Improving Teamwork, Confidence, and Collaboration Among Members of a Pediatric Cardiovascular Intensive Care Unit Multidisciplinary Team Using Simulation-Based Team Training

Abstract

Findings show that simulation-based team training (SBTT) is effective at increasing teamwork skills. Postpediatric cardiac surgery cardiac arrest (PPCS-CA) is a high-risk clinical situation with high morbidity and mortality. Whereas adult guidelines managing cardiac arrest after cardiac surgery are available, little exists for pediatric cardiac surgery. The authors developed a post-PPCS-CA algorithm and used SBTT to improve identification and management of PPCS-CA in the pediatric cardiovascular intensive care unit. Their goal was to determine whether participation aids in improving teamwork, confidence, and communication during these events. The authors developed a simulation-based training course using common postcardiac surgical emergency scenarios with specific learning objectives. Simulated scenarios are followed by structured debriefings. Participants were evaluated based on critical performance criteria, key elements in the PPCS-CA algorithm, and Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) principles. Surveys performed before, immediately after, and 3 months after participation evaluated perception of skill, knowledge, and confidence. The study had 37 participants (23 nurses, 5 cardiology/critical care trainees, 5 respiratory therapists, and 4 noncategorized subjects). Confidence and skill in the roles of team leader, advanced airway management, and cardioversion/defibrillation were increased significantly (p < 0.05) immediately after training and 3 months later. A significant increase (p < 0.05) also was observed in the use of Team STEPPS concepts immediately after training and 3 months later. This study showed SBTT to be effective in improving communication and increasing confidence among members of a multidisciplinary team during crisis scenarios. Thus, SBTT provides an excellent tool for teaching and implementing new processes.

Team-training in healthcare: a narrative synthesis of the literature

“…Self-efficacy or confidence in one's ability to engage in effective teamwork behaviours during future clinical events was the most commonly reported outcome at this level among the studies reviewed in table 2. Self-efficacy is an important antecedent that shapes intentions to use effective teamwork skills during clinical practice and has been related to increased use of effective teamwork behaviours 65. Overall, previous reviews and the additional seven primary articles that evaluated these outcomes provide evidence that team-training can positively impact these types of outcomes (see online supplementary appendix).…”

Examining the nature of interprofessional interventions designed to promote patient safety: a narrative review

“…For example, studies that used interprofessional education activities involved interactive seminars, workshops or team-based simulation [20][21][22][23]. Often these educational interventions employed TeamSTEPPS or CRM (crisis resource management) approaches [24][25][26][27].…”

Do interprofessional simulations increase knowledge retention and perceptions of teamwork skills in a surgical trauma burn ICU setting?

“…Continued examination of patient outcomes reveals the importance of teamwork, which is now accepted as an essential component of patient care (Figueroa MI, Sepanski R, Goldberg SP, & Shah S, 2013). Multiple studies show a relationship between poorly functioning teams and increased medical errors, which may lead to suboptimal patient outcomes (Acero et al, 2012;Figueroa MI et al, 2013; The high acuity of the patients in the STBICU also requires the resident physicians (RPs) to be astutely trained to respond to clinical emergencies.…”

“…Multiple studies show a relationship between poorly functioning teams and increased medical errors, which may lead to suboptimal patient outcomes (Acero et al, 2012;Figueroa MI et al, 2013; The high acuity of the patients in the STBICU also requires the resident physicians (RPs) to be astutely trained to respond to clinical emergencies. Previously, no training specific to the STBICU patient population existed to prepare resident physicians for their rotations through the unit.…”

“…( (Sweeney, Stephany, Whicker, Bookman, & Turner, 2011) Figueroa and colleagues (2012) found similar results. Participants felt significantly more equipped to participate in, and lead an actual code (p <0.05), manage an advanced airway, and perform cardioversion/defibrillation (p <0.05) (Figueroa MI et al, 2013). Results from another IPS intervention revealed knowledge test scores for baseline, post-intervention and re-evaluation of 86%, 96%, and 93%, respectively .…”