Changes of collective orientation through a medical student’s anaesthesia simulation course – simulation-based training study with non-technical skills debriefing versus medical debriefing

Abstract

Background Non-technical skills (NTS) are known to have a positive impact on quality of medical care. The team performance enhancing behaviour, as an example for NTS, is termed “Collective Orientation” (CO). In this study, we investigated the effect of a simulator-based anaesthesia training upon student’s CO in relation to medical and TeamGAINS (guided team self-correction, advocacy-inquiry and systemic-constructivist techniques) debriefing. We hypothesized (a) the scale collective orientation, as demonstrated in other team setting, is applicable to fourth year German medical students, (b) collective orientation increases by a four-hour anaesthesia simulation course, (c) the change in collective orientation can be influenced by type of debriefing. Method All classes of an anaesthesia module (4th year medical students) were randomized into two groups. Students took part in a four-hour simulation course with team scenarios, supported by a simulated nurse. In group one the trainer focused on a debriefing on medical problems and in group two, a debriefing according to the specifications of the TeamGAINS concept was conducted. The primary outcome was the mean difference between the collective orientation measured (via questionnaires) immediately before (T1) and after (T2) training. Results Cronbach’s alpha for all scales and measurement points was higher than 0.72. The scale “affiliation” decreases in the group medical debriefing MD = 0.1 ( p = 0.008; r = 0.31) and was unchanged in the group TeamGAINS. “Dominance” increases in both groups. The values were MD = 0.19 ( p = 0.003; r = 0.25) for medical debriefing and MD = 0.22 ( p = 0.01; r = 0.40) for TeamGAINS debriefing. Conclusion The collective orientation questionnaire can be applied to fourth year medical students. Simulation courses influence the attitude towards teamwork. The influence is negatively to the subscale “affiliation” by a “medical debriefing” and independently regardless of the nature of the debriefing for the subscale “dominance”. We recommend a debriefing for medical students using the TeamGAINS approach to clarify the connection between the individual performance and non-technical skills. Anaesthesia simulation courses have the potential being a part of a longitudinal education curriculum for teaching non-technical skills.

Change of Collective Orientation Through an Interprofessional Training with Medical Students and Student Nurses Depending on Presence and Professional Group

“…This effect of changed CO does not seem to depend on professional experience, as we have made the same observation with experienced anesthesiologists before (21). As observed in a previous study, this effect does not occur, when the nurse is simulated by a physician (25). This simulation artifact is apparently not correctable and in uences the attitude of belonging to the team.…”

How Do They Learn: Types and Characteristics of Medical Student Engagement in the Simulation-Based Learning Environment

“…Teamwork is crucial for success: varied backgrounds and interests enable them to solve the problems from different perspectives [34]. Eismann et al showed simulation courses have an in uence on teamwork [35]. This study found that the more closely learning context is related to real-life practices, the more mutual encouragement takes place among peers along with more positive feedback from the facilitator, which in turn promotes student engagement.…”

How Do They Learn: Types and Characteristics of Medical Student Engagement in the Simulation-Based Learning Environment

“…Teamwork is crucial for success: varied backgrounds and interests enable them to solve the problems from different perspectives [32]. Eismann et al showed simulation courses have an in uence on teamwork [33]. This study found that the more closely learning context is related to real-life practices, the more mutual encouragement takes place among peers along with more positive feedback from the lecturer, which in turn promotes student engagement.…”