MedEdPORTAL (Oct 2013)
Interprofessional Teamwork Training in Neonatal Resuscitation Using TeamSTEPPS and Event-Based Approach Simulation
Abstract
Abstract Introduction The Interprofessional Teamwork Training in Neonatal Resuscitation course includes a mix of didactic and simulation-based learning activities. The didactic teamwork and communication portion includes the TeamSTEPPS Fundamentals Course curriculum, which focuses on five core competencies of teamwork that include: team structure, leadership, situational monitoring, mutual support, and communication. Methods The simulation-based training exercises utilize an event-based approach and was designed to facilitate learning of the TeamSTEPPS concepts by allowing students to apply the concepts in a realistic scenario. The simulations involve a neonatal resuscitation which include scripted performance errors. The entire course can be conducted in 4–6 hours. Results We have performed a pilot study of the course at our institution with very positive results. Forty-two participants completed the course, including 29 nurses, 10 physicians, and three respiratory therapists. Attitudes towards teamwork improved significantly from the pretest to the posttest (p < .001). Participant teamwork knowledge scores on the LB also improved significantly (pretest 86.8% ± SD = 7.5 vs. posttest 92.6% ± SD = 6.3; p < .001). Teamwork skills during the simulated neonatal resuscitations improved significantly. Improvements were seen in team structure (pretest 2.5 ± SD = 1.3 vs. posttest 4.2 ± SD = 0.9; p < .001), leadership (pretest 2.6 ± SD = 1.3 vs. posttest 4.4 ± SD = 0.8; p < .001), situation monitoring (pretest 2.5 ± SD = 1.1 vs. posttest 4.3 ± SD = 0.7; p < .001), mutual support (pretest 2.9 ± SD = 1.4 vs. posttest 4.3 ± SD = 0.9;p < .001) and communication (pretest 3.0 ± SD = 1.1 vs. posttest 4.4 ± SD = 0.9; p < .001). Challenges by the nurses to the incorrect dose of epinephrine double from 38.4% before the training to 76.9% after the training (p= .063). Before the training, fellow's ordering an incorrect dose were challenged 55% of the time but no attending neonatologists were challenged (OR = 11). After the training, fellows were challenged 77% of the time and attendings were challenged 75% of the time (OR = 1.1). Inadequate compressions were corrected by the resuscitation leader 61.5% of the time before the training and 84.6% of the time after the training (p = .248). Discussion We feel this half-day interprofessional teamwork course offers a valuable training experience to providers involved in neonatal resuscitation. The basic teamwork concepts taught during the course are universally applicable throughout medicine, and the simulation-based activities could easily be modified to include pediatric and adult resuscitations.
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