Simulation-based team training

Learn to cooperate toward shared goals using the principles of CRM

Monday, 25 September, 2017

Throughout the health care community, small groups of individuals work together as teams. Physicians, nurses, pharmacists, technicians, and other health professionals must coordinate their activities to make safe and efficient patient care a priority. In health care, it is not enough to be proficient in just your own individual tasks; one should also be a good team player.

However, even though a myriad of the conditions addressed by health professionals require interdisciplinary teams, members of these teams are rarely trained together. Furthermore, they often come from separate disciplines and diverse educational programs.

Given the interdisciplinary nature of the work and the necessity of cooperation among the workers who perform it, it is likely that teamwork plays an important role in ensuring patient safety and avoiding errors.

Teamwork behaviors

Teams make fewer mistakes than individuals do, especially when each team member knows his or her responsibilities, as well as what other team members are responsible for. Team structures, such as recognizing and acknowledging the mistakes of others, coordinating work, and compensating for each other ensures that fewer errors are made.

Still, simply installing a team structure does not automatically ensure it will operate effectively. Teamwork is not an automatic consequence of placing people together in the same room; it depends on a willingness to cooperate toward shared goals. In health care, shared goals might include maintaining a patient's health status and avoiding errors.

Learn to work together

Teamwork can be promoted in several ways. The most commonly used method is training entire teams together to better prepare them for effective cooperation. A team training is very suitable to achieve:

  • Improved communication between the team members
  • Better coordinated clinical processes and use of medical equipment
  • Enhanced decision-making process
  • Well managed errors and incidents

Simulation-based team training in a safe and realistic environment

Obstetrics, for example, lends itself to multidisciplinary team training. It is a field in which nurses, midwives, obstetricians and paediatricians work together and where decisions must be made and actions must be carried out under extreme time pressure. The Máxima Medical Centre (MMC) in Eindhoven/Veldhoven, has taken the initiative in the Netherlands in applying team training using practical medical simulation.

Multiprofessional teams are trained in teamwork skills using the principles of Crew Resource Management (CRM) and Noldus’ technology. During the one-day training, the teams provided care to a simulated patient. The scenarios were all videotaped, and the recordings were used to facilitate the debriefing after each scenario.

Video recording team training for debriefing

The teams of MMC have gathered that both trainees and trainers benefit from video recording of the training scenarios, since Viso provides the opportunity to evaluate medical skills and non-medical skills in a more objective manner. Aside from knowledge and skills, cooperation and communication between the various team members was monitored.

The non-obtrusiveness of video recording with Viso allows the performing team to completely focus on the medical scenario, since the trainers (and any other observers, such as colleagues) can monitor the training session from another room.

The learning moment is in the debriefing

Debriefings are structured discussions facilitated by a team leader for the purpose of reviewing individual and team performance in an open, blame-free, non-punitive environment. The latter is of great importance.

Debriefing serves to identify areas where the team performed well along with opportunities for improvement, and it serves to build teamwork and facilitate communication.

Feedback has positive effects on team members. Discussing the scenarios afterwards constitutes an important and possibly even the most important part of the simulation. The use of video recordings in team training is the basis for debriefing. It enables you to show what really happened.

Viso medsim

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References

Weaver, S.J.; Dy, S.M.; Rosen, M.A. (2014). Team training in healthcare: a narrative synthesis of the literature. BMJ Quality & Safety, (23), 359-372.   

Fluit, C.R.M.G.; Klaassen, T.P.F.M. (2011). Achtergronden bij de Richtlijn simulatie teamtraining. Tijdschrift voor Medisch Onderwijs, (30), 11–27. 

Baker, D.P.; Gustafson, S.; Beaubien, J. M.; Salas, E. & Barach, P. (2005). Medical Team Training Programs in Health Care. Advances in Patient Safety: From Research to Implementation.