A Brain-Based Instruction Simulation Approach to Improve Code Team Response in an Internal Medicine Unit

Abstract

Background and Objectives. The code team course is a 3-hour, interactive course that follows a 4-phase brain-based lesson plan for simulation. Interprofessional teams receive instruction and practice in evidence-based teamwork, communication, and individual skills. Methods. This quantitative research included a pre-test and post-test design in an urban Department of Medicine. Sixteen groups (n=109) participated in the course over a period of eight weeks. Classroom metrics included pre- and post-course High-Quality cardiopulmonary resuscitation (CPR) and code team didactic knowledge assessed by Wilcoxon rank-sum tests. In addition, four in-situ mock code simulations were conducted to provide the researchers with baseline and post-intervention data. Code team performance assessment scores were tallied and compared between baseline and post-intervention by Fisher’s Exact Test. Results. The classroom metrics produced significant results. High-Quality CPR scores were higher post-training than pre-training (median score 4 vs. 3, respectively; p=0.006). Didactic knowledge test scores were also significantly higher (median score 90 vs. 70, respectively; p <0.001). In-situ team performance improved in several areas. There was a significant improvement in the area of cardiac code management in the day shift group. The percent “done well” improved from 25% (5/20) to 100% (20/20) (p= <0.001). Conclusion. The results of this pilot study suggest that code team training using the 4-phase BBL plan for simulation is associated with improvements in interprofessional team knowledge and performance during cardiac emergencies. It is equally important that the training is conducted over a short period in order to ensure that all team members are properly prepared.

Brain-based learning research for adult education and human resource development

“…The studies mainly focused on a comparison of independent measures or multivariate analysis and none of the BBL studies applied structural equation modeling and multilevel analysis to estimate the relationship among the different variables. The analysis of BBL studies using elementary/intermediate and advanced statistics tended to test the effect of brain-based instructional models or BBL interventions on learners’ or trainees’ cognitive development and learning performance (Borness et al , 2013; Clapper et al , 2018; Foster et al , 2016). Experimental studies including pre- and post-test models depended more on using brain imaging techniques to uncover the black box of cognition and memory or to measure actual changes of the neural networks more precisely, resulting from BBL interventions (Bora, 2012).…”

“…BBL research has evolved with an extensive range of research topics. For example, A plethora of studies on learner/learning processes has addressed the impact of brain-based instructional and training methods on a broad range of educational issues such as team performance (Clapper et al , 2018), emotional intelligence (Bora, 2012), teacher professional development (Dubinsky et al , 2013) and math and reading for college students (Zamarian et al , 2009). Although a string of experiment-based inquiry has focused more on young adults in higher education institutions, there have been recent attempts to apply BBL to organizational contexts to improve employees’ cognitive abilities and productivity (Borness et al , 2013).…”

Healthcare Simulation Research in Simulation and Gaming: Past, Present, and Future

“…In the first article by Clapper et al (2018) entitled “A Brain-Based Instruction Simulation Approach to Improve Code Team Response in an Internal Medicine Unit,” the authors examine the impact of an interactive, three-hour, code team course that followed a brain-based lesson plan which included four phases. Using a pre-test and post-test design, the investigators assigned interprofessional teams to participate in an eight-week code team course.…”

“…The results showed significant improvements in CPR quality and in-situ simulation-based team performance status-post-training. Based on these results, the authors conclude that code team training using the brain-based learning plan with four phases can improve team knowledge and performance, particularly when there is an emergency of a cardiac-related nature (Clapper et al, 2018).…”

A Multi-center Simulation-Based Emergency Medicine Resident Boot Camp Can Improve Teamwork, Communication, and Clinical Skills

“…Medical simulation is an instrumental teaching modality for learners throughout the medical field [ 1 - 5 ]. One of the more recent developments in medical simulation is the implementation of educational boot camps.…”