ObjectivesCrew resource management (CRM) training formats have become a popular method to increase patient safety by consideration of the role that human factors play in healthcare delivery. The purposes of this review were to identify what is subsumed under the label of CRM in a healthcare context and to determine how such training is delivered and evaluated.DesignSystematic review of published literature.Data sourcesPubMed, PsycINFO and ERIC were searched through 8 October 2018.Eligibility criteria for selecting studiesIndividually constructed interventions for healthcare staff that were labelled as CRM training, or described as based on CRM principles or on aviation-derived human factors training. Only studies reporting both an intervention and results were included.Data extraction and synthesisThe studies were examined and coded for relevant passages. Characteristics regarding intervention design, training conditions and evaluation methods were analysed and summarised both qualitatively and quantitatively.ResultsSixty-one interventions were included. 48% did not explain any keyword of their CRM intervention to a reproducible detail. Operating room teams and surgery, emergency medicine, intensive care unit staff and anaesthesiology came in contact most with a majority of the CRM interventions delivered in a 1-day or half-day format. Trainer qualification is reported seldomly. Evaluation methods and levels display strong variation.ConclusionsCritical topics were identified for the CRM training community and include the following: the need to agree on common terms and definitions for CRM in healthcare, standards of good practice for reporting CRM interventions and their effects, as well as the need for more research to establish non-educational criteria for success in the implementation of CRM in healthcare organisations.

Abstract:Findings of studies on the unique effects of reasoning and working memory regarding complex problem solving are inconsistent. To find out if these inconsistencies are due to a lack of symmetry between the studies, we reconsidered the findings of three published studies on this issue, which resulted in conflicting conclusions regarding the inter-relations between reasoning, working memory, and complex problem solving. This was achieved by analysing so far unpublished problem solving data from the study of Bühner, Krumm, Ziegler, and Plücken (2006) (N= 124). One of the three published studies indicated unique effects of working memory and reasoning on complex problem solving using aggregated scores, a second study found no unique contribution of working memory using only figural scores, and a third study reported a unique influence only for reasoning using only numerical scores. Our data featured an evaluation of differences across content facets and levels of aggregation of the working memory scores. Path models showed that the results of the first study could not be replicated using content aggregated scores; the results of the second study could be replicated if only figural scores were used, and the results of the third study could be obtained by using only numerical scores. For verbal content, none of the published results could be replicated. This leads to the assumption that not only symmetry is an issue when correlating non-symmetrical data, but that content also has to be taken into account when comparing different studies on the same topic.

Abstract. The “digit span backwards” (DSB) is the most commonly used test in clinical neuropsychology to assess working memory capacity. Yet, it remains unclear how the task is solved cognitively. The present study was conducted to examine the use of visual and verbal cognitive strategies in the DSB. Further, the relationship between the DSB and a complex span task, based on the Simultaneous Storage and Processing task ( Oberauer et al., 2003 ), was investigated. Visualizers performed better than verbalizers in the dual task condition (rPB = .23) only when the relevant digits were presented optically. Performance in the DSB correlated only weakly with the complex span task in all conditions (all τ ≤ .21). The results indicate that the processing modality is determined by the preference for a cognitive strategy rather than the presentation modality and suggest that the DSB measures different working aspects than commonly used experimental working memory tasks.

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Objectives We sought to establish the feasibility of chunking crew resource management (CRM) training into micro-size interventions and to compare different training approaches in the context of micro-learning. Design We evaluated whether participants in micro-learning CRM activities achieved learning objectives following training. In a between-subjects design, groups were observed for behaviour during a simulation that was part of a 15-minute modular intervention and tested for recollection afterwards. Participants The 129 participants recruited for this study were medical students, who already had relevant experience treating patients. Interventions The experimental setting involved three 5-minute components: video, simulation, and debriefing. Different groups viewed videos involving different didactic concepts: one group observed a videotaped concrete example of a medical care team applying a CRM tool (example group), and one group observed a videotaped lecture on the same topic (lecture group). Main outcome measures All simulations were videotaped and coded in detail for the occurrence of and time spent engaging in team behaviour and medical care. Questionnaires were administered before, immediately after, and two weeks after the intervention. We compared the groups’ behaviour during the simulation (team cooperation and medical care), retention of knowledge from the training content, and results of the evaluation. Results Both groups exhibited most of the behaviours included in the content of the instructional videos during the simulations and recollected information 2 weeks later. The example group exhibited significantly more of the training content during the simulation and demonstrated better retention 2 weeks later. Although the example group spent more time on team coordination, there was no difference in the number of executed medical measures. Conclusion Delivering CRM training in chunks of relatively short and highly standardised interventions appears feasible. In this study, the form of didactical presentation caused a difference in learning success between groups: a traditional lecture was outperformed by an instructional video demonstrating a practical example.