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The effective reduction of medical errors depends on an environment of safety for patients in both clinically-based and systems-oriented arenas. Formal teamwork training is proposed as a systems approach that will achieve these ends. In a study conducted by Dynamics Research Corporation, weaknesses and error patterns in Emergency Department teamwork were assessed, and a prospective evaluation of a formal teamwork training intervention was conducted. Improvements were obtained in five key teamwork measures, and most importantly, clinical errors were significantly reduced.

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The HARDMAN Comparability Methodology was developed by the Navy to estimate human resource requirements during the early phases of weapon system development.The Army has modified the system to support its own needs in this area. Four real system applications in the Army and an evaluation by the Jet Propulsion Laboratory indicated that it is useful, useable, and reasonably credible, and provides a near-term solution to the Army s needs. An Army Guide is under development.

To improve crew coordination in aviation operations, the Army has adopted an Aircrew Coordination Training (ACT) program. However, the Army does not have a reliable, objective set of metrics for assessing the extent of the resulting crew coordination. Consequently, ARTARDA and DRC developed measures of aircrew coordination to assist in evaluating the effectiveness of the Army ACT program. A rational approach to evaluation requires that assessment be structured and tied to well-defined objectives. The initial stages of the project were driven by the recognition of two crucial deficiencies. First, there was no fundamental conceptual framework for aircrew coordination articulated in the literature. Second, most ACT evaluation schemes were based on measuring attitude change, rather than attitudes and behavior. To remedy these deficiencies, a conceptual model of aircrew coordination was developed and coordination objectives were established. Based on this work, an aircrew coordination evaluation measurement suite was constructed to measure both attitudes and behaviors. This work will assist in moving ACT programs to a much sounder footing since many ACT courses have been criticized for being too "soft." The ARIARDA project, with a robust theoretical model and associated behavioral outcomes, will integrate ACT training and evaluation in the Army. Moreover, because the model is general, it can provide guidance to other agencies developing crew coordination training or evaluation.

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