Teamwork in the trauma room evaluation of a multimodal team training program

Abstract

Introduction:Poor teamwork leads to preventable medical errors, and thus negatively impacts medical care. One way to improve teamwork is training. A multimodality team training program was designed to impact the attitudes and behavior of first-year residents who will encounter medical situations in the trauma room. The training program included low-fidelity role plays, lectures, and high-fidelity simulation with feedback.Materials and Methods:The training program was a one-day workshop that was conducted twice, once for each of the two groups over two days at the beginning of the academic year in July. A total of 41 first-year interns (10 Emergency Medicine and 31 Surgery) were recruited for participation. Participants completed a Situational judgment test (SJT) on trauma teamwork before training. The training began with a low-fidelity simulation that served as an icebreaker to team concepts. Subsequently, a lecture with discussion provided key points regarding teamwork in the trauma room. A high-fidelity simulation then allowed participation in one of four trauma room scenarios with medical expert debriefing. The course concluded with a course summary and an assessment of participant attitudes regarding training along with a second administration of SJT.Results:Participant reactions to the training were positive overall. Results of SJT showed a positive effect for team training in three of the four possible comparisons.Conclusion:The program was well received by the residents. Results suggest that a comprehensive training approach using role play, lecture, and simulation can positively affect behavioral choices for teamwork in the trauma room.

Systematic review of coaching to enhance surgeons' operative performance

“…These groups were analyzed subsequently using the GRADE system in Table II. Six studies 9,20,25,28,29,31 reported on more than one outcome and were included in more than one outcome summary. Because many of the observational studies yielded a Very Low GRADE score in each outcome cohort shown in Table II, we used the MERSQI score to better differentiate the quality of evidence of these studies (see Table I).…”

“…Seven studies included participants' perception and attitude toward coaching interventions and participants' opinions on their confidence and stress level after being coached. 9,17,25,29,31,34,37 On the basis of the GRADE evaluation, this outcome category received a Very Low strength of evidence and a mean MERSQI score of 10, the lowest mean compared with the other three outcome categories. The main factors driving this relatively low score were selection bias (voluntary enrollment), nonblinded observers and self-assessed outcome measures.…”

“…Four studies 22,26,27,32 were randomized controlled trials (RCTs) that compared the intervention group with a control group. Eighteen studies 6,[17][18][19][20][21][23][24][25][28][29][30][31][33][34][35][36][37] were observational studies using a single group prepost design, and one study was a descriptive study analyzing audio-recorded video coaching. 9 The different types of reported outcomes were categorized largely based on Kirkpatrick's model of training evaluation.…”

Critical Appraisal of Emergency Medicine Education Research: The Best Publications of 2012

“…Publication in EM journals predominated (36; 75%). Three (6%) appeared in medical education journals, and nine (19%) were published in journals ranging from surgery 33,42,44,54 to psychiatry. 31,52 Others included palliative medicine, 26 critical care, 56 and simulation.…”

“…The sources of funding were as follows: five federal (two NIH, one Canada, and one Taiwan), five universitysponsored, two industry-supported, and two organizationally funded. Research methodology included 17 surveys (36%), 17,19,21,25,30,31,33,37,40,42,46,[50][51][52]54,60,61 15 (31%) observational analyses, [14][15][16]22,23,27,32,33,38,44,47,49,56,57,59 and three (6%) qualitative methodology studies. 19,28,45 There were only 12 (25%) with an experimental or quasi-experimental study design, 20,24,26,35,36,39,41,43,48,53,55,57 with five of the highlighted articles using this rigorous design.…”