Teaching leadership in trauma resuscitation

Gregg, Shea C.; Heffernan, Daithi S.; Connolly, Michael D.; Stephen, Andrew H.; Leuckel, Stephanie N.; Harrington, David; Machan, Jason T.; Adams, Charles A.; Cioffi, William G.

doi:10.1097/ta.0000000000001186

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…Our interviews with supervisors contributed to our knowledge about ways to provide feedback and coaching in the moment, a need identified by earlier research and CBME. [16][17][18][19][20] They identified approaches and specific phrases to adapt the R2C2 model for inthe-moment use to allow shorter and more frequent feedback conversations. In doing so, they maintained the core elements of the R2C2 resident formal model and found that the structured approach to building a relationship, exploring reactions, determining content, and coaching for change was a practical way to have a discussion even when time was limited or the focus was on a specific task.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,12 The need for high-quality in-the-moment feedback is evident given research reports of performance improvement following immediate feedback, issues of recall post-feedback, and the association between depression and lack of timely and appropriate feedback. [16][17][18][19] It is of particular interest to those working in competency-based medical education (CBME) settings where learners are expected to meet milestones or complete entrustable professional activities (EPAs). CBME necessitates frequent feedback following direct observation of workplace-based performance with informal in-the-moment conversations at the end of a shift, clinic, or after a single patient encounter to focus on a specific skill or competence.…”

Section: Introductionmentioning

confidence: 99%

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In-the-Moment Feedback and Coaching: Improving R2C2 for a New Context

Lockyer

Armson

Könings

et al. 2020

Journal of Graduate Medical Education

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Background The R2C2, a 4-phase feedback and coaching model, builds relationships, explores reactions, determines content and coaches for change, and facilitates formal feedback conversations between clinical supervisors/preceptors and residents. Formal discussions about performance are typically based on collated information from daily encounter sheets, objective structured clinical examinations, multisource feedback, and other data. This model has not been studied in settings where brief feedback and coaching conversations occur immediately after a specific clinical experience. Objective We explored how supervisors adapt the R2C2 model for in-the-moment feedback and coaching and developed a guide for its use in this context. Methods Eleven purposefully selected supervisors were interviewed in 2018 to explore where they used the R2C2 model, how they adapted it for in-the-moment conversations, and phrases used corresponding to each phase that could guide design of a new R2C2 in-the-moment model. Results Participants readily adapted the model to varied feedback situations; each of the 4 phases were relevant for conversations. Phase-specific phrases that could enable effective coaching conversations in a limited amount of time were identified. Data facilitated a revision of the original R2C2 model for in-the-moment feedback and coaching conversations and design of an accompanying trifold brochure to enable its effective use. Conclusions The R2C2 in-the-moment model offers a systematic approach to feedback and coaching that builds on the original model, yet addresses time constraints and the need for an iterative conversation between the reaction and content phases. The model enables supervisors to coach and co-create an action plan with residents to improve performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

In-the-Moment Feedback and Coaching: Improving R2C2 for a New Context

Lockyer

Armson

Könings

et al. 2020

Journal of Graduate Medical Education

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“…57,64 The two remaining studies used observational periods. 52,53 In general, debriefing had a favorable effect on team performance. One particular type of debriefing does not appear to be superior to other types of debriefing Table 4.…”

Section: Nts (Tablementioning

confidence: 98%

“…One focused on an ALS course 51 and two on real-time ALS interventions. 52,53 There was a large heterogeneity in both the age of the patient and the setting of the simulated ALS scenarios. A detailed overview of results is available in Data Supplement S2.…”

Section: Study Selection Population and Topic Of The Interventionmentioning

confidence: 99%

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The Effect of Teaching Nontechnical Skills in Advanced Life Support: A Systematic Review

Dewolf

Clarebout

Wauters

et al. 2020

AEM Education and Training

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Objectives: The objective of this study was to evaluate the effect of nontechnical skills (NTS) training on performance in advanced life support (ALS) simulation. Furthermore, we aimed to determine the ideal frequency of training sessions for an optimal retention and the value of debriefing.Methods: A systematic search was performed using PubMed, EMBASE, WoS, ERIC, CINAHL, and the Cochrane Library conducted through August 1, 2018. All primary studies mentioning NTS in ALS education were included. Three reviewers independently extracted data on study design and outcome. The MERSQI approach was used to evaluate the overall quality of evidence.Results: Of the 10,723 identified articles, 40 studies were included with a combined total of 3,041 participants, ranging from students to experts. Depending on the focus of the study, articles were categorized in NTS (n = 25), retention (n = 8), and feedback (n = 10). Incorporating NTS during ALS simulation showed significant improvements in timing for performing critical first steps. Furthermore, good leadership skills had a favorable effect on overall technical performance and teamwork during simulation improved team dynamics and performance. Finally, debriefing also had a beneficial effect on team performance. One particular type of debriefing does not appear to be superior to other types of debriefing. Conclusion:Team simulation training resulted in improved NTS and a reduction in the time required to complete a simulated cardiac arrest. Therefore, a formal NTS program should be introduced into ALS courses. Feedback and repetitive practice are key factors to train NTS. The impact of training on team behaviors can persist for at least 3 to 6 months. In conclusion, understanding and improving NTS may help to create more effective teams. The effect on patient outcome requires further investigation.S urvival from out-of-hospital cardiac arrest (CA) remains low around 10.3% with survival depending on location of arrest, initial rhythm, and patient and rescue factors. 1 Therefore, the American Heart Association (AHA) and European Resuscitation Council (ERC) guidelines emphasize the importance of technical skills (TS). 2 However, errors are frequently the result of failure in nontechnical skills (NTS). 3 Therefore, the quality of NTS in terms of teamwork, leadership, communication, and situational awareness is likely just as important for achieving a better patient outcome. [3][4][5][6][7] As a result, NTS training was recently included in several medical courses, including the advanced life support (ALS) course. [8][9][10][11] This training can potentially reduce patient morbidity and mortality by enabling

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