Communication errors between team members underlie many of the preventable patient errors within the US healthcare system. Medical students do not get the opportunity to take advantage of TeamSTEPPS® training because they are not consistently a part of hospital-based teams. Most of their communication skills training are focused on the doctor and patient relationship and less focus on teamwork (TW) skills. Developing TW skills earlier in medical education may help lead to better communication and patient safety; however, there is little time in preclinical medical education due to full curricula. The purpose of this study was to integrate TW skills development into existing physiology-based high fidelity patient simulations (HFPS) by using strategic triggers. A mixedmethods approach was used with the use of an evaluation tool and qualitative interviews to determine student perceptions of learning in these HFPS. Furthermore, since HFPS is costly in terms of faculty time, we aimed to find ways to reduce faculty time involvement. One hundred twenty first year medical students participated in three HFPS and observed one. The data show that TW skills are significantly improved between the first and last HFPS for most teams of students. There were no differences between learner-observer-led and faculty-led debriefs in development of TW skills. Qualitative student interviews show that they believe TW skills were learned by the HFPS and also that observing HFPS was beneficial in their learning. Overall, these data suggest that TW skills can be improved by integrating these into physiology-based HFPS with strategically placed triggers.

This study explored educators' and students' understanding of feedback and studied educators' implementation and students' utilization of feedback.This is a retrospective observational study that employed a qualitative, in‐depth, semi‐structured interview method. The study was conducted in the MD program at the University of Central Florida College of Medicine. The participants included 11 full‐time faculty members and 13 students from the Class of 2016. Interview transcripts were subject to coding and thematic analysis. Standard end‐of‐course student evaluations were also analyzed for each of the 14 courses in the pre‐clerkship curriculum to gain insight into satisfaction about feedback.The majority of faculty and all student participants gave only basic definitions of feedback and lacked insight into the components of effective feedback. The most commonly listed form of feedback was weekly online formative quizzes. Online quizzes are a type of formative assessment and represent an opportunity for feedback but are not feedback in itself. The fact that participants identified opportunities for feedback as actual feedback indicated a possible misconception among both faculty and students. Eighty two percent of the faculty felt that they were unable to provide the desired level of feedback while 62% of students felt that they did not receive desired feedback. In end‐of‐course evaluations a summary question about level of feedback satisfaction scored lower than overall module satisfaction in all but one instance. Taking interview responses and end‐of‐course evaluation data, the study has identified a need for faculty and student education about what effective feedback is and how to better incorporate it in the education program.