emphasis on the impact of training on clinical outcomes. Ninety-two articles were identified, comprising evidence in the following clinical situations: eclampsia, shoulder dystocia, postpartum haemorrhage, maternal collapse, cord prolapse and teamwork training. Evidence exists for a benefit in knowledge or skills gained from simulation training and for the benefit of training in small units without access to high-fidelity equipment or facilities. Evidence exists for a positive impact of training in obstetric emergencies, although the majority of the available evidence applies to evaluation at the level of participants' confidence, knowledge or skills rather than at the level of impact on clinical outcomes. The model of simulation-based training is an appropriate one for the Australian setting and should be further utilised in rural and remote settings. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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Clay-Williams, Robyn; Greenfield, David; Stone, Judy; Braithwaite, Jeffrey
2014-01-01
Evidence suggests that Crew Resource Management (CRM), a form of team training, is beneficial. In CRM training, participants learn individual portable team skills such as communication and decision making through group discussion and activities. However, the usual 1-day course format is not always compatible with health care organizational routines. A modular training format, while theoretically sound, is untested for interprofessional team training. The aim of this study was to explore the potential for modularized CRM training to be delivered to a group of interprofessional learners. Modularized CRM training, consisting of two 2-hour workshops, was delivered to health care workers in an Australian tertiary hospital. Kirkpatrick's evaluation model provided a framework for the study. Baseline attitude surveys were conducted prior to each workshop. Participants completed a written questionnaire at the end of each workshop that examined their motivations, reactions to the training, and learner demographics. An additional survey, administered 6 weeks post training, captured self-assessed behavior data. Twenty-three individuals from a range of professions and clinical streams participated. One in 5 participants (22%) reported that they translated teamwork skills to the workplace. While positive about the workshop format and content, many respondents identified personal, team, and organizational barriers to the application of the workshop techniques. CRM training when delivered in a modular format has positive outcomes. Following the training, some respondents overcame workplace barriers to attempt to change negative workplace behavior. This progress provides cautious optimism for the potential for modular CRM training to benefit groups of interprofessional health staff. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.
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A mixed-methods study of interprofessional learning of resuscitation skills.
Bradley, Paul; Cooper, Simon; Duncan, Fiona
2009-09-01
This study aimed to identify the effects of interprofessional resuscitation skills teaching on medical and nursing students' attitudes, leadership, team-working and performance skills. Year 2 medical and nursing students learned resuscitation skills in uniprofessional or interprofessional settings, prior to undergoing observational ratings of video-recorded leadership, teamwork and skills performance and subsequent focus group interviews. The Readiness for Interprofessional Learning Scale (RIPLS) was administered pre- and post-intervention and again 3-4 months later. There was no significant difference between interprofessional and uniprofessional teams for leadership, team dynamics or resuscitation tasks performance. Gender, previous interprofessional learning experience, professional background and previous leadership experience had no significant effect. Interview analysis showed broad support for interprofessional education (IPE) matched to clinical reality with perceived benefits for teamwork, communication and improved understanding of roles and perspectives. Concerns included inappropriate role adoption, hierarchy issues, professional identity and the timing of IPE episodes. The RIPLS subscales for professional identity and team-working increased significantly post-intervention for interprofessional groups but returned to pre-test levels by 3-4 months. However, interviews showed interprofessional groups retained a 'residual positivity' towards IPE, more so than uniprofessional groups. An intervention based on common, relevant, shared learning outcomes set in a realistic educational context can work with students who have differing levels of previous IPE and skills training experience. Qualitatively, positive attitudes outlast quantitative changes measured using the RIPLS. Further quantitative and qualitative work is required to examine other domains of learning, the timing of interventions and impact on attitudes towards IPE.
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Teamwork methods for accountable care: relational coordination and TeamSTEPPS®.
Gittell, Jody Hoffer; Beswick, Joanne; Goldmann, Don; Wallack, Stanley S
2015-01-01
To deliver greater value in the accountable care context, the Institute of Medicine argues for a culture of teamwork at multiple levels--across professional and organizational siloes and with patients and their families and communities. The logic of performance improvement is that data are needed to target interventions and to assess their impact. We argue that efforts to build teamwork will benefit from teamwork measures that provide diagnostic information regarding the current state and teamwork interventions that can respond to the opportunities identified in the current state. We identify teamwork measures and teamwork interventions that are validated and that can work across multiple levels of teamwork. We propose specific ways to combine them for optimal effectiveness. We review measures of teamwork documented by Valentine, Nembhard, and Edmondson and select those that they identified as satisfying the four criteria for psychometric validation and as being unbounded and therefore able to measure teamwork across multiple levels. We then consider teamwork interventions that are widely used in the U.S. health care context, are well validated based on their association with outcomes, and are capable of working at multiple levels of teamwork. We select the top candidate in each category and propose ways to combine them for optimal effectiveness. We find relational coordination is a validated multilevel teamwork measure and TeamSTEPPS® is a validated multilevel teamwork intervention and propose specific ways for the relational coordination measure to enhance the TeamSTEPPS intervention. Health care systems and change agents seeking to respond to the challenges of accountable care can use TeamSTEPPS as a validated multilevel teamwork intervention methodology, enhanced by relational coordination as a validated multilevel teamwork measure with diagnostic capacity to pinpoint opportunities for improving teamwork along specific dimensions (e.g., shared knowledge, timely communication) and in specific role relationships (e.g., nurse/medical assistant, emergency unit/medical unit, primary care/specialty care).
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Team-based learning for psychiatry residents: a mixed methods study
2013-01-01
Background Team-based learning (TBL) is an effective teaching method for medical students. It improves knowledge acquisition and has benefits regarding learner engagement and teamwork skills. In medical education it is predominately used with undergraduates but has potential benefits for training clinicians. The aims of this study were to examine the impact of TBL in a sample of psychiatrists in terms of classroom engagement, attitudes towards teamwork, learner views and experiences of TBL. Methods Forty-four psychiatry residents participated in an Addictions Psychiatry TBL module. Mixed-methods were used for evaluation. Self-rated measures of classroom engagement (Classroom Engagement Survey, CES) were compared with conventional lectures, and attitudes regarding the value of teams (Value of Teams Scale, VTS) were compared before and after the module. Independent t-tests were used to compare ‘lecture’ CES scores with TBL CES scores and pre and post scores for the VTS. Feedback questionnaires were completed. Interviews were conducted with a subset of residents and transcripts analysed using thematic analysis. Results Twenty-eight residents completed post-course measures (response rate 63.6%). Seven participants volunteered for qualitative interviews–one from each team. There was a significant difference in the mean CES score lectures compared to TBL (p < 0.001) but no difference was found in mean VTS score pre and post for either subscale (p = 0.519; p = 0.809). All items on the feedback questionnaire were positively rated except two regarding session preparation. The qualitative analysis generated seven themes under four domains: ‘Learning in teams’, ‘Impact on the individual learner’, ‘Relationship with the teacher’ and ‘Efficiency and effectiveness of the learning process’. Conclusions In this group of residents, TBL significantly improved learner-rated classroom engagement and seemed to promote interactivity between learners. TBL was generally well-received, although required learners to prepare for class which was difficult for some. TBL did not change these clinicians’ views about teamwork. PMID:24025540
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Auerbach, Andrew D; Sehgal, Niraj L; Blegen, Mary A; Maselli, Judith; Alldredge, Brian K; Vittinghoff, Eric; Wachter, Robert M
2012-02-01
Improving communication between caregivers is an important approach to improving safety. To implement teamwork and communication interventions and evaluate their impact on patient outcomes. A prospective, interrupted time series of a three-phase a run-in period (phase 1), during which a training programme was given to providers and staff on each unit; phase 2, which focused on unit-based safety teams to identify and address care problems using skills from phase 1; and phase 3, which focused on engaging patients in communication efforts. General medical inpatient units at three northern California hospitals. Administrative data were collected from all adults admitted to the target units, and a convenience sample of patients interviewed during and after hospitalisation. Readmission, length of stay and patient reports of teamwork, problems with care, and overall satisfaction. 10 977 patients were admitted; 581 patients (5.3% of total sample) were interviewed in hospital, and 313 (2.9% overall, 53.8% of interviewed patients) completed 1-month surveys. No phase of the study was associated with adjusted differences in readmission or length of stay. The phase 2 intervention appeared to be associated with improvement in reports of whether physicians treated them with respect, whether nurses treated them with respect or understood their needs (p<0.05 for all). Interestingly, patients were more likely to perceive that an error took place with their care and agreed less that their caregivers worked well together as a team. No phase had a consistent impact on patient reports of care processes or overall satisfaction. Limitations The study lacks direct measures of patient safety. Efforts to simultaneously improve caregivers' ability to troubleshoot care and enhance communication may improve patients' perception of team functions, but may also increase patients' perception of safety gaps.
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A picture tells 1000 words: learning teamwork in primary care.
Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun; Foley, Tony
2013-04-01
Teamwork and patient centredness are frequently articulated concepts in medical education, but are not always explicit in the curriculum. In Ireland, recent government policy emphasises the importance of a primary care team approach to health care. We report on an appraisal of a newly introduced community-based student attachment, which focused on teamwork. To review students' experience of teamwork following a community clinical placement by examining student assignments: essays, poetry, music and art. Year-2 graduate-entry students (n = 45) spent 2 weeks with a primary care team. Attachments comprised placements with members of the primary care team, emphasising team dynamics, at the end of which students submitted a representative piece of work, which captured their learning. Essays (n = 22) were analysed using a thematic content analysis. Artwork consisted of painting, collage, photography, poetry and original music (n = 23). These were analysed using Gardner's entry points. Three core themes emerged in both written and visual work: patient centredness; communication; and an improved appreciation of the skills of other health care professionals. Students identified optimal team communication occurring when patient outcomes were prioritised. Metaphors relating to puzzles, hands and inter-connectedness feature strongly. The poems and artwork had a high impact when they were presented to tutors. Primary care team placements focus student attention on teamwork and patient centredness. Student artwork shows potential as a tool to evaluate student learning in medical education. © Blackwell Publishing Ltd 2013.
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Carson, O M; Laird, E A; Reid, B B; Deeny, P G; McGarvey, H E
2018-02-22
A cohort of year two students (n = 181) was exposed to a transformational and experiential learning intervention in the form of team-led poster development workshops to enhance competence and interpersonal skills for working in teams. The aims of this study were to test the suitability of an amended TeamSTEPPS teamwork perceptions questionnaire (T-TPQ) for measuring the impact of the intervention on students' perceptions of team working, and to ascertain students' views about the experience. This was a two phase pilot study. Phase 1 was a repeated measures design to test the T-TPQ for evaluating the impact of the experiential intervention, and Phase 2 was a survey of students' views and opinions. Descriptive and statistical analysis of the data were performed. Our findings suggest that age and part-time employment mediate towards more positive teamwork perceptions. Teamwork perceptions increased from week 3 to week 9 of the experiential intervention, and students viewed the experience positively. This was the first time that the T-TPQ was tested for suitability for measuring the impact of an experiential learning intervention among nursing students. Despite limitations, our study indicates that the amended T-TPQ is sensitive to changes in teamwork perceptions in repeated measures design studies among nursing students. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Honein-AbouHaidar, Gladys N; Stuart-McEwan, Terri; Waddell, Tom; Salvarrey, Alexandra; Smylie, Jennifer; Dobrow, Mark J; Brouwers, Melissa C; Gagliardi, Anna R
2017-02-23
Diagnostic assessment programmes (DAPs) can reduce wait times for cancer diagnosis, but optimal DAP design is unknown. This study explored how organisational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. A mixed-methods approach integrated data from descriptive qualitative interviews and medical record abstraction at 4 lung cancer DAPs. Findings were analysed with the Integrated Team Effectiveness Model. 4 DAPs at 2 teaching and 2 community hospitals in Canada. 22 staff were interviewed about organisational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged teamwork and service delivery: referral volume/workload, time since launch, days per week of operation, rural-remote population, number and type of full-time/part-time human resources, staff colocation, information systems. As a result, all sites failed to meet target benchmarks (from referral to consultation median 4.0 visits, median wait time 35.0 days). Recommendations included improved information systems, more staff in all specialties, staff colocation and expanded roles for patient navigators. Findings were captured in a conceptual framework of lung cancer DAP teamwork determinants and outcomes. This study identified several DAP characteristics that could be improved to facilitate teamwork and enhance service delivery, thereby contributing to knowledge of organisational determinants of teamwork and associated outcomes. Findings can be used to update existing DAP guidelines, and by managers to plan or evaluate lung cancer DAPs. Ongoing research is needed to identify ideal roles for navigators, and staffing models tailored to case volumes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter
2012-03-01
To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.
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Multidisciplinary team simulation for the operating theatre: a review of the literature.
Tan, Shaw Boon; Pena, Guilherme; Altree, Meryl; Maddern, Guy J
2014-01-01
Analyses of adverse events inside the operating theatre has demonstrated that many errors are caused by failure in non-technical skills and teamwork. While simulation has been used successfully for teaching and improving technical skills, more recently, multidisciplinary simulation has been used for training team skills. We hypothesized that this type of training is feasible and improves team skills in the operating theatre. A systematic search of the literature for studies describing true multidisciplinary operating theatre team simulation was conducted in November and December 2012. We looked at the characteristics and outcomes of the team simulation programmes. 1636 articles were initially retrieved. Utilizing a stepwise evaluation process, 26 articles were included in the review. The studies reveal that multidisciplinary operating theatre simulation has been used to provide training in technical and non-technical skills, to help implement new techniques and technologies, and to identify latent weaknesses within a health system. Most of the studies included are descriptions of training programmes with a low level of evidence. No randomized control trial was identified. Participants' reactions to the training programme were positive in all studies; however, none of them could objectively demonstrate that skills acquired from simulation are transferred to the operating theatre or show a demonstrable benefit in patient outcomes. Multidisciplinary operating room team simulation is feasible and widely accepted by participants. More studies are required to assess the impact of this type of training on operative performance and patient safety. © 2013 Royal Australasian College of Surgeons.
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Sustaining simulation training programmes--experience from maternity care.
Ayres-de-Campos, D; Deering, S; Siassakos, D
2011-11-01
There is little scientific evidence to support the majority of simulation-based maternity training programmes, but some characteristics appear to be associated with sustainability. Among these are a clear institutional-level commitment to the course, strong leadership in course organisation, a curriculum relevant to clinical practice, a nonthreatening learning environment, the establishment of multiprofessional training and the use of simulators appropriate to the learning objectives. There is still some debate on whether simulation-based sessions should be carried out in dedicated training time outside normal working hours or in ad-hoc drills that are run during clinical sessions, whether they should be located in clinical areas, simulation centres, or both, and whether or not they should include standardised generic teamwork training sessions. In this review, we discuss the main characteristics that appear to make a simulation-based training programme a sustainable initiative. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.
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Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra
2016-01-01
Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.
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Shoushtarian, M; Barnett, M; McMahon, F; Ferris, J
2014-12-01
To assess the introduction of Practical Obstetric Multi-professional Training (PROMPT) into maternity units and evaluate effects on organisational culture and perinatal outcomes. A retrospective cohort study. Maternity units in eight public hospitals in metropolitan and regional Victoria, Australia. Staff in eight maternity units and a total of 43,408 babies born between July 2008 and December 2011. Representatives from eight Victorian hospitals underwent a single day of training (Train the Trainer), to conduct PROMPT. Organisational culture was compared before and after PROMPT. Clinical outcomes were evaluated before, during and after PROMPT. The number of courses run and the proportion of staff trained were determined. Organisational culture was measured using the Safety Attitude Questionnaire. Clinical measures included Apgar scores at 1 and 5 minutes (Apgar 1 and Apgar 5), cord lactate, blood loss and length of baby's stay in hospital. Seven of the eight hospitals conducted PROMPT. Overall about 50% of staff were trained in each year of the study. Significant increases were found in Safety Attitude Questionnaire scores representing domains of teamwork (Hedges' g 0.27, 95% confidence interval [95% CI] 0.13-0.41), safety (Hedges' g 0.28, 95% CI 0.15-0.42) and perception of management (Hedges' g 0.17, 95% CI 0.04-0.31). There were significant improvements in Apgar 1 (OR 0.84, 95% CI 0.77-0.91), cord lactates (odds ratio 0.92, 95% CI 0.85-0.99) and average length of baby's stay in hospital (Hedges' g 0.03, 95% CI 0.01-0.05) during or after training, but no change in Apgar 5 scores or proportion of cases with high blood loss. PROMPT can be introduced using the Train the Trainer model. Improvements in organisational culture and some clinical measures were observed following PROMPT. © 2014 Royal College of Obstetricians and Gynaecologists.
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Improving teamwork and communication in trauma care through in situ simulations.
Miller, Daniel; Crandall, Cameron; Washington, Charles; McLaughlin, Steven
2012-05-01
Teamwork and communication often play a role in adverse clinical events. Due to the multidisciplinary and time-sensitive nature of trauma care, the effects of teamwork and communication can be especially pronounced in the treatment of the acutely injured patient. Our hypothesis was that an in situ trauma simulation (ISTS) program (simulating traumas in the trauma bay with all members of the trauma team) could be implemented in an emergency department (ED) and that this would improve teamwork and communication measured in the clinical setting. This was an observational study of the effect of an ISTS program on teamwork and communication during trauma care. The authors observed a convenience sample of 39 trauma activations. Cases were selected by their presenting to the resuscitation bay of a Level I trauma center between 09:00 and 16:00, Monday through Thursday, during the study period. Teamwork and communication were measured using the previously validated Clinical Teamwork Scale (CTS). The observers were three Trauma Nursing Core Course certified RNs trained on the CTS by observing simulated and actual trauma cases and following each of these cases with a discussion of appropriate CTS scores with two certified Advanced Trauma Life Support instructors/emergency physicians. Cases observed for measurement were scored in four phases: 1) preintervention phase (baseline); 2) didactic-only intervention, the phase following a lecture series on teamwork and communication in trauma care; 3) ISTS phase, real trauma cases scored during period when weekly ISTSs were performed; and 4) potential decay phase, observations following the discontinuation of the ISTSs. Multirater agreement was assessed with Krippendorf's alpha coefficient; agreement was excellent (mean agreement = 0.92). Nonparametric procedures (Kruskal-Wallis) were used to test the hypothesis that the scores observed during the various phases were different and to compare each individual phase to baseline scores. The ISTS program was implemented and achieved regular participation of all components of our trauma team. Data were collected on 39 cases. The scores for 11 of 14 measures improved from the baseline to the didactic phase, and the mean and median scores of all CTS component measures were greatest during the ISTS phase. When each phase was compared to baseline scores, using the baseline as a control, there were no significant differences seen during the didactic or the decay phases, but 12 of the 14 measures showed significant improvements from the baseline to the simulation phase. However, when the Kruskal-Wallis test was used to test for differences across all phases, only overall communication showed a significant difference. During the potential decay phase, the scores for every measure returned to baseline phase values. This study shows that an ISTS program can be implemented with participation from all members of a multidisciplinary trauma team in the ED of a Level I trauma center. While teamwork and communication in the clinical setting were improved during the ISTS program, this effect was not sustained after ISTS were stopped. © 2012 by the Society for Academic Emergency Medicine.
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1992-01-01
Several trains and a power plant were successfully attacked as far east as Troyes and Soissons. It was moving day, this time from the vicinity of...planes were seen. Flying armed reconnaissance ahead of our columns thrusting east past Sens and Troyes , P-47’s had just dropped eight 5oo-pound bombs
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Developing teamwork skills in capstone design courses.
Goldberg, Jay
2010-01-01
The majority of our biomedical engineering graduates will eventually work in an industry where they will be part of multidisciplinary teams that use the collective skills, expertise, experience, and training of each team member. Diversity within these teams provides different perspectives, opinions, and ways of viewing problems, leading to a larger set of potential solutions. Successful careers require engineers to be able to function on multidisciplinary teams.
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Wages and Skills Utilization: Effect of Broad Skills and Generic Skills on Wages in Singapore
ERIC Educational Resources Information Center
Ramos, Catherine R.; Ng, Michael Chi Man; Sung, Johnny; Loke, Fiona
2013-01-01
Many people go for training to upgrade their skills which is hoped to pave the way for better pay. But what are the kinds of skills that really affect wages? Employers have emphasized the value of generic skills such as interpersonal and communication skills, teamwork and problem solving. Does possession of these skills translate to at least the…
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Total Quality Management: Getting Started
1990-08-01
Quality Management (TQM) program using Organizational Development (OD) intervention techniques to gain acceptance of the program. It emphasizes human behavior and the need for collaborative management and consensus in organizational change. Lessons learned stress the importance of choosing a skilled TQM facilitator, training process action teams, and fostering open communication and teamwork to minimize resistance to change. Keywords: Management planning and control, Quality control, Quality , Management , Organization change, Organization development,
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Multiprofessional education to stimulate collaboration: a circular argument and its consequences
Roodbol, Petrie F.
2010-01-01
The current developments in healthcare are unprecedented. The organization of health care is complex. Collaboration is essential to meet all the healthcare needs of patients and to achieve coordinated and unambiguous information. Multiprofessional education (MPE) or multidisciplinary training (MDT) seems a logical step to stimulate teamwork. However, collaboration and MPE are wrestling with the same problems: social identity and acceptance. PMID:21818197
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Damian, April Joy; Gallo, Joseph; Leaf, Philip; Mendelson, Tamar
2017-11-21
While there is increasing support for training youth-serving providers in trauma-informed care (TIC) as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers' professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Government workers and nonprofit professionals (N = 90) who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16) was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Analysis of survey data indicated significant improvements in participants' organizational culture and professional satisfaction at training completion. Participants' perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including "Implementation of more flexible, less-punitive policies towards clients," "Adoption of trauma-informed workplace design," "Heightened awareness of own traumatic stress and need for self-care," and "Greater sense of camaraderie and empathy for colleagues." Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and individual factors including providers' compassion satisfaction, burnout, and secondary traumatic stress, to better support TIC implementation.
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Performance Evaluation: A Deadly Disease?
ERIC Educational Resources Information Center
Aluri, Rao; Reichel, Mary
1994-01-01
W. Edwards Deming condemned performance evaluations as a deadly disease afflicting American management. He argued that performance evaluations nourish fear, encourage short-term thinking, stifle teamwork, and are no better than lotteries. This article examines library literature from Deming's perspective. Although that literature accepts…
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Overseas trained nurses' perception of UK nurses' caring attitudes: a qualitative study.
Alexis, Obrey
2009-08-01
The aim of this study was to explore overseas nurses' perception of their nursing colleagues' caring attitudes in the National Health Service (NHS) in the UK. A qualitative phenomenological approach using semi-structured interviews was used to obtain data from 12 overseas nurses. The interview transcripts were transcribed verbatim and analysed using van Manen thematic approach. Although many themes emerged following thematic analysis, this study will report the findings of three themes such as empathy, understanding and caring perspectives, emotional impact and lack of teamwork. In conclusion, this study provides an insight and it increases our understanding of overseas nurses' perceptions of their nursing colleagues' caring attitudes in the NHS in the UK. This paper concludes by indicating that teamwork, being empathetic, understanding and reducing emotional labour for overseas nurses could lead to a more satisfied working environment for overseas nurses in the NHS in the UK.
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Trevena, Lyndal J
2007-01-01
Problem-based learning (PBL) has been implemented within numerous undergraduate health curricula but less so in workforce training. Public health practice requires many of the skills that PBL aims to develop such as teamwork, self-directed learning and the integration of multiple sources of information within problem solving. This paper summarises the historical development of PBL and the educational principles underpinning it. It hypothesises that the public health workforce would benefit from some exposure to this type of learning and highlights some of the practical issues for its implementation.
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1992-08-01
Tanzer, 1988) 200 Lee placed great emphasis on employee training, and developed the Samsung Education and Training Center modeled after Matsushita’s...their employees was credited with this huge success. By 1988 Samsung had the capability to produce between five to eight million 256K DRAM chips per...organization in which everyone, from top management to the lowest line level employees , had to work together as a team. The concept of teamwork at every
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A Multifaceted Approach to Teamwork Assessment in an Undergraduate Business Program
ERIC Educational Resources Information Center
Kemery, Edward R.; Stickney, Lisa T.
2014-01-01
We describe a multifaceted, multilevel approach to teamwork learning and assessment. It includes teamwork knowledge, peer and self-appraisal of teamwork behavior, and individual and team performance on objective tests for teaching and assessing teamwork in an undergraduate business program. At the beginning of this semester-long process, students…
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Corvin, Jaime A.; DeBate, Rita; Wolfe-Quintero, Kate; Petersen, Donna J.
2017-01-01
Public health professionals have been challenged to radically reform public health training to meet evolving demands of twenty-first century public health. Such a transformation requires a systems thinking approach with an interdisciplinary focus on problem solving, leadership, management and teamwork, technology and information, budgeting and finance, and communication. This article presents processes for implementing and evaluating a revised public health curriculum and outlines lessons learned from this initiative. To date, more than 200 students have participated in the initial pilot testing of this program. A rigorous process and outcome evaluation plan was developed and employed. Results from the evaluation were used to enhance the resulting curriculum. Specifically, all instructional materials were evaluated by both the students who received the materials and the faculty who presented the materials. As each successive pilot is delivered, both enrollment and faculty involvement has increased. Through this process, the value of committed faculty, the importance of engaging learners in the evaluation of an education program, and the need to implement curriculum that has been carefully evaluated and evidence-informed in nature has emerged. We credit our successful transformation of the Masters in Public Health core to the challenge provided by the Framing the Future task force, the commitment of our College of Public Health leadership, the engagement of our faculty, and the time we allowed for the process to unfold. Ultimately, we believe this transformed curriculum will result in better trained public health professionals, interdisciplinary practitioners who can see public health challenges in new and different ways. PMID:29164093
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Corvin, Jaime A; DeBate, Rita; Wolfe-Quintero, Kate; Petersen, Donna J
2017-01-01
Public health professionals have been challenged to radically reform public health training to meet evolving demands of twenty-first century public health. Such a transformation requires a systems thinking approach with an interdisciplinary focus on problem solving, leadership, management and teamwork, technology and information, budgeting and finance, and communication. This article presents processes for implementing and evaluating a revised public health curriculum and outlines lessons learned from this initiative. To date, more than 200 students have participated in the initial pilot testing of this program. A rigorous process and outcome evaluation plan was developed and employed. Results from the evaluation were used to enhance the resulting curriculum. Specifically, all instructional materials were evaluated by both the students who received the materials and the faculty who presented the materials. As each successive pilot is delivered, both enrollment and faculty involvement has increased. Through this process, the value of committed faculty, the importance of engaging learners in the evaluation of an education program, and the need to implement curriculum that has been carefully evaluated and evidence-informed in nature has emerged. We credit our successful transformation of the Masters in Public Health core to the challenge provided by the Framing the Future task force, the commitment of our College of Public Health leadership, the engagement of our faculty, and the time we allowed for the process to unfold. Ultimately, we believe this transformed curriculum will result in better trained public health professionals, interdisciplinary practitioners who can see public health challenges in new and different ways.
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Identifying Deteriorating Patients Through Multidisciplinary Team Training.
Merriel, Abi; van der Nelson, Helen; Merriel, Sam; Bennett, Joanne; Donald, Fiona; Draycott, Timothy; Siassakos, Dimitrios
2016-11-01
Multidisciplinary training has improved maternity outcomes when the training has been well attended, regular, in house, used high-fidelity simulators, and integrated teamwork training. If these principles were used in other settings, better clinical care may result. This before-after study sought to establish whether a short multidisciplinary training intervention can improve recognition of the deteriorating patient using an aggregated physiological parameter scoring system (Early Warning Score [EWS]). Nursing, medical, and allied nursing staff participated in an hour-long training session, using real-life scenarios with simple tools and structured debriefing. After training, staff were more likely to calculate EWS scores correctly (68.02% vs 55.12%; risk ratio [RR] = 1.24, 95% confidence interval [CI] = 1.07-1.44), and observations were more likely to be performed at the correct frequency (78.57% vs 68.09%; RR = 1.20, 95% CI = 1.09-1.32). Multidisciplinary training, according to core principles, can lead to more accurate identification of deteriorating patients, with implications for subsequent care and outcome. © The Author(s) 2015.
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Welp, Annalena; Meier, Laurenz L; Manser, Tanja
2016-04-19
Effectively managing patient safety and clinicians' emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork. We employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role. Analyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety. The current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive-behavioral teamwork negatively impacts clinician-rated patient safety. Thus, reducing clinician emotional exhaustion is an important prerequisite of managing teamwork and patient safety. From a practical point of view, team-based interventions targeting patient safety are less likely to be effective when clinicians are emotionally exhausted.
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Siems, Ashley; Cartron, Alexander; Watson, Anne; McCarter, Robert; Levin, Amanda
2017-02-01
Rapid response teams (RRTs) improve the detection of and response to deteriorating patients. Professional hierarchies and the multidisciplinary nature of RRTs hinder team performance. This study assessed whether an intervention involving crew resource management training of team leaders could improve team performance. In situ observations of RRT activations were performed pre- and post-training intervention. Team performance and dynamics were measured by observed adherence to an ideal task list and by the Team Emergency Assessment Measure tool, respectively. Multiple quartile (median) and logistic regression models were developed to evaluate change in performance scores or completion of specific tasks. Team leader and team introductions (40% to 90%, P = .004; 7% to 45%, P = .03), floor team presentations in Situation Background Assessment Recommendation format (20% to 65%, P = .01), and confirmation of the plan (7% to 70%, P = .002) improved after training in patients transferred to the ICU (n = 35). The Team Emergency Assessment Measure metric was improved in all 4 categories: leadership (2.5 to 3.5, P < .001), teamwork (2.7 to 3.7, P < .001), task management (2.9 to 3.8, P < .001), and global scores (6.0 to 9.0, P < .001) for teams caring for patients who required transfer to the ICU. Targeted crew resource management training of the team leader resulted in improved team performance and dynamics for patients requiring transfer to the ICU. The intervention demonstrated that training the team leader improved behavior in RRT members who were not trained. Copyright © 2017 by the American Academy of Pediatrics.
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Training Multidisciplinary Biomedical Informatics Students: Three Years of Experience
van Mulligen, Erik M.; Cases, Montserrat; Hettne, Kristina; Molero, Eva; Weeber, Marc; Robertson, Kevin A.; Oliva, Baldomero; de la Calle, Guillermo; Maojo, Victor
2008-01-01
Objective The European INFOBIOMED Network of Excellence 1 recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. Design A carefully developed 3-year training program for biomedical informatics students addressed these educational aspects through the following four activities: (1) an internet course database containing an overview of all Medical Informatics and BioInformatics courses, (2) a BioMedical Informatics Summer School, (3) a mobility program based on a ‘brokerage service’ which published demands and offers, including funding for research exchange projects, and (4) training challenges aimed at the development of multi-disciplinary skills. Measurements This paper focuses on experiences gained in the development of novel educational activities addressing work in multidisciplinary teams. The training challenges described here were evaluated by asking participants to fill out forms with Likert scale based questions. For the mobility program a needs assessment was carried out. Results The mobility program supported 20 exchanges which fostered new BMI research, resulted in a number of peer-reviewed publications and demonstrated the feasibility of this multidisciplinary BMI approach within the European Union. Students unanimously indicated that the training challenge experience had contributed to their understanding and appreciation of multidisciplinary teamwork. Conclusion The training activities undertaken in INFOBIOMED have contributed to a multi-disciplinary BMI approach. It is our hope that this work might provide an impetus for training efforts in Europe, and yield a new generation of biomedical informaticians. PMID:18096914
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What is happening under the surface? Power, conflict and the performance of medical teams.
Janss, Rozemarijn; Rispens, Sonja; Segers, Mien; Jehn, Karen A
2012-09-01
The effect of teamwork on team performance is broadly recognised in the medical field. This recognition is manifested in educational programmes in which attention to interpersonal behaviours during teamwork is growing. Conflict and power differences influence interpersonal behaviours and are marked topics in studies of group functioning in the social and organisational psychology literature. Insights from the domain of social sciences put the ongoing improvement of teamwork into broader perspective. This paper shows how knowledge from the domain of social and organisational psychology contributes to the understanding of teamwork in the medical environment. More specifically, this paper suggests that unfolding the underlying issues of power and conflict within medical teams can be of extra help in the development of educational interventions aimed at improving team performance. We review the key social psychology and organisational behaviour literature concerning power and conflict, and relate the insights derived from this to the team process of ad hoc medical action teams. We present a theoretical framework in which insights into power and conflict are used to explain and predict team dynamics in ad hoc medical action teams. Power and conflict strongly influence interpersonal behaviour. Characteristics of medical action teams give rise to all kinds of issues of disagreement and are accompanied by complex issues of intra-team power distribution. We argue that how team members coordinate, cooperate and communicate is steered by members' personal motivations, which, in turn, strongly depend on their perceptions of power and conflict. Given the importance of the performance of these teams, we suggest future directions for the development of training interventions building on knowledge and theories derived from social and organisational psychology. © Blackwell Publishing Ltd 2012.
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Relationship between organizational climate and empowerment of nurses in Hong Kong.
Mok, Esther; Au-Yeung, Betty
2002-05-01
The authors explore the relationship between organizational climate and empowerment among the nursing staff of a regional hospital in Hong Kong. The main purpose of the study was to apply the modified Spreitzer measure of empowerment in a hospital and to examine the relationship of organizational climate to perceptions of empowerment. From 658 questionnaires sent out, 331 nurses participated in the study with a response rate of 50.3%. Survey measures administered included the modified Litwin and Stringer Organizational Climate Questionnaire (LSOCQ) and the modified Spreitzer empowerment instrument. The relationships between organizational climate and empowerment were examined in a series of bivariate correlational analyses. The final section of the questionnaire asked the respondents to list three elements in the organizational climate that they perceived would further increase their feelings of empowerment. Exploratory factor analysis of the modified LSOCQ resulted in six factors: leadership, working harmony, challenge, recognition, teamwork and decision making. There was a positive correlation between organizational climate and psychological empowerment. Using multiple regression analysis, all the six derived climate factors significantly accounted for 44% of the variance. Among the six predicting factors, leadership and teamwork showed the most positive relationship with psychological empowerment. Responses from the open questions on perception of organizational climate that further enhance nurses' feelings of empowerment were categorized into eight areas. They include leadership, communication, working relationship, recognition, structure, training, teamwork and stress management. The study echoes previous studies in finding that organizational climate and, in particular, supportive leadership and teamwork are related to empowerment. The findings also suggest that the nurses in the study did not put much emphasis on the importance of participative decision making.
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Curran, Vernon R; Deacon, Diana R; Fleet, Lisa
2005-05-01
Interprofessional education is an approach to educating and training students and practitioners from different health professions to work in a collaborative manner in providing client and/or patient-centred care. The introduction and successful implementation of this educational approach is dependent on a variety of factors, including the attitudes of students, faculty, senior academic administrators (e.g., deans and directors) and practitioners. The purpose of this study was to examine attitudes towards interprofessional teamwork and interprofessional education amongst academic administrators of post-secondary health professional education programs in Canada. A web-based questionnaire in English and French was distributed via e-mail messaging during January 2004 to academic administrators in Canada representing medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy post-secondary educational programs. Responses were sought on attitudes towards interprofessional teamwork and interprofessional education, as well as opinions regarding barriers to interprofessional education and subject areas that lend themselves to interprofessional education. In general, academic administrators responding to the survey hold overall positive attitudes towards interprofessional teamwork and interprofessional education practices, and the results indicate there were no significant differences between professions in relation to these attitudinal perspectives. The main barriers to interprofessional education were problems with scheduling/calendar, rigid curriculum, turf battles and lack of perceived value. The main pre-clinical subject areas which respondents believed would lend themselves to interprofessional education included community health/prevention, ethics, communications, critical appraisal, and epidemiology. The results of this study suggest that a favourable perception of both interprofessional teamwork and interprofessional education exists amongst academic administrators of Canadian health professional education programs. If this is the case, the post-secondary system in Canada is primed for the introduction of interprofessional education initiatives which support the development of client and patient-centred collaborative practice competencies.
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Schwarz, Betje; Neuderth, Silke; Gutenbrunner, Christoph; Bethge, Matthias
2015-01-01
Systematic reviews indicate the effectiveness of multimodal rehabilitation. In Germany this has been shown, in particular, for work-related medical rehabilitation. A recently published guideline on work-related medical rehabilitation supports the dissemination of these programmes. The feasibility of this guideline was examined in a multicentre study. This paper presents findings on the relevance of multiprofessional teamwork for the implementation of successful work-related medical rehabilitation. Focus groups were conducted with 7 inpatient orthopaedic rehabilitation teams and examined using qualitative content analysis. Multiprofessional teamwork emerged inductively as a meaningful theme. All teams described multiprofessional teamwork as a work-related medical rehabilitation success factor, referring to its relevance for holistic treatment of multifactorially impaired patients. Although similar indicators of successful multiprofessional teamwork were named, the teams realized multiprofessional teamwork differently. We found 3 team types, corresponding to multidisciplinary, interdisciplinary and transdisciplinary team models. These types and models constitute a continuum of collaborative practice, which seems to be affected by context-related factors. The significance of multiprofessional teamwork for successful multimodal rehabilitation was underlined. Indicators of ideal multiprofessional teamwork and contextual facilitators were specified. The contingency approach to teamwork, as well as the assumption of multiprofessional teamwork as a continuum of collaborative practice, is supported. Stronger consideration of multiprofessional teamwork in the work-related medical rehabilitation guideline is indicated.
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[Perception of students of a public university on the Education Program for Work in Health].
Pinto, Anna Carolina Martins; Oliveira, Isabela Viana; dos Santos, Ana Luiza Soares; da Silva, Luiza Eunice Sá; Izidoro, Gabriela da Silva Lourelli; Mendonça, Raquel de Deus; Lopes, Aline Cristine Souza
2013-08-01
This study sought to analyze the Education Program for Work in Health from the perspective of students at a public university in Belo Horizonte, State of Minas Gerais, in their first year and its impact on the students' qualification. It is a prospective cohort study with students who participated on this program, and the data was collected by a structured and self-applied questionnaire, during the sixth and tenth months of the program, with sociodemographic questions, methodology, aims and impact of the program. The majority reported that the program's proposed aims were attained, especially interdisciplinary work and academic research focused on the Unified Health System's needs. The program also contributed to training in research, teaching and extension work, and in the second evaluation, the students reported greater interaction with social equipment. It is considered that the program is an important strategy for human resources training in accordance with the Unified Health System's needs, by enabling the exercise of teamwork, communication, agility and creativity to deal with adverse situations, as well as the practice of the primary health care principles integrated in the community.
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[Reflective portfolio: a proposal for teaching and learning geared on competencies].
Cotta, Rosângela Minardi Mitre; da Costa, Glauce Dias; Mendonça, Erica Toledo
2013-06-01
This article seeks to analyze the experience of collective construction of portfolios as a teaching-learning method in the discipline of Health Policy, identifying the competencies developed by students. Qualitative research, whose collection and data processing were conducted by means of documental and thematic analysis of 34 portfolios. The "Learning to be" and "Learning to live and work together" competencies were considered according to the proposals of the UNESCO report for Education. The training of critical-reflexive individuals, provided by the portfolio, was particularly observed when students reported the transformation of the negative views that they had about the health care system - an inefficient and precarious policy - to a positive vision - policy which deals with the principles of equity, integrity and universality. This process of critical transformation is the result of the practice and use of communication skills, information management (search, selection, analysis and evaluation of information), leadership, cooperation and human relationships (teamwork, ethics and recognition of diversity), and personal competencies (time management, responsibility and planning), namely important skills in the training of professionals committed to the national health policy.
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ERIC Educational Resources Information Center
Hirschfeld, Robert R.; Jordan, Mark H.; Feild, Hubert S.; Giles, William F.; Armenakis, Achilles A.
2006-01-01
The authors explored the idea that teams consisting of members who, on average, demonstrate greater mastery of relevant teamwork knowledge will demonstrate greater task proficiency and observed teamwork effectiveness. In particular, the authors posited that team members' mastery of designated teamwork knowledge predicts better team task…
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Teamwork and the National Security Personnel System
2007-03-18
and thereby improve organizational performance. However, concern exists that only rewarding individual performance may adversely impact teamwork...collaboration, and information sharing which could ultimately impact organizational performance. This paper explores the importance of teamwork for...indicates that pay-for-performance systems can harm teamwork suggesting that NSPS could negatively impact teamwork within the DoD. Recommendations are
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ERIC Educational Resources Information Center
Watland, Kathleen Hanold; Santori, David
2014-01-01
Teamwork and the ability to work collaboratively on a team are important skills in almost every industry or profession. The use of student teams in college courses is increasing and most academic programs require teamwork as part of the students' academic learning experience. While teamwork and other experiential collaborative learning…
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Leadership and Teamwork in Trauma and Resuscitation
Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand
2016-01-01
Introduction Leadership skills are described by the American College of Surgeons’ Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. Methods We searched the PubMed database using the keywords “leadership” and then either “trauma” or “resuscitation” as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. Results We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance. Conclusion Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership’s effect on patient-level outcome. PMID:27625718
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Leadership and Teamwork in Trauma and Resuscitation.
Ford, Kelsey; Menchine, Michael; Burner, Elizabeth; Arora, Sanjay; Inaba, Kenji; Demetriades, Demetrios; Yersin, Bertrand
2016-09-01
Leadership skills are described by the American College of Surgeons' Advanced Trauma Life Support (ATLS) course as necessary to provide care for patients during resuscitations. However, leadership is a complex concept, and the tools used to assess the quality of leadership are poorly described, inadequately validated, and infrequently used. Despite its importance, dedicated leadership education is rarely part of physician training programs. The goals of this investigation were the following: 1. Describe how leadership and leadership style affect patient care; 2. Describe how effective leadership is measured; and 3. Describe how to train future physician leaders. We searched the PubMed database using the keywords "leadership" and then either "trauma" or "resuscitation" as title search terms, and an expert in emergency medicine and trauma then identified prospective observational and randomized controlled studies measuring leadership and teamwork quality. Study results were categorized as follows: 1) how leadership affects patient care; 2) which tools are available to measure leadership; and 3) methods to train physicians to become better leaders. We included 16 relevant studies in this review. Overall, these studies showed that strong leadership improves processes of care in trauma resuscitation including speed and completion of the primary and secondary surveys. The optimal style and structure of leadership are influenced by patient characteristics and team composition. Directive leadership is most effective when Injury Severity Score (ISS) is high or teams are inexperienced, while empowering leadership is most effective when ISS is low or teams more experienced. Many scales were employed to measure leadership. The Leader Behavior Description Questionnaire (LBDQ) was the only scale used in more than one study. Seven studies described methods for training leaders. Leadership training programs included didactic teaching followed by simulations. Although programs differed in length, intensity, and training level of participants, all programs demonstrated improved team performance. Despite the relative paucity of literature on leadership in resuscitations, this review found leadership improves processes of care in trauma and can be enhanced through dedicated training. Future research is needed to validate leadership assessment scales, develop optimal training mechanisms, and demonstrate leadership's effect on patient-level outcome.
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Rios-Velazquez, Carlos; Robles-Suarez, Reynaldo; Gonzalez-Negron, Alberto J; Baez-Santos, Ivan
2006-05-01
The Delta Cooperative Model (DCM) is a dynamic and innovative teamwork design created to develop fundamentals in research skills. High school students in the DCM belong to the Upward Bound Science and Math (UBSM) program at the Inter American University, Ponce Campus. After workshops on using the scientific method, students were organized into groups of three students with similar research interests. Each student had to take on a role within the group as either a researcher, data analyst, or research editor. Initially, each research team developed hypothesis-driven ideas on their proposed project. In intrateam research meetings, they emphasized team-specific tasks. Next, interteam meetings were held to present ideas and receive critical input. Finally, oral and poster research presentations were conducted at the UBSM science fair. Several team research projects covered topics in medical, environmental, and general microbiology. The three major assessment areas for the workshop and DCM included: (i) student's perception of the workshops' effectiveness in developing skills, content, and values; (ii) research team self- and group participation evaluation, and (iii) oral and poster presentation during the science fair. More than 91% of the students considered the workshops effective in the presentation of scientific method fundamentals. The combination of the workshop and the DCM increased student's knowledge by 55% from pre- to posttests. Two rubrics were designed to assess the oral presentation and poster set-up. The poster and oral presentation scores averaged 83% and 75% respectively. Finally, we present a team assessment instrument that allows the self- and group evaluation of each research team. While the DCM has educational plasticity and versatility, here we document how the this model has been successfully incorporated in training and engaging students in scientific research in microbiology.
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Colonio Salazar, F B; Andiappan, M; Radford, D R; Gallagher, J E
2017-05-01
This study explored, and compared, the attitudes of student groups trained at the University of Portsmouth Dental Academy (UPDA) in 2010/2011 towards dental interprofessional education (IPE). The study population consisted of fifth-year student dentists (n = 80) from King's College London Dental Institute, second- and third-year dental hygiene and therapy (n = 38) and first-year dental nursing (n = 14) students from UPDA. A 19-item, validated and dentally modified questionnaire, 'Readiness for Inter-Professional Learning Scale (RIPLS)', was administered. RIPLS contains three subscales: teamwork and collaboration, professional identity and roles and responsibilities. Mean (x¯) and standard deviation (SD) of the scores were calculated, following reversal of negative items. All the analyses were carried out using SPSS version 20 and STATA version 11. An overall response rate of 71% (n = 94) was achieved. In reference to teamwork and collaboration, all groups strongly indicated that IPE can contribute to learning teamwork skills (x¯ = 24.98, SD = 3.5) and improving relationships with team members (x¯ = 12.93, SD = 1.63); however, the scores did not differ between the groups (P = 0.09 and P = 0.16, respectively). Concerning professional identity, student dentists had significantly higher preference for a discipline-based approach (P = 0.002); were more likely to agree that 'it is not necessary for undergraduate dental and dental care professional students to learn together' (P = 0.01); and perceived that 'clinical problem-solving skills can only be learnt effectively with other students from their own discipline' (P = 0.02) than dental hygiene and therapy students. In relation to roles and responsibilities, participants demonstrated a strong sense of their own professional role. Student dentists reported that they had 'to gain more knowledge and skills' than dental hygiene and therapy (P = 0.01) and dental nursing (P = 0.01) students. Dental hygiene and therapy students were less likely than student dentists to agree that 'the role of dental nurses and hygienists was to mainly provide support for dentists' (P = 0.001). The findings suggest that IPE was perceived as beneficial in relation to teamwork; however, the study raises issues regarding professional identity and roles. Educators should consider differing perceptions of professional roles and identities when planning and delivering interprofessional programmes. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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Nancarrow, Susan A; Smith, Tony; Ariss, Steven; Enderby, Pamela M
2015-07-01
Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. © 2014 John Wiley & Sons Ltd.
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Advancing interprofessional education through the use of high fidelity human patient simulators
Smithburger, Pamela L.; Kane-Gill, Sandra L.; Kloet, Megan A.; Lohr, Brian; Seybert, Amy L.
Background Modern medical care increasingly requires coordinated teamwork and communication between healthcare professionals of different disciplines. Unfortunately, healthcare professional students are rarely afforded the opportunity to learn effective methods of interprofessional (IP) communication and teamwork strategies during their education. The question of how to best incorporate IP interactions in the curricula of the schools of health professions remains unanswered. Objective We aim to solve the lack of IP education in the pharmacy curricula through the use of high fidelity simulation (HFS) to allow teams of medical, pharmacy, nursing, physician assistant, and social work students to work together in a controlled environment to solve cases of complex medical and social issues. Methods Once weekly for a 4-week time period, students worked together to complete complex simulation scenarios in small IP teams consisting of pharmacy, medical, nursing, social work, and physician assistant students. Student perception of the use of HFS was evaluated by a survey given at the conclusion of the HFS sessions. Team communication was evaluated through the use of Communication and Teamwork Skills (CATS) Assessment by 2 independent evaluators external to the project. Results The CATS scores improved from the HFS sessions 1 to 2 (p = 0.01), 2 to 3 (p = 0.035), and overall from 1 to 4 (p = 0.001). The inter-rater reliability between evaluators was high (0.85, 95% CI 0.71, 0.99). Students perceived the HFS improved: their ability to communicate with other professionals (median =4); confidence in patient care in an IP team (median=4). It also stimulated student interest in IP work (median=4.5), and was an efficient use of student time (median=4.5) Conclusions The use of HFS improved student teamwork and communication and was an accepted teaching modality. This method of exposing students of the health sciences to IP care should be incorporated throughout the curricula. PMID:24155851
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Gender and teamwork: an analysis of professors' perspectives and practices
NASA Astrophysics Data System (ADS)
Beddoes, Kacey; Panther, Grace
2018-05-01
Teamwork is increasingly seen as an important component of engineering education programmes. Yet, prior research has shown that there are numerous ways in which teamwork is gendered, and can lead to negative experiences for women students. This article presents the first interview findings on professors' perspectives on gender and teamwork. Semi-structured interviews were conducted with 39 engineering professors to determine what and how they thought about gender in engineering and engineering education. For this article, the parts of the interviews about teamwork are analysed. We conclude that professors need tools to help them facilitate gender-inclusive teamwork, and those tools must address the beliefs that they already hold about teamwork. The findings raise questions about the adoption of evidence-based instructional practices and suggest current teamwork practices may exacerbate gender inequalities in engineering.
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Implementing an interprofessional first-year teamwork project: some key reflections.
McNaughton, Susan Maree
2013-09-01
Implementing an interprofessional teamwork project for first-year students presents pedagogical and practical challenges. While transferable skills and attributes are important, engagement of students with limited professional experience in teamwork depends on relevance to current learning needs. This report outlines principles learned from planning and implementing a teamwork project for an interprofessional health administration and service development course. Practising interprofessional teamwork as leaders and teachers, aligning with previous, current and future teamwork content and processes and responding to student feedback and achievement have been the key factors in shaping the project over three semesters. Face-to-face and online interprofessional teamwork learning has necessitated developing resources that support self-direction, using familiar technology and providing enabling physical environments. Implications for first-year interprofessional teamwork are that structured well-resourced processes, responsiveness and alignment of learning all improve student outcomes.
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Interprofessional teamwork in the trauma setting: a scoping review
2013-01-01
Approximately 70 to 80% of healthcare errors are due to poor team communication and understanding. High-risk environments such as the trauma setting (which covers a broad spectrum of departments in acute services) are where the majority of these errors occur. Despite the emphasis on interprofessional collaborative practice and patient safety, interprofessional teamworking in the trauma setting has received little attention. This paper presents the findings of a scoping review designed to identify the extent and nature of this literature in this setting. The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and CINAHL databases were searched from January 2000 to April 2013 for results of interprofessional teamworking in the trauma setting. A hand search was conducted by reviewing the reference lists of relevant articles. In total, 24 published articles were identified for inclusion in the review. Studies could be categorized into three main areas, and within each area were a number of themes: 1) descriptions of the organization of trauma teams (themes included interaction between team members, and leadership); 2) descriptions of team composition and structure (themes included maintaining team stability and core team members); and 3) evaluation of team work interventions (themes included activities in practice and activities in the classroom setting). Descriptive studies highlighted the fluid nature of team processes, the shared mental models, and the need for teamwork and communication. Evaluative studies placed a greater emphasis on specialized roles and individual tasks and activities. This reflects a multiprofessional as opposed to an interprofessional model of teamwork. Some of the characteristics of high-performing interprofessional teams described in this review are also evident in effective teams in the community rehabilitation and intermediate care setting. These characteristics may well be pertinent to other settings, and so provide a useful foundation for future investigations. PMID:24188523
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Omura, Mieko; Maguire, Jane; Levett-Jones, Tracy; Stone, Teresa Elizabeth
2017-11-01
Communication errors have a negative impact on patient safety. It is therefore essential that healthcare professionals have the skills and confidence to speak up assertively when patient safety is at risk. Although the facilitators to and barriers of assertive communication have been the subject of previous reviews, evidence regarding the effectiveness of interventions designed to enhance assertive communication is lacking. Thus, this paper reports the findings from a systematic review of the effectiveness of assertiveness communication training programs for healthcare professionals and students. The objective of this review is to identify, appraise and synthesise the best available quantitative evidence in relation to the effectiveness of assertiveness communication training programs for healthcare professionals and students on levels of assertiveness, communication competence and impact on clinicians' behaviours and patient safety. The databases included: CINAHL, Cochrane library, EMBASE, Informit health collection, MEDLINE, ProQuest nursing and allied health, PsycINFO, Scopus and Web of Science. The search for unpublished studies included: MedNar, ProQuest Dissertations & Theses A&I. Studies published in English from 2001 until 2016 inclusive were considered. The review included original quantitative research that evaluated (a) any type of independent assertiveness communication training program; and (b) programs with assertiveness training included as a core component of team skills or communication training for healthcare professionals and students, regardless of healthcare setting and level of qualification of participants. Studies selected based on eligibility criteria were assessed for methodological quality and the data were extracted by two independent researchers using the Joanna Briggs Institute critical appraisal and data extraction tools. Eleven papers were critically appraised using the Joanna Briggs Institute critical appraisal checklists. Eight papers from the USA, Australia, Ireland, and Taiwan were included in the review. Interventions to improve assertive communication were reported to be effective to some degree with all targeted groups except experienced anaesthesiologists. Face-to-face and multimethod programs, support from leaders, teamwork skills training and communication techniques adapted from the aviation industry were identified as appropriate approaches for optimising the effectiveness of assertiveness communication training programs. Behavioural change as the result of assertiveness interventions was evaluated by observer-based rating scales during simulation, whilst self-perceived knowledge and attitudes were evaluated using validated scales. Future research should consider evaluation of sustained effect on behaviour change and patient safety. Copyright © 2017 Elsevier Ltd. All rights reserved.
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[Contexts, impasses and challenges for training Public Health workers in Brazil].
de Almeida Filho, Naomar Monteiro
2013-06-01
An introductory comment is made on the historical background, institutional impasses and curriculum challenges for training Public Health workers in Brazil. Initially, a thesis is proposed, namely that the Brazilian state has not fulfilled its responsibility to ensure quality public services for the population, with access and equity, shaping "the four perversions of Brazilian education." Secondly, it analyzes the public health system, which is theoretically universal, but being underfunded and with acknowledged shortcomings, contributes to the increase in social exclusion. Lastly, it highlights the need for new models for training people who are technologically competent, suitable for teamwork, creative, autonomous, problem-solving, engaged in health promotion, open to social participation and committed to the humanization of health.
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Auerbach, Marc; Roney, Linda; Aysseh, April; Gawel, Marcie; Koziel, Jeannette; Barre, Kimberly; Caty, Michael G; Santucci, Karen
2014-12-01
This study aimed to evaluate the feasibility and measure the impact of an in situ interdisciplinary pediatric trauma quality improvement simulation program. Twenty-two monthly simulations were conducted in a tertiary care pediatric emergency department with the aim of improving the quality of pediatric trauma (February 2010 to November 2012). Each session included 20 minutes of simulated patient care, followed by 30 minutes of debriefing that focused on teamwork, communication, and the identification of gaps in care. A single rater scored the performance of the team in real time using a validated assessment instrument for 6 subcomponents of care (teamwork, airway, intubation, breathing, circulation, and disability). Participants completed a survey and written feedback forms. A trend analysis of the 22 simulations found statistically significant positive trends for overall performance, teamwork, and intubation subcomponents; the strength of the upward trend was the strongest for the teamwork (τ = 0.512), followed by overall performance (τ = 0.488) and intubation (τ = 0.433). Two hundred fifty-one of 398 participants completed the participant feedback form (response rate, 63%), reporting that debriefing was the most valuable aspect of the simulation. An in situ interdisciplinary pediatric trauma simulation quality improvement program resulted in improved validated trauma simulation assessment scores for overall performance, teamwork, and intubation. Participants reported high levels of satisfaction with the program, and debriefing was reported as the most valuable component of the program.
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Dueñas, Gladys G.; Zanoni, Aileen; Grover, Anisha B.
2016-01-01
Objective. To prepare first-year and second-year pharmacy and medical students to build effective collaborative health care teams by participating in an interprofessional experiential 6-semester course series. Design. An interprofessional experiential course series was designed using a variety of teaching methods to achieve both interprofessional and experiential learning outcomes. A standardized objective behavioral assessment was developed to measure team performance of interprofessional communication and teamwork. In addition, student perceptions were measured using a validated instrument. Assessment. A majority of teams demonstrated appropriate competence with respect to interprofessional communication and teamwork. Additionally, a majority of students expressed positive perceptions of interprofessional collaboration with respect to teamwork, roles and responsibilities, and patient outcomes. Conclusion. An interprofessional experiential course series can be successfully implemented to achieve both interprofessional and experiential learning outcomes. Highly collaborative teams and positive student perceptions provide evidence of achievement of interprofessional education learning outcomes. PMID:27402988
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Thornley, P; Quinn, A; Elley, K
2015-08-28
This study reports on an investigation into clinical audit (CA) educational and service delivery outcomes in a dental foundation training (DFT) programme. The aim was to investigate CA teaching, learning and practice from the perspective of foundation dentists (FDs) and to record suggestions for improvement. A qualitative research methodology was used. Audio recordings of focus group interviews with FDs were triangulated by an interview with a group of training programme directors (TPDs). The interviews were transcribed and thematically analysed using a 'Framework' approach within Nvivo Data Analysis Software. FDs report considerable learning and behaviour change. However, TPDs have doubts about the long-term effects on service delivery. There can be substantial learning in the clinical, managerial, communication and professionalism domains, and in the development of time management, organisational and team-working skills. Information is provided about use of resources and interaction with teachers and colleagues. CA provides learning opportunities not produced by other educational activities including 'awkward conversations' with team-members in the context of change management and providing feedback. This is relevant when applying the recommendations of the Francis report. This paper should be useful to any dentist conducting audit or team training. Suggestions are made for improvements to resources and support including right touch intervention. Trainers should teach in the 'Goldilocks Zone'.
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The eighth NASA total quality management accomplishments report, 1990
NASA Technical Reports Server (NTRS)
1990-01-01
The eighth annual accomplishments report provides numerous examples of quality strategies that have proven effective and efficient in a time when cost reduction is critical. NASA's continuous improvement efforts can provide insight for others to succeed in their own endeavors. The report covers: top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.
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NASA total quality management 1989 accomplishments report
NASA Technical Reports Server (NTRS)
1990-01-01
Described here are the accomplishments of NASA as a result of the use of Total Quality Management (TQM). The principles in practice which led to these process refinements are important cultural elements to any organization's productivity and quality efforts. The categories of TQM discussed here are top management leadership and support, strategic planning, focus on the customer, employee training and recognition, employee empowerment and teamwork, measurement and analysis, and quality assurance.
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2011-01-01
Background Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown. Methods A single-arm intervention study tested the association between simulated team practice and measures of interprofessional collaboration, nurse-physician relationships, and attitudes toward health care teams. Participants were 154 post-licensure nurses, allied health professionals, and physicians. Self- and proxy-report survey measurements were taken before simulation training and two and six weeks after. Results Multilevel modeling revealed little change over the study period. Variation in interprofessional collaboration and attitudes was largely attributable to between-person characteristics. A constructed categorical variable indexing 'leadership capacity' found that participants with highest and lowest values were more likely to endorse shared team leadership over physician centrality. Conclusion Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care. PMID:21443779
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Riley, William; Begun, James W; Meredith, Les; Miller, Kristi K; Connolly, Kathy; Price, Rebecca; Muri, Janet H; McCullough, Mac; Davis, Stanley
2016-12-01
To improve safety practices and reduce adverse events in perinatal units of acute care hospitals. Primary data collected from perinatal units of 14 hospitals participating in the intervention between 2008 and 2012. Baseline secondary data collected from the same hospitals between 2006 and 2007. A prospective study involving 342,754 deliveries was conducted using a quality improvement collaborative that supported three primary interventions. Primary measures include adoption of three standardized care processes and four measures of outcomes. Chart audits were conducted to measure the implementation of standardized care processes. Outcome measures were collected and validated by the National Perinatal Information Center. The hospital perinatal units increased use of all three care processes, raising consolidated overall use from 38 to 81 percent between 2008 and 2012. The harms measured by the Adverse Outcome Index decreased 14 percent, and a run chart analysis revealed two special causes associated with the interventions. This study demonstrates the ability of hospital perinatal staff to implement efforts to reduce perinatal harm using a quality improvement collaborative. Findings help inform the relationship between the use of standardized care processes, teamwork training, and improved perinatal outcomes, and suggest that a multiplicity of integrated strategies, rather than a single intervention, may be essential to achieve high reliability. © Health Research and Educational Trust.
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NASA Technical Reports Server (NTRS)
Foyle, David C.; Shafto, Michael G.; Hart, Sandra G. (Technical Monitor)
1994-01-01
The National Aeronautics and Space Administration (NASA) is well known for its roles in the space program and in aeronautics. Because teamwork is essential for most NASA missions, NASA has experience in both research on teamwork and implementation of team projects. The purpose of this chapter is not to summarize research results on teamwork. This chapter will summarize our insight into teamwork as it applies to the large institutions and organizations with which we have been associated: University academic systems, Navy research laboratories, and NASA. These organizations represent a variety of systems in which teamwork is commonplace.
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Role of care pathways in interprofessional teamwork.
Scaria, Minimol Kulakkottu
2016-08-24
Cohesive interprofessional teamwork is essential to successful healthcare services. Interprofessional teamwork is the means by which different healthcare professionals - with diverse knowledge, skills and talents - collaborate to achieve a common goal. Several interventions are available to improve teamwork in the healthcare setting. This article explores the role of care pathways in improving interprofessional teamwork. Care pathways enhance teamwork by promoting coordination, collaboration, communication and decision making to achieve optimal healthcare outcomes. They result in improved staff knowledge, communication, documentation and interprofessional relations. Care pathways also contribute to patient-centred care and increase patient satisfaction.
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ERIC Educational Resources Information Center
Koh, Elizabeth; Hong, Helen; Tan, Jennifer Pei-Ling
2018-01-01
Teamwork, one of the core competencies for the twenty-first century learner, is a critical skill for work and learning. However, assessing teamwork is complex, in particular, developing a measure of teamwork that is domain-generic and applicable across a wide range of learners. This paper documents one such study that leverages technology to help…
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Lee, Chun-Chia; Chang, Jen-Wei
2013-11-01
The need for teamwork has grown significantly in today's organizations. Especially for online game communities, teamwork is an important means of online game players' engagement. This study aims to investigate the impacts of trust on players' teamwork with affective commitment and normative commitment as mediators. Furthermore, this research includes team experience as a moderator to compare the difference between different player groups. A model was proposed and tested on 296 online game players' data using structural equation modeling. Findings revealed that team experience moderated the relationship between trust and teamwork. The results indicated that trust promotes more teamwork only for players with high experience through affective commitment than those who with low experience. Implications of the findings are discussed.
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Ginzburg, Samara B; Deutsch, Susan; Bellissimo, Jaclyn; Elkowitz, David E; Stern, Joel Nh; Lucito, Robert
2018-01-01
The evolution of health care systems in response to societal and financial pressures has changed care delivery models, which presents new challenges for physicians. Leadership training is increasingly being recognized as an essential component of medical education training to prepare physicians to meet these needs. Unfortunately, most medical schools do not include leadership training. It has been suggested that a longitudinal and integrated approach to leadership training should be sought. We hypothesized that integration of leadership training into our hybrid problem-based learning (PBL)/case-based learning (CBL) program, Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), would be an effective way for medical students to develop leadership skills without the addition of curricular time. We designed a unique leadership program in PEARLS in which 98 medical students participated during each of their six courses throughout the first 2 years of school. A program director and trained faculty facilitators educated students and coached them on leadership development throughout this time. Students were assessed by their facilitator at the end of every course on development of leadership skills related to teamwork, meaningful self-assessment, process improvement, and thinking outside the box. Students consistently improved their performance from the first to the final course in all four leadership parameters evaluated. The skills that demonstrated the greatest change were those pertaining to thinking outside the box and process improvement. Incorporation of a longitudinal and integrated approach to leadership training into an existing PBL/CBL program is an effective way for medical students to improve their leadership skills without the addition of curricular time. These results offer a new, time-efficient option for leadership development in schools with existing PBL/CBL programs.
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Possible ways for Public Health Surveillance practices evaluation.
Vilela, Maria Filomena de Gouveia; Santos, Dario Nunes Dos; Kemp, Brigina
2017-10-01
This is an evaluative and qualitative study that proposes to investigate self-assessment evaluation as a device to analyze Health Surveillance practices through a questionnaire built by researchers, adapted from the Self-Assessment of Improved Access and Primary Care Quality (AMAQ) and available on the FORMSUS platform. Forty-one Health Surveillance workers and managers of a large municipality from São Paulo State evaluated the realms of "management", "teamwork" and their respective sub-realms. Two categories were created to analyze the results: "Management" and "Team" in dialogue with references from Management, Evaluation and Health Surveillance. Most "management" and "teamwork" sub-realms were deemed satisfactory. Self-assessment evaluation through an applied evaluation tool was shown to be a powerful resource for the analysis of Health Surveillance practices in combination with other devices adopted by the Unified Health System (SUS). Unlike usual evaluation processes guided by quantitative markers, this self-assessable evaluative process included subjects and enabled the possibility of incorporating a new look at itself to the way Health Surveillance is carried out and support future management contracts between workers and managers.
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van Gessel, Elisabeth; Picchiottino, Patricia; Doureradjam, Robert; Nendaz, Mathieu; Mèche, Petra
2018-03-08
Demography of patients and complexity in the management of multimorbid conditions has made collaborative practice a necessity for the future, also in Switzerland. Since 2012, the University of Applied Sciences (UAS) and its Healthcare School as well as the University of Geneva (UG) with its Medical Faculty have joined forces to implement a training program in collaborative practice, using simulation as one of the main learning/teaching process. The actual program consists of three sequential modules and totalizes 300 h of teaching and learning for approximately 1400-1500 students from six tracks (nutritionists, physiotherapists, midwives, nurses, technologists in medical radiology, physicians); in 2019 another hundred pharmacists will also be included. The main issues addressed by the modules are Module 1: the Swiss healthcare system and collaborative tools. Module 2: roles and responsibilities of the different health professionals, basic tools acquisition in team working (situation monitoring, mutual support, communication). Module 3: the axis of quality and safety of care through different contexts and cases. A very first evaluation of the teaching and learning and particularly on the aspects of acquisition of collaborative tools shows positive attitudes of students towards the implementation of this new training program. Furthermore, a pre-post questionnaire on teamwork aspects reveals significant modifications.
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Olupeliyawa, Asela M; O'Sullivan, Anthony J; Hughes, Chris; Balasooriya, Chinthaka D
2014-02-01
Teamwork is an important and challenging area of learning during the transition from medical graduate to intern. This preliminary investigation examined the psychometric and logistic properties of the Teamwork Mini-Clinical Evaluation Exercise (T-MEX) for the workplace-based assessment of key competencies in working with health care teams. The authors designed the T-MEX for direct observation and assessment of six collaborative behaviors in seven clinical situations important for teamwork, feedback, and reflection. In 2010, they tested it on University of New South Wales senior medical students during their last six-week clinical term to investigate its overall utility, including validity and reliability. Assessors rated students in different situations on the extent to which they met expectations for interns for each collaborative behavior. Both assessors and students rated the tool's usefulness and feasibility. Assessment forms for 88 observed encounters were submitted by 25 students. The T-MEX was suited to a broad range of collaborative clinical practice situations, as evidenced by the encounter types and the behaviors assessed by health care team members. The internal structure of the behavior ratings indicated construct validity. A generalizability study found that eight encounters were adequate for high-stakes measurement purposes. The mean times for observation and feedback and the participants' perceptions suggested usefulness for feedback and feasibility in busy clinical settings. Findings suggest that the T-MEX has good utility for assessing trainee competence in working with health care teams. It fills a gap within the suite of existing tools for workplace-based assessment of professional attributes.
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Ballangrud, Randi; Husebø, Sissel Eikeland; Hall-Lord, Marie Louise
2017-12-02
Teamwork is an integrated part of today's specialized and complex healthcare and essential to patient safety, and is considered as a core competency to improve twenty-first century healthcare. Teamwork measurements and evaluations show promising results to promote good team performance, and are recommended for identifying areas for improvement. The validated TeamSTEPPS® Teamwork Perception Questionnaire (T-TPQ) was found suitable for cross-cultural validation and testing in a Norwegian context. T-TPQ is a self-report survey that examines five dimensions of perception of teamwork within healthcare settings. The aim of the study was to translate and cross-validate the T-TPQ into Norwegian, and test the questionnaire for psychometric properties among healthcare personnel. The T-TPQ was translated and adapted to a Norwegian context according to a model of a back-translation process. A total of 247 healthcare personnel representing different professionals and hospital settings responded to the questionnaire. A confirmatory factor analysis was carried out to test the factor structure. Cronbach's alpha was used to establish internal consistency, and an Intraclass Correlation Coefficient was used to assess the test - retest reliability. A confirmatory factor analysis showed an acceptable fitting model (χ 2 (df) 969.46 (546), p < 0.001, Root Mean Square Error of Approximation (RMSEA) = 0.056, Tucker-Lewis Index (TLI) = 0.88, Comparative fit index (CFI) = 0.89, which indicates that each set of the items that was supposed to accompany each teamwork dimension clearly represents that specific construct. The Cronbach's alpha demonstrated acceptable values on the five subscales (0.786-0.844), and test-retest showed a reliability parameter, with Intraclass Correlation Coefficient scores from 0.672 to 0.852. The Norwegian version of T-TPQ was considered to be acceptable regarding the validity and reliability for measuring Norwegian individual healthcare personnel's perception of group level teamwork within their unit. However, it needs to be further tested, preferably in a larger sample and in different clinical settings.
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De Oliveira, Gildasio S; Dexter, Franklin; Bialek, Jane M; McCarthy, Robert J
2015-01-01
Supervision of anesthesiology residents is a major responsibility of faculty (academic) anesthesiologists. Supervision can be evaluated daily for individual anesthesiologists using a 9-question instrument. Faculty anesthesiologists with lesser individual scores contribute to lesser departmental (global) scores. Low (<3, "frequent") department-wide evaluations of supervision are associated with more mistakes with negative consequences to patients. With the long-term aim for residency programs to be evaluated partly based on the quality of their resident supervision, we assessed the 9-item instrument's reliability and validity when used to compare anesthesia programs' rotations nationwide. One thousand five hundred residents in the American Society of Anesthesiologists' directory of anesthesia trainees were randomly selected to be participants. Residents were contacted via e-mail and requested to complete a Web-based survey. Nonrespondents were mailed a paper version of the survey. Internal consistency of the supervision scale was excellent, with Cronbach's α = 0.909 (95% CI, 0.896-0.922, n = 641 respondents). Discriminant validity was found based on absence of rank correlation of supervision score with characteristics of the respondents and programs (all P > 0.10): age, hours worked per week, female, year of anesthesia training, weeks in the current rotation, sequence of survey response, size of residency class, and number of survey respondents from the current rotation and program. Convergent validity was found based on significant positive correlation between supervision score and variables related to safety culture (all P < 0.0001): "Overall perceptions of patient safety," "Teamwork within units," "Nonpunitive response to errors," "Handoffs and transitions," "Feedback and communication about error," "Communication openness," and rotation's "overall grade on patient safety." Convergent validity was found also based on significant negative correlation with variables related to the individual resident's burnout (all P < 0.0001): "I feel burnout from my work," "I have become more callous toward people since I took this job," and numbers of "errors with potential negative consequences to patients [that you have] made and/or witnessed." Usefulness was shown by supervision being predicted by the same 1 variable for each of 3 regression tree criteria: "Teamwork within [the rotation]" (e.g., "When one area in this rotation gets busy, others help out"). Evaluation of the overall quality of supervision of residents by faculty anesthesiologists depends on the reliability and validity of the instrument. Our results show that the 9-item de Oliveira Filho et al. supervision scale can be applied for overall (department, rotation) assessment of anesthesia training programs.
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Gillman, Lawrence M; Widder, Sandy; Clément, Julien; Engels, Paul T; Paton-Gay, John Damian; Brindley, Peter G
2016-04-01
The Standardized Trauma and Resuscitation Team Training (S.T.A.R.T.T.) course focuses on training multidisciplinary trauma teams: surgeons/physicians, registered nurses (RNs), respiratory therapists (RTs) and, most recently, prehospital personnel. The S.T.A.R.T.T. curriculum highlights crisis management (CRM) skills: communication, teamwork, leadership, situational awareness and resource utilization. This commentary outlines the modifications made to the course curriculum in order to satisfy the learning needs of a bilingual audience. The results suggest that bilingual multidisciplinary CRM courses are feasible, are associated with high participant satisfaction and have no clear detriments.
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Developing team cognition: A role for simulation
Fernandez, Rosemarie; Shah, Sachita; Rosenman, Elizabeth D.; Kozlowski, Steve W. J.; Parker, Sarah Henrickson; Grand, James A.
2016-01-01
SUMMARY STATEMENT Simulation has had a major impact in the advancement of healthcare team training and assessment. To date, the majority of simulation-based training and assessment focuses on the teamwork behaviors that impact team performance, often ignoring critical cognitive, motivational, and affective team processes. Evidence from team science research demonstrates a strong relationship between team cognition and team performance and suggests a role for simulation in the development of this team-level construct. In this article we synthesize research from the broader team science literature to provide foundational knowledge regarding team cognition and highlight best practices for using simulation to target team cognition. PMID:28704287
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Mental practice: a simple tool to enhance team-based trauma resuscitation.
Lorello, Gianni R; Hicks, Christopher M; Ahmed, Sana-Ara; Unger, Zoe; Chandra, Deven; Hayter, Megan A
2016-03-01
Effective trauma resuscitation requires the coordinated efforts of an interdisciplinary team. Mental practice (MP) is defined as the mental rehearsal of activity in the absence of gross muscular movements and has been demonstrated to enhance acquiring technical and procedural skills. The role of MP to promote nontechnical, team-based skills for trauma has yet to be investigated. We randomized anaesthesiology, emergency medicine, and surgery residents to two-member teams randomly assigned to either an MP or control group. The MP group engaged in 20 minutes of MP, and the control group received 20 minutes of Advanced Trauma Life Support (ATLS) training. All teams then participated in a high-fidelity simulated adult trauma resuscitation and received debriefing on communication, leadership, and teamwork. Two blinded raters independently scored video recordings of the simulated resuscitations using the Mayo High Performance Teamwork Scale (MHPTS), a validated team-based behavioural rating scale. The Mann-Whitney U-test was used to assess for between-group differences. Seventy-eight residents provided informed written consent and were recruited. The MP group outperformed the control group with significant effect on teamwork behaviour as assessed using the MHPTS: r=0.67, p<0.01. MP leads to improvement in team-based skills compared to traditional simulation-based trauma instruction. We feel that MP may be a useful and inexpensive tool for improving nontechnical skills instruction effectiveness for team-based trauma care.
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Leonard, M; Graham, S; Bonacum, D
2004-10-01
Effective communication and teamwork is essential for the delivery of high quality, safe patient care. Communication failures are an extremely common cause of inadvertent patient harm. The complexity of medical care, coupled with the inherent limitations of human performance, make it critically important that clinicians have standardised communication tools, create an environment in which individuals can speak up and express concerns, and share common "critical language" to alert team members to unsafe situations. All too frequently, effective communication is situation or personality dependent. Other high reliability domains, such as commercial aviation, have shown that the adoption of standardised tools and behaviours is a very effective strategy in enhancing teamwork and reducing risk. We describe our ongoing patient safety implementation using this approach within Kaiser Permanente, a non-profit American healthcare system providing care for 8.3 million patients. We describe specific clinical experience in the application of surgical briefings, properties of high reliability perinatal care, the value of critical event training and simulation, and benefits of a standardised communication process in the care of patients transferred from hospitals to skilled nursing facilities. Additionally, lessons learned as to effective techniques in achieving cultural change, evidence of improving the quality of the work environment, practice transfer strategies, critical success factors, and the evolving methods of demonstrating the benefit of such work are described.
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Puoane, Thandi; Cuming, Katie; Sanders, David; Ashworth, Ann
2008-11-01
Staff at 11 rural hospitals in an under-resourced region of Eastern Cape Province, South Africa, participated in an intervention to improve the quality of care of severely malnourished children through training and support aimed at implementing the WHO case-management guidelines. Despite similar intervention inputs, some hospitals reduced their case-fatality rates by at least half, whereas others did not. The aim of this study was to investigate reasons for this disparity. Two successful and two poorly performing hospitals were purposively selected based on their case-fatality rates, which were <10% in the successful hospitals and >30% in those performing poorly. Comparative data were collected during June to October 2004 through structured observations of ward procedures, compilation of hospital data on case-loads and resources, and staff interviews and discussions related to attitudes, teamwork, training, supervision, managerial support and leadership. The four study hospitals had broadly similar resources, infrastructure and child:nurse ratios, and all had made changes to their clinical and dietary management following training. Case-management was broadly in line with WHO guidelines but the study revealed clear differences in institutional culture which influenced quality of care. Staff in the successful hospitals were more attentive and assiduous than staff in the poorly performing hospitals, especially in relation to rehydration procedures, feeding and the recording of vital signs. There was a strong emphasis on in-service training and induction of incoming staff in the successful hospitals and better supervision of junior staff and carers. Nurses had more positive attitudes towards malnourished children and their carers, and were less judgmental. Underlying factors were differences in leadership, teamwork, and managerial supervision and support. We conclude that unless there are supportive structures at managerial level, the potential benefits of efficacious interventions and related training programmes to improve health worker performance can be thwarted.
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Bad Attitudes: Why Design Students Dislike Teamwork
ERIC Educational Resources Information Center
Tucker, Richard; Abbasi, Neda
2016-01-01
Positive experiences of teamwork in design contexts significantly improve students' satisfaction with teaching and their attitudes towards future teamwork. Thus, an understanding of the factors leading to negative and positive team experiences can inform strategies to support effective teamwork. This paper examines design students' perceptions and…
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Total cost of ownership: the role of clinical engineering.
Hockel, Dale; Kintner, Michael
2014-06-01
Hospitals often incur substantial hidden costs associated with service agreements that they enter into with original equipment manufacturers at the time of equipment purchase. Hospitals should perform an analysis of the total cost of ownership (TCO) of their organizations' medical equipment to identify opportunities for performance improvement and savings. The findings of the TCO analysis can point to areas where clinical engineering service management can be improved through investments in technology, training, and teamwork.
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C3Conflict a Simulation Environment for Studying Teamwork in Command and Control
2011-06-01
the Sciences (pp. 173- 217). Amsterdam/New York: Rodopi. Kolb , D. A. (1984). Experiential Learning – Experience as a source of learning and...increases dramatically when the students can see a replay and discuss their collaboration. Kolb has expressed a generally accepted model of experiential ... learning ( Kolb , 1998). The model can be adapted for research and team training performed with computer-based simulations (Granlund, 2008). The main
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Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia
2015-03-01
The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence doing procedures and 29 of 37 (78%) reported knowing when the procedure should be applied. Oxford Non-Technical Skills evaluation demonstrated significant improvement in PGY 2 resident performance assessed during the 2 study periods: communication score increased from 3 to 3.71 (P=.01), leadership score increased from 2.77 to 3.86 (P<.001), teamwork score increased from 3.15 to 3.86 (P=.007), and procedural ability score increased from 2.23 to 3.43 (P=.03). There were no statistically significant improved scores in PGY 2 decision making or situation awareness. No improvements in skills were seen among PGY 1 participants. The PGY 2 residents improved their skills, but the PGY 1 residents did not. Participants found interprofessional simulations to be realistic and a valuable educational tool. Interprofessional simulation provides a valuable means of educating surgical residents and evaluating their skills in real-life clinical scenarios.
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Context in Quality of Care: Improving Teamwork and Resilience.
Tawfik, Daniel S; Sexton, John Bryan; Adair, Kathryn C; Kaplan, Heather C; Profit, Jochen
2017-09-01
Quality improvement in health care is an ongoing challenge. Consideration of the context of the health care system is of paramount importance. Staff resilience and teamwork climate are key aspects of context that drive quality. Teamwork climate is dynamic, with well-established tools available to improve teamwork for specific tasks or global applications. Similarly, burnout and resilience can be modified with interventions such as cultivating gratitude, positivity, and awe. A growing body of literature has shown that teamwork and burnout relate to quality of care, with improved teamwork and decreased burnout expected to produce improved patient quality and safety. Copyright © 2017 Elsevier Inc. All rights reserved.
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Mijakoski, Dragan; Karadzinska-Bislimovska, Jovanka; Basarovska, Vera; Minov, Jordan; Stoleski, Sasho; Angeleska, Nada; Atanasovska, Aneta
2015-03-15
Few studies have examined teamwork as mediator and moderator of work demands-burnout and job engagement-job satisfaction relationships in healthcare workers (HCWs) in South-East Europe. To assess mediation and moderation effect of teamwork on the relationship between independent (work demands or job engagement) and dependent (burnout or job satisfaction) variables. Work demands, burnout, job engagement, and job satisfaction were measured with Hospital Experience Scale, Maslach Burnout Inventory, Utrecht Work Engagement Scale, and Job Satisfaction Survey, respectively. Hospital Survey on Patient Safety Culture was used for assessment of teamwork. In order to examine role of teamwork as a mediating variable we fit series of regression models for burnout and job satisfaction. We also fit regression models predicting outcome (burnout or job satisfaction) from predictor (work demands or job engagement) and moderator (teamwork) variable. Teamwork was partial mediator of work demands-burnout relationship and full mediator of job engagement-job satisfaction relationship. We found that only job engagement-job satisfaction relationship was moderated by teamwork. Occupational health services should target detection of burnout in HCWs and implementation of organizational interventions in hospitals, taking into account findings that teamwork predicted reduced burnout and higher job satisfaction.
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Neily, Julia; Mills, Peter D; Lee, Pamela; Carney, Brian; West, Priscilla; Percarpio, Katherine; Mazzia, Lisa; Paull, Douglas E; Bagian, James P
2010-08-01
Communication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities. Facilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1='no impact' and 5='significant impact.' We used logistic regression to examine implementation of briefing/debriefing. Ninety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4-5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4-5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03). Sites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.
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Nurok, Michael; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan
2010-05-01
To create and test a reproducible method for measuring emotional climate, surgical team skills, and threats to patient outcome by conducting an observational study to assess the impact of a surgical team skills and communication improvement intervention on these measurements. Observational study. Operating rooms in a high-volume thoracic surgery center from September 5, 2007, through June 30, 2008. Thoracic surgery operating room teams. Two 90-minute team skills training sessions focused on findings from a standardized safety culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication, and leadership. The sessions created an interactive forum to educate team members on the importance of communication and to role-play optimal interactive and communication strategies. Calculated indices of emotional climate, team skills, and threat to patient outcome. The calculated communication and team skills score improved from the preintervention to postintervention periods, but the improvement extinguished during the 3 months after the intervention (P < .001). The calculated threat-to-outcome score improved following the team training intervention and remained statistically improved 3 months later (P < .001). Using a new method for measuring emotional climate, teamwork, and threats to patient outcome, we were able to determine that a teamwork training intervention can improve a calculated score of team skills and communication and decrease a calculated score of threats to patient outcome. However, the effect is only durable for threats to patient outcome.
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Nursing teamwork, staff characteristics, work schedules, and staffing.
Kalisch, Beatrice J; Lee, Hyunhwa
2009-01-01
This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.
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Lown, Beth A; Manning, Colleen F
2010-06-01
To assess the impact of Schwartz Center Rounds, an interdisciplinary forum where attendees discuss psychosocial and emotional aspects of patient care. The authors investigated changes in attendees' self-reported behaviors and beliefs about patient care, sense of teamwork, stress, and personal support. In 2006-2007, researchers conducted retrospective surveys of attendees at six sites offering Schwartz Center Rounds ("the Rounds") for > or =3 years and prospective surveys of attendees at 10 new Rounds sites that have held > or =7 Rounds. Most of the retrospective survey respondents indicated that attending Rounds enhanced their likelihood of attending to psychosocial and emotional aspects of care and enhanced their beliefs about the importance of empathy. Respondents reported better teamwork, including heightened appreciation of the roles and contributions of colleagues. There were significant decreases in perceived stress (P < .001) and improvements in the ability to cope with the psychosocial demands of care (P < .05). In the prospective study, after control for presurvey differences, the more Rounds one attended, the greater the impact on postsurvey insights into psychosocial aspects of care and teamwork (both: P < .05). Respondents to both retrospective and prospective surveys described changes in institutional culture and greater focus on patient-centered care and institution-specific initiatives. Schwartz Center Rounds may foster enhanced communication, teamwork, and provider support. The impact on measured outcomes increased with the number of Rounds attended. The Rounds represent an effective strategy for providing support to health care professionals and for enhancing relationships among them and with their patients.
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2013-01-01
Background Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on the selection of instruments for measuring team-level factors by systematically collating, categorizing, and reviewing quantitative self-report instruments. Methods Data sources: We searched MEDLINE, PsycINFO, and Health and Psychosocial Instruments; reference lists of systematic reviews; and citations and references of the main report of instruments. Study selection: To determine the scope of the review, we developed and used a conceptual framework designed to capture factors relevant to evaluating CQI in primary care (the InQuIRe framework). We included papers reporting development or use of an instrument measuring factors relevant to teamwork. Data extracted included instrument purpose; theoretical basis, constructs measured and definitions; development methods and assessment of measurement properties. Analysis and synthesis: We used qualitative analysis of instrument content and our initial framework to develop a taxonomy for summarizing and comparing instruments. Instrument content was categorized using the taxonomy, illustrating coverage of the InQuIRe framework. Methods of development and evidence of measurement properties were reviewed for instruments with potential for use in primary care. Results We identified 192 potentially relevant instruments, 170 of which were analyzed to develop the taxonomy. Eighty-one instruments measured constructs relevant to CQI teams in primary care, with content covering teamwork context (45 instruments measured enabling conditions or attitudes to teamwork), team process (57 instruments measured teamwork behaviors), and team outcomes (59 instruments measured perceptions of the team or its effectiveness). Forty instruments were included for full review, many with a strong theoretical basis. Evidence supporting measurement properties was limited. Conclusions Existing instruments cover many of the factors hypothesized to contribute to QI success. With further testing, use of these instruments measuring team factors in evaluations could aid our understanding of the influence of teamwork on CQI outcomes. Greater consistency in the factors measured and choice of measurement instruments is required to enable synthesis of findings for informing policy and practice. PMID:23410500
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Contract Teamwork: A Way Out of the Ivory Tower.
ERIC Educational Resources Information Center
McMillan, Sally J.
How can teamwork be implemented effectively in university-level advertising classrooms? This paper reviews literature on the nature, structure, and function of teams and processes for managing teamwork. Based on this literature, an innovative approach to contract teamwork is introduced for use in an entry-level graduate course on integrated…
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Validity and Reliability of the Teamwork Scale for Youth
ERIC Educational Resources Information Center
Lower, Leeann M.; Newman, Tarkington J.; Anderson-Butcher, Dawn
2017-01-01
Purpose: This study examines the psychometric properties of the Teamwork Scale for Youth, an assessment designed to measure youths' perceptions of their teamwork competency. Methods: The Teamwork Scale for Youth was administered to a sample of 460 youths. Confirmatory factor analyses examined the factor structure and measurement invariance of the…
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Pfrimmer, Dale
2009-07-01
Effective teamwork and communication is critical to the delivery of safe and reliable patient care. Communication breakdowns account for the overwhelming majority of sentinel events. Effective teamwork and communication can help prevent mistakes and decrease patient risk. The implementation of simple tools and behaviors can greatly enhance patient safety and improve perceptions of teamwork.
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Teaching Teamwork through Coteaching in the Business Classroom
ERIC Educational Resources Information Center
Kliegl, Julie A.; Weaver, Kari D.
2014-01-01
Business educators recognize the importance of developing teamwork as an employability skill. However, current methods used to teach teamwork have been met with mixed results from both students and educators. This article integrates research on the importance of teamwork, team development processes, and coteaching through examining a case study…
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Häske, David; Beckers, Stefan K; Hofmann, Marzellus; Lefering, Rolf; Gliwitzky, Bernhard; Wölfl, Christoph C; Grützner, Paul; Stöckle, Ulrich; Dieroff, Marc; Münzberg, Matthias
2017-01-01
Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness. This was a prospective pre-post intervention trial and was part of the mixed-method longitudinal EPPTC (Effect of Paramedic Training on Pre-Hospital Trauma Care) study, evaluating subjective and objective changes among participants and real patient care, as a result of PHTLS courses. The courses provide an overview of the SAMPLE approach for interrogation of anamnestic information, which is believed to be responsible for patient safety as relevant, among others, "Allergies," "Medication," and "Patient History" (AMP). The focus of the course is not the documentation. In total, 320 protocols were analyzed before and after the training. The PHTLS course led to a significant increase (p < 0.001) in the "AMP" information in the documentation. The subgroups analysis of "allergies" (+47.2%), "drugs" (+38.1%), and "medical history" (+27.8%) before and after the PHTLS course showed a significant increase in the information content. In summary, we showed that PHTLS training improves documentation quality, which we used as a surrogate endpoint for learning effectiveness and awareness. In this regard, we demonstrated that participants use certain parts of training in real life, thereby suggesting that the learning methods of PHTLS training are effective. These results, however, do not indicate whether patient care has changed.
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Measuring teamwork and conflict among Emergency Medical Technician personnel
Patterson, P. Daniel; Weaver, Matthew D.; Weaver, Sallie J.; Rosen, Michael A.; Todorova, Gergana; Weingart, Laurie R.; Krackhardt, David; Lave, Judith R.; Arnold, Robert M.; Yealy, Donald M.; Salas, Eduardo
2011-01-01
Objective We sought to develop a reliable and valid tool for measuring teamwork among Emergency Medical Technician (EMT) partnerships. Methods We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool. We performed a series of Exploratory Factor Analyses (EFA) and Confirmatory Factor Analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. Results We received 687 completed surveys. The EFA analyses identified a 9-factor solution. We labeled these factors [1] Team Orientation, [2] Team Structure & Leadership, [3] Partner Communication, Team Support, & Monitoring, [4] Partner Trust and Shared Mental Models, [5] Partner Adaptability & Back-Up Behavior, [6] Process Conflict, [7] Strong Task Conflict, [8] Mild Task Conflict, and [9] Interpersonal Conflict. We tested a short form (30-item SF) and long form (45-item LF) version. The CFA analyses determined that both the SF and LF versions possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties with a mean Cronbach’s alpha coefficient ≥0.70 across all 9-factors (mean=0.84; min=0.78, max=0.94). The mean Cronbach’s alpha coefficient for the EMT-TEAMWORK-LF version was 0.87 (min=0.79, max=0.94). There was wide variation in weighted scores across all 9 factors and the global score for the SF and LF versions. Mean scores were lowest for the Team Orientation factor (48.1, SD 21.5 SF; 49.3 SD 19.8 LF) and highest (more positive) for the Interpersonal Conflict factor (87.7 SD 18.1 for both SF and LF). Conclusions We developed a reliable and valid survey to evaluate teamwork between EMT partners. PMID:22128909