Integration and Improvement of Teamwork Skills in First Year Medical Students by Using Physiology-Based High Fidelity Patient Simulations

Abstract

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.

Developing a tool for observing group critical thinking skills in first-year medical students: a pilot study using physiology-based, high-fidelity patient simulations

“…In our Table 2. Comparison of median ratings for each observation from all of the groups' first and last simulation HFPS, the second part of each debriefing session focuses on group dynamics to address some of these concerns, as past studies have shown that group dynamics can improve over series of HFPS, if these are included as a topic in debriefs (27). For this study, the initial discussion of teamwork skills was addressed after the first simulation.…”

“…For this study, the initial discussion of teamwork skills was addressed after the first simulation. Therefore, as students improve teamwork skills, it is possible that this could also contribute to improved scores on the CTSRI (27). Further studies are still necessary to look at group interaction and the role it plays in the group thought process.…”