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Multidisciplinary Simulation-Based Team Training: Knowledge Acquisition and Shifting Perception

https://doi.org/10.1016/j.ecns.2020.01.001Get rights and content

Highlights

  • A simulation-based team training workshop was successfully implemented in the pediatric cardiac intensive care unit in a multidisciplinary setting.

  • All types of providers scored low in areas of communication, and the knowledge of these principles improved after the workshop.

  • The workshop improved perceptions of team dynamics and improved confidence levels, particularly in inexperienced providers.

Abstract

Background

A multidisciplinary simulation-based team training workshop was implemented to improve the knowledge and application of crisis resource management (CRM) principles in the pediatric cardiac intensive care unit.

Methods

The workshop consisted of two scenarios followed by structured debriefing. The participants were asked to complete a survey, before and three months after the workshop, evaluating the knowledge base of CRM principles and perception of team dynamics.

Results

The initial survey was completed by 144 participants; the follow-up was completed by 72 participants. There was a significant knowledge gap before the workshop, particularly in the areas of closed-loop communication and key principles for effective communication, which improved after the workshop. There was improvement in the perception of team performance three months after the workshop.

Conclusions

This study shows that a multidisciplinary simulation-based team training in the pediatric cardiac intensive care unit improves knowledge of CRM principles in addition to improved perception of effective teamwork.

Section snippets

Theoretical Framework

The educational framework for this simulation workshop was based on Kolb's Experiential Learning Theory. The learners participated in the simulation providing concrete experience and then reflected on their actions during the structured debrief session, providing the opportunity for reflective observation. During the structured debrief, the learners were encouraged to think of different actions they could have taken and to generalize these topics to other situations they have been in, allowing

Clinical and Simulation Setting

An SBTT workshop was implemented in the pCICU from March to May 2017. The hospital where the study was conducted is a freestanding 272-bed pediatric teaching hospital with a 27-bed pCICU and approximately 600 cardiopulmonary bypass surgical cases annually. The institutional review board determined that this study was institutional review board exempt; however, informed consent was obtained from all participants completing the surveys.

Over the three-month training period, 26 workshops were

Results

One hundred forty-four participants completed the preworkshop survey, consisting of 99 RNs, 18 RTs, and 27 TLs (5 APPs, 12 fellows, 10 attending physicians). The baseline experiences of the participants in their respective role, in the pCICU and in simulation, are summarized in Table. Seventy-two (50%) participants completed the postworkshop survey, consisting of 51 RNs, eight RTs, and 13 TLs (1 APP, six fellows, six attending physicians). There was no significant difference in the years of

Discussion

Creating a culture of safety in health care is necessary for reducing errors and improving patient care (Institute of Medicine, 2001, Nieva and Sorra, 2003). Despite the rising awareness, health care providers do not consistently report the perception of a safety culture, and this has been demonstrated in the area of pediatric cardiology and cardiothoracic surgery (Bognar et al., 2008). CRM principles have been successfully implemented in health care with the goal of creating and improving a

Conclusions

In summary, we have described the effectiveness of a multidisciplinary SBTT in the pCICU in improving both knowledge of CRM principles and in individual confidence during crisis situations. At baseline, there can be a big discrepancy how someone perceives team dynamics and in their knowledge of CRM principles based on their individual background and training. In addition, we have shown that while the perception of good team dynamics may exist in a group, the actual knowledge and application of

Acknowledgment

The authors would like to acknowledge the simulation educators for the time they committed to this workshop, as well as the simulation technicians who helped program and deliver the scenario. Additionally, we wish to acknowledge the Pediatrics Biostatistics Core for their statistical support of this study.

References (19)

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical approval: The institutional review board (IRB) of Emory University determined that this study did not require IRB review because it does not meet the definition of research with human subjects as set forth by Emory policies and procedures and federal rules. However, informed consent was obtained from all participants completing the surveys.

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