A Systematic Review of Teamwork Training Interventions in Medical Student and Resident Education

Chakraborti, Chayan; Boonyasai, Romsai T.; Wright, Scott M.; Kern, David E.

doi:10.1007/s11606-008-0600-6

Cited by 132 publications

(96 citation statements)

References 37 publications

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“…The program was highly rated by participants, and the multidisciplinary setting was particularly valued. The next steps moving forward would be a more robust evaluation of the effectiveness of multidisciplinary educational programs in changing behaviors and clinical practice at the bedside 36 . We hope our curriculum and materials will stimulate continued interest in shifting education away from existing silos and towards shared understanding of the communication and teamwork that patients deserve.…”

Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

et al. 2008

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Section: Discussionmentioning

confidence: 99%

A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

et al. 2008

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“…15 Prior reviews have examined teamwork training and interventions, as well as the outcomes of effective teams. 1,[16][17][18][19][20][21][22][23][24] These reviews have advanced the understanding of 'what works' to improve teamwork (i.e. curricula and interventions), but they do not fully answer the critical question of how teamwork is best measured in healthcare.…”

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confidence: 99%

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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OBJECTIVE: Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. DATA SOURCES: We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. STUDY ELIGIBILITY: Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. STUDY APPRAISAL AND SYNTHESIS METHODS:Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. RESULTS: Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. LIMITATIONS: Review is limited to quantitative assessments of teamwork in internal medicine. CONCLUSIONS:There is strong validity evidence for several published tools assessing teamwork in internal medicine. However, few teamwork assessments have been directly linked to patient outcomes. 3,4 Recognizing this, the Institute of Medicine, the Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), and others have made teamwork a top priority in their recommendations for improving healthcare. [5][6][7][8][9] Teamwork is also prominently positioned within the American Board of Internal Medicine (ABIM) requirements for maintenance of certification for internists, 10 as well as the Accreditation Council for Graduate Medical Education's core competencies, 11 milestones, 12 and medical student competencies. 13 As such, every physician at the undergraduate, graduate, and continuing professional level must demonstrate competency in teamwork.While there is broad agreement on the imperative to improve teamwork, there is littl...

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“…26 Published transitional care curricula in internal medicine and family medicine rarely describe use of experiential learning (eg, direct patient contact, real-life experience with different care systems and disciplines) in diverse care systems, 10,[28][29][30][31][32] whereas residency curricula in home or nursing home settings or interdisciplinary teams do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] For example, nursing home curricula do not focus on how the complex care structure of postacute care affects transitions, or how transitional care to and from the nursing home can be optimized at an individual patient and system level. 20,21,24 Our curriculum addresses this gap by providing exposure to the continuum of care that patients experience.…”

Section: Discussionmentioning

confidence: 99%

“…10 Other curricula involve different care settings or interdisciplinary teams but do not focus on transitional care. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] We describe a curriculum to teach internal medicine residents to provide better transitional care at hospital discharge through experiential learning in different care settings outside of the acute hospital with a focus on other health care disciplines involved in care transitions.…”

Section: Introductionmentioning

confidence: 99%

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

Schoenborn¹,

Christmas²

2013

Journal of Graduate Medical Education

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Background Care transitions are common and highly vulnerable times during illness. Physicians need better training to improve care transitions. Existing transitional care curricula infrequently involve settings outside of the hospital or other health care disciplines. Intervention We created a curriculum to teach internal medicine residents how to provide better transitional care at hospital discharge through experiential, interdisciplinary learning in different care settings outside of the acute hospital, and we engaged other health care disciplines frequently involved in care transitions. Setting/Participants Nineteen postgraduate year-1 internal medicine trainees at an academic medical center in an urban location completed experiences in a postacute care facility, home health care, and outpatient clinics. Program Description The 2-week required curriculum involved teachers from geriatric medicine; physical, occupational, and speech therapy; and home health care, with both didactic and experiential components and self-reflective exercises. Program Evaluation The curriculum was highly rated (6.86 on a 9-point scale) and was associated with a significant increase in the rating of the overall quality of transitional care education (from 4.09 on a 5-point scale in 2011 to 4.53 in 2012) on the annual residency program survey. Learners reported improved knowledge in key curricular areas and that they would change practice as a result of the curriculum. Conclusions Our transitional care curriculum for internal medicine residents provides exposure to care settings and health care disciplines that patients frequently encounter. The curriculum has shown positive, short-term effects on learners' perceived knowledge and behavior.

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A Systematic Review of Teamwork Training Interventions in Medical Student and Resident Education

Cited by 132 publications

References 37 publications

A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

Getting Out of Silos: An Innovative Transitional Care Curriculum for Internal Medicine Residents Through Experiential Interdisciplinary Learning

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