Does classroom-based Crew Resource Management training improve patient safety culture? A systematic review

Abstract

Aim:To evaluate the evidence of the effectiveness of classroom-based Crew Resource Management training on safety culture by a systematic review of literature.Methods:Studies were identified in PubMed, Cochrane Library, PsycINFO, and Educational Resources Information Center up to 19 December 2012. The Methods Guide for Comparative Effectiveness Reviews was used to assess the risk of bias in the individual studies.Results:In total, 22 manuscripts were included for review. Training settings, study designs, and evaluation methods varied widely. Most studies reporting only a selection of culture dimensions found mainly positive results, whereas studies reporting all safety culture dimensions of the particular survey found mixed results. On average, studies were at moderate risk of bias.Conclusion:Evidence of the effectiveness of Crew Resource Management training in health care on safety culture is scarce and the validity of most studies is limited. The results underline the necessity of more valid study designs, preferably using triangulation methods.

Infection control link nurses in acute care hospitals: a scoping review

“…Six of the studies that did report on the effect of ICLN programs had a single-center uncontrolled study design [7, 8, 26, 35, 36, 38]. These studies hold a high risk of selection bias [40]. Prevention of healthcare-associated infections may be influenced by many other factors than the ICLN program itself, and controlled studies may not find significant effects due to low statistical power (type II error) [41].…”

Interventions to improve team effectiveness within health care: a systematic review of the past decade

“…This resulted in 5763 articles. In addition, 262 articles were identified through the systematic reviews published in the last decade [3,4,7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. In total, 6025 articles were screened.…”

“…In 2014, O'Dea et al [9] showed with their meta-analysis that CRM training (a type of team intervention) has a strong effect on knowledge and behaviour in acute care settings (as a specific healthcare setting). In addition to the aforementioned reviews, a dozen additional literature reviews that focus on the relationship between (a specific type of) team interventions and team performance could be mentioned [7,[10][11][12][13][14][15][16][17][18][19]. In sum, the extensive empirical evidence shows that team performance can be improved through diverse team interventions.…”

The experience of learning to speak up: a narrative inquiry on newly graduated registered nurses

“…CRM was originated from the aviation industry, to reduce human errors and foster a culture of patient safety. However, the evidence of its effectiveness in healthcare in terms of an improved culture of safety is inconclusive with limited validity (Verbeek-van Noord et al 2014). Also, there is no strong direct evidence to show whether the knowledge gained from these education programmes can be applied in actual practice or whether the voices of those who speak up will be heard by the healthcare team.…”

“…This study provides practice-based evidence to the suggestion that the learning process has been oversimplified and over-standardised (Fawcett & Rhynas 2014). At the same time, the effectiveness of safety tools (Riesenberg et al 2009) alongside the one-off CRM training (Stevens et al 2012, Verbeek-van Noord et al 2014) remains questionable.…”