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O'Leary F. How to deliver effective paediatric simulation based education. Paediatr Respir Rev 2024:S1526-0542(24)00045-9. [PMID: 39179445 DOI: 10.1016/j.prrv.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 08/26/2024]
Abstract
Simulation based education (SBE) is an educational tool increasingly used in the approach to the initial and ongoing education of healthcare professionals. Like all education tools, SBE needs to be used appropriately to achieve the desired outcomes. Using Cognitive Load Theory (CLT) in the instructional design of simulations is essential to maximise participant learning by reducing extraneous load and optimising intrinsic load. Educators can modify task fidelity, task complexity and instructional support to optimise learning. Specific methodologies can be used in program design such as rapid cycle deliberate practice, round the table teaching, low dose high frequency and flipped classroom. Fidelity and authenticity are important factors to consider when choosing design elements to ensure learner engagement, but not to overwhelm cognitive load. An integral part of SBE is the feedback or debriefing component. Several evidence-based methodologies can be employed to facilitate post simulation learning, including Debriefing with Good Judgement and PEARLS. Educators also need to consider faculty education and development, such as the discovery, growth and maturity model.
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Affiliation(s)
- Fenton O'Leary
- Department of Paediatric Emergency Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia; Clinical Associate Professor, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia.
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Meneghesso I, Marcatto IF, Wada BF, Guermandi M, Girão FB. Self-confidence and knowledge in leadership in critical care: simulation with the "blindfolded" technique. Rev Gaucha Enferm 2023; 43:e20220213. [PMID: 36888816 DOI: 10.1590/1983-1447.2022.20220213.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/17/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE To verify the contributions of using the "blindfolded" technique on nursing students' self-confidence and knowledge in critical patient care in simulated clinical scenarios. METHOD A quasi-experimental study conducted with 25 nursing students from a Federal University in the inland of São Paulo between November and December 2021. The participants answered the "Self-confidence Scale" and the Checklist of CPR Knowledge, Skills and Attitudes, before and after the intervention. A descriptive analysis of the checklist was performed and the Wilcoxon test was used to evaluate the checklist and the "Self-confidence Scale". RESULTS There was a mean of 4.04 additional correct answers in the sample analyzed, based on the difference in the number of correct answers between both moments. A total of 80% of the sample showed an increase in knowledge. CONCLUSION After the clinical simulation with the "blindfolded" technique, the students in leadership roles presented an increase in knowledge and self-confidence during the assistance provided in critical scenarios.
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Affiliation(s)
- Izabela Meneghesso
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Isadora Freitas Marcatto
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Beatriz Fernandes Wada
- Universidade Federal de São Carlos (UFSCar), Centro de Ciências Biológicas e da Saúde, Departamento de Enfermagem. São Carlos, São Paulo, Brasil
| | - Maísa Guermandi
- Universidade Federal de São Carlos (UFSCar), Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Carlos, São Paulo, Brasil
| | - Fernanda Berchelli Girão
- Universidade Federal de São Carlos (UFSCar), Departamento de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Carlos, São Paulo, Brasil
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Gupta R, Toppozini C, Caruso TJ, Lobos AT. Integrating leadership into interprofessional non-acute care pediatric provider resuscitation training. J Clin Transl Res 2022; 8:499-505. [PMID: 36452004 PMCID: PMC9706314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND AND AIM Due to limited clinical exposure, non-acute care pediatric providers often rely on simulated experiences to maintain resuscitation skills. Few training options designed for the non-acute care setting exist, are often difficult to access, and lack incorporation of non-technical skills. The first five minutes (FFM) is a previously published curriculum designed to train non-acute care providers. The goal of this study was to determine the curriculum's effectiveness during a pilot intervention. METHODS A single cohort of multi-professional, non-acute care pediatric providers participated. The primary outcome skill was "establishing leadership," and secondary outcomes included other technical and non-technical skills. Learning of outcome skills was assessed using changes in retrospective pre-post self-assessment Likert scale scores. Differences were compared using paired t-tests and ANOVA. RESULTS Thirty-seven participants submitted self-assessments. There was improvement in establishing leadership (pre-mean 1.14, post-mean 2.30, P < 0.01), and all other objectives studied. Compared to each other, subgroups of nurses, physicians, and respiratory therapists demonstrated significant differences in learning of technical skills, but similar improvements with non-technical skills. CONCLUSION These findings suggest that the FFM curriculum is an effective tool for training non-acute care pediatric providers interprofessional resuscitation skills. Future research should assess provider behavioral changes, retention of training requirements, and patient outcomes. RELEVANCE FOR PATIENTS Traditional resuscitation education programs focus largely, or entirely, on performance of technical skills and algorithmic actions. However, non-technical skills, such as leadership, are crucial to the overall success of resuscitation efforts. The FFM program was developed to incorporate leadership principles into the resuscitation education of non-acute care pediatric inpatient providers, and this curricular evaluation suggests that improvements in participant leadership skills occurred due to the program.
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Affiliation(s)
- Ronish Gupta
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, McMaster University, ON, Canada
- School of Education, Johns Hopkins University, MD, USA
| | | | - Thomas J. Caruso
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, CA, USA
| | - Anna-Theresa Lobos
- Children’s Hospital of Eastern Ontario, ON, Canada
- Division of Critical Care, Department of Pediatrics, University of Ottawa, ON, Canada
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Kojima T, Nakahari H, Kawatsu Y. Blindfolded in-situ simulation can help improve non-technical skills in anesthesia emergencies. J Clin Anesth 2022; 81:110888. [PMID: 35700663 DOI: 10.1016/j.jclinane.2022.110888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Taiki Kojima
- Department of Anesthesiology, Aichi Children's Health and Medical Center, Obu-City, Aichi, Japan; Division of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan.
| | - Hirofumi Nakahari
- Department of Anesthesiology, Aichi Children's Health and Medical Center, Obu-City, Aichi, Japan
| | - Yuta Kawatsu
- Department of Anesthesiology, Aichi Children's Health and Medical Center, Obu-City, Aichi, Japan
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Ulmer FF, Lutz AM, Müller F, Riva T, Bütikofer L, Greif R. Communication Patterns During Routine Patient Care in a Pediatric Intensive Care Unit: The Behavioral Impact of In Situ Simulation. J Patient Saf 2022; 18:e573-e579. [PMID: 34224500 DOI: 10.1097/pts.0000000000000872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Effective communication minimizes medical errors and leads to improved team performance while treating critically ill patients. Closed-loop communication is routinely applied in high-risk industries but remains underutilized in healthcare. Simulation serves as an educational tool to introduce, practice, and appreciate the efficacy of closed-loop communication. METHODS This observational before-and-after study investigates behavioral changes in communication among nurses brought on by simulation team training in a pediatric intensive care unit (PICU). The communication patterns of PICU nurses, who had no prior simulation experience, were observed during routine bedside care before and after undergoing in situ simulation.One month before and 1 and 3 months after simulation (intervention), 2 trained raters recorded nurse communications relative to callouts, uttered by the sender, and callbacks, reciprocated by the recipient. The impact of simulation on communication patterns was analyzed quantitatively. RESULTS Among the 15 PICU nurses included in this study, significant changes in communication behavior were observed during patient care after communication-focused in situ simulation. The PICU nurses were significantly less likely to let a callout go unanswered during clinical routine. The effect prevailed both 1 month (P = 0.039) and 3 months (P = 0.033) after the educational exposure. CONCLUSIONS This observational before-and-after study describes the prevalence and pattern of communication among PICU nurses during routine patient care and documents PICU nurses transferring simulation-acquired communication skills into their clinical environment after a single afternoon of in situ simulation. This successful transfer of simulation-acquired skills has the potential to improve patient safety and outcome.
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Affiliation(s)
- Francis F Ulmer
- From the Department of Pediatrics, Section of Pediatric Critical Care
| | - Andrea M Lutz
- Department of Anesthesiology and Pain Therapy, Bern University Hospital, University of Bern
| | - Fabienne Müller
- From the Department of Pediatrics, Section of Pediatric Critical Care
| | - Thomas Riva
- Department of Anesthesiology and Pain Therapy, Bern University Hospital, University of Bern
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Taher H, Fares A, Wishahy AM. Laparoscopic resurrection of an old technique; a new approach for Total Urogenital Separation and Rectal pull through in patients with long channel Cloacal malformation. J Endourol 2022; 36:1177-1182. [PMID: 35152733 PMCID: PMC9422784 DOI: 10.1089/end.2021.0724] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background and Aims: Before the significance of urethral length was highlighted in patients with cloacal malformation, total urogenital mobilization using a posterior sagittal approach was recommended for common channel (CC) length <3 cm, those >3 cm it was followed by urogenital separation. However, many urologists are advocating that the urethral length rather than length of the CC should influence the choice of operation. It is also recommended that total urogenital mobilization should be avoided in patients with short urethral length as intraoperative decision to shift to urogenital separation will risk devascularization of the urethra, advocating total urogenital separation (TUS) from the start; the later technique was deemed difficult using open approach. We describe our experience with laparoscopic TUS and rectal pull-through in patients with cloacal malformation. Methods: Six patients were operated for a period of 3 years from December 2017 to July 2021; they underwent laparoscopic TUS and rectal pull-through. Preoperative investigations included cystoscopy, genitogram, and MRI pelvis and abdominal ultrasound. IRB approval has been obtained from research ethical committee at Cairo University. Results: Six female patients born with single perineal opening had colostomy at birth. Age during the second operation ranged from 1 to 4 years. Length of the CC ranged between 2 and 5 cm. Proximal urethral length ranged between 0.5 and 1.5 cm and vaginal depth >3 cm. Average operative time was 4.25 hours. Postoperative period was 1–5 days and uneventful. On the long-term follow-up. No patient developed urethrovaginal fistula and one patient developed vaginal stenosis. All patients had no urinary problems, dry over 4-hour interval, voiding spontaneously, and had normal kidney functions. Conclusions: Laparoscopic urogenital separation, as well as vaginal and rectal pull-through for cloacal malformation, is feasible in cloacal malformation providing anatomical repair.
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Affiliation(s)
- Heba Taher
- Cairo University Kasr Alainy Faculty of Medicine, 63527, Cairo, Egypt
| | - Ahmed Fares
- Fayoum University Faculty of Medicine, 158405, pediatric surgery, Fayoum, Egypt
| | - Ahmed M.K Wishahy
- Cairo University Kasr Alainy Faculty of Medicine, 63527, pediatric surgery, Cairo, Egypt
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Meneghesso I, Marcatto IF, Wada BF, Guermandi M, Girão FB. Autoconfiança e conhecimento na liderança em atendimento crítico: simulação com a técnica “olhos vendados”. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20220213.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
RESUMO Objetivo: Verificar as contribuições do uso da técnica de “olhos vendados” na autoconfiança e conhecimento de estudantes de enfermagem no atendimento ao paciente crítico em cenários clínicos simulados. Método: Estudo quase-experimental com 25 estudantes do curso de enfermagem de uma Universidade Federal do interior de São Paulo entre novembro e dezembro de 2021. Os participantes responderam à Escala Self-confidence Scale e ao Checklist de Conhecimento, Habilidades e Atitudes em Reanimação Cardiorrespiratória, pré e pós-intervenção. Realizou-se a análise descritiva do checklist e o teste de Wilcoxon para avaliar o checklist e Self-confidence Scale. Resultados: Média de 4,04 acertos adicionais na amostra analisada, através da diferença de acertos entre os dois momentos. Um total de 80% da amostra demonstrou um aumento no conhecimento. Conclusão: Os estudantes em papéis de liderança após a simulação clínica com a técnica “olhos vendados”, apresentaram um aumento de conhecimento e autoconfiança durante a assistência nos cenários críticos.
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Lopez de Alda JX, Patel N, McNinch N, Ahmed RA. A Blindfolded Pediatric Trauma Simulation and Its Effect on Communication and Crisis Resource Management Skills. Cureus 2021; 13:e19484. [PMID: 34912625 PMCID: PMC8665896 DOI: 10.7759/cureus.19484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Miscommunication is a common cause of medical errors and patient harm. Simulation is a good tool to improve communication skills, but there is little literature on advanced techniques to improve closed loop communication (CLC) in an effort to minimize medical errors. This study looks to evaluate whether blindfolding simulation participants is an effective tool in improving communication, and whether this advanced teaching technique is useful for critical pediatric scenarios. Methods Participants included Emergency Medicine (EM) residents and Pediatric EM fellows with Advanced Trauma Life Support (ATLS) certification. Participants were randomized into groups and completed a pediatric trauma scenario. Recorded simulations were reviewed by three independent faculty for primary objective measures of total instances of communication and CLC utilization during critical actions in the simulation. The secondary objective was the perceived stress load by participants when utilizing this teaching methodology. Wilcoxon rank sum test (WRS), Fisher's exact test (FET), and Cochran-Armitage test (CAT) were utilized for statistical analysis. Results Statistically significant differences were noted in total communication between groups. Median and interquartile ranges (IQR) of total instances of communication were 17.0 (14.7-17.1) in non-blindfolded groups versus 21.0 (19.0-22.0) in blindfolded groups (p-value=0.002). Statistically significant increase in CLC was noted during the critical action of monitor placement in the blindfolded group (OR=13.7, 95% CI=1.4-133.8). No differences were noted in crisis resource management (CRM) scores. NASA Task Load Index (NASA-TLX) scores of both groups revealed similar stress levels. Statistical testing based upon the year of training was limited by small sample size and large number of categories. Conclusions Blindfolded simulations increased total instances of communication overall and improved CLC in one critical action without increasing stress levels. The blindfolded trauma simulation exercise is an effective advanced technique to reinforce CLC utilization and communication skills.
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Affiliation(s)
- Juan X Lopez de Alda
- Pediatric Emergency Medicine, Akron Children's Hospital, Akron, USA
- Pediatric Emergency Medicine, Golisano Children's Hospital of Southwest Florida, Fort Myers, USA
| | - Nirali Patel
- Pediatric Emergency Medicine, Akron Children's Hospital, Akron, USA
| | - Neil McNinch
- Epidemiology and Public Health, Akron Children's Hospital, Rebecca D. Considine Research Institute, Akron, USA
| | - Rami A Ahmed
- Emergency Medicine, Indiana University School of Medicine, Indianapolis, USA
- Emergency Medicine, Methodist Hospital, Indianapolis, USA
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Li P, Zhou H, Cao H, Xu B, Guo T, Zhu W, Zhao Y, Zhuo R, Ma L, Tao T, Zhou X, Feng Z. Robotic-assisted Laparoscopic Management of Bladder/Prostate Rhabdomyosarcoma in Children: Initial Series and 1-yr Outcomes. J Endourol 2021; 35:1520-1525. [PMID: 34254831 DOI: 10.1089/end.2020.1238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To present our preliminary experiences of robotic-assisted laparoscopic radical or partial cystectomy for bladder/prostate rhabdomyosarcoma in children. METHODS A retrospective study was conducted with children who underwent robotic-assisted laparoscopic surgery for bladder/prostate rhabdomyosarcoma (B/P RMS) between July 2018 and March 2020. The patient characteristics, tumor position, perioperative information, short time oncologic survival outcomes, and urinary function were recorded and evaluated. RESULTS We identified eight children who underwent robotic-assisted laparoscopic surgery for B/P RMS. Partial cystectomy was performed on all but one patient, who underwent a radical cystectomy and sigmoid neobladder reconstruction. Preoperative chemotherapy was administered to all eight patients, while preoperative radiotherapy was conducted in three cases, including one patient with a history of pelvic rhabdomyosarcoma. Unilateral/bilateral ureter reimplantation was done in four cases in which the patients' ureter orifices were involved. The mean follow-up time was 13.3 months, and no local recurrence or metastasis was observed. No patient experienced urinary incontinence eventually. CONCLUSION Robotic-assisted laparoscopic resection for bladder rhabdomyosarcoma in children is safe and feasible. Preoperative radiotherapy could decrease the tumor volume so that the membranous urethra could be preserved for as long as possible. The oncological efficacy and overall survival rate require further investigation and longer follow-up.
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Affiliation(s)
- Pin Li
- Bayi Children's Hospital, 196539, Beijing, China;
| | - Huixia Zhou
- Bayi Children's Hospital Affiliated to PLA Army General Hospital, Pediatric Urology, 5 Nanmencang, Dongchneg District, Beijing, China, 100700.,Chinese PLA Medical Academy, Urology, No. 28 Fuxing Road, Haidian District, Beijing, China, 100853;
| | - Hualin Cao
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region, 477248, Department of Urology, Guilin, Guangxi, China;
| | - Bo Xu
- Xiamen Maternity and Child Health Hospital, 576636, Department of Pediatric Surgery, Xiamen, Fujian, China;
| | - Tao Guo
- Bayi Children's Hospital, 196539, Beijing, China;
| | - Weiwei Zhu
- Bayi Children's Hospital, 196539, Beijing, China;
| | - Yang Zhao
- Bayi Children's Hospital, 196539, Beijing, China;
| | - Ran Zhuo
- Bayi Children's Hospital Affiliated to PLA Army General Hospital, Pediatric Urology, Dongchneg District, Beijing, China;
| | - Lifei Ma
- Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, Beijing, Urology, Beijing, China;
| | - Tian Tao
- Bayi Children's Hospital Affiliated to The Military General Hospital of Beijing PLA, Beijing, Beijing, China;
| | - Xiaoguang Zhou
- Bayi Children's Hospital Affiliated to PLA Army General Hospital, Department of Pediatric Urology, Dongcheng District, Beijing, China;
| | - Zhichun Feng
- Bayi Children's Hospital, 196539, Beijing, China;
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Scicchitano E, Stark P, Koetter P, Michalak N, Zurca AD. Blindfolding Improves Communication in Inexperienced Residents Undergoing ACLS Training. J Grad Med Educ 2021; 13:123-127. [PMID: 33680312 PMCID: PMC7901606 DOI: 10.4300/jgme-d-20-00620.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/10/2020] [Accepted: 11/30/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Closed-loop communication (CLC) is associated with decreased medical errors and improved time-to-task completion during resuscitations. Depriving team leaders of sight during training may accelerate the acquisition of favorable communication skills; however, its effect on the frequency of CLC is unclear, especially with trainees. OBJECTIVE We assessed the effect of depriving interns of sight during advanced cardiovascular life support (ACLS) on verbal communication patterns and resuscitation confidence. METHODS All interns undergoing ACLS training in June 2019 at a single center were eligible. Interns were randomized to blindfolded training (BT) or standard training (ST). BT team leaders were blindfolded during practice sessions and permitted to use sight during testing. Testing scenarios were video- and audio-recorded. Recordings were assessed for teams' performance and communication patterns. Participants were surveyed for confidence with resuscitation skills before and after ACLS training. RESULTS All 87 eligible interns participated in the study (100% participation). Eighty-five of 87 (98%) interns were included for analysis; 46 were randomized to BT and 39 to ST. Interns in the BT group were significantly more likely to exhibit CLC (mean: BT 20.3, ST 16.6; P = .003), directed communication (mean: BT 4.3, ST 1.5; P < .001), and follower-initiated communication (mean: BT 12.8, ST 10.2; P = .028). There was no significant difference in clinical performance measures or self-reported confidence with resuscitation between BT and ST groups. CONCLUSIONS Blindfolding trainees results in greater instances of CLC, directed communication, and follower-initiated communication during ACLS training.
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Wilson S, Rixon A, Hartanto S, White P, Judkins S. Review article: Systematic literature review of leadership in emergency departments. Emerg Med Australas 2020; 32:935-952. [PMID: 33089650 DOI: 10.1111/1742-6723.13658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 01/04/2023]
Abstract
Emergency medicine (EM) is a discipline with complex leadership demands. However, studies of EM physician leadership and ED leadership are in their infancy. As such, there is a lack of clarity about the forms, antecedents, enablers, barriers and consequences of EM physician leadership. A systematic review of the scientific literature was conducted to reveal the different conceptualisations of EM physician leadership, the activities involved in the practice of leadership, and the knowledge and skills of effective ED leaders. Seven databases were systematically searched for peer-reviewed empirical studies on the topic of EM physicians carrying out a manager or leadership role in an ED setting. Finally, 26 articles were included, and their findings were synthesised and analysed narratively. Two conceptualisations of EM physician leadership were found, reflecting clinical leadership and medical leadership, respectively. Clinical leadership is performed by all EM physicians, often informally, within their daily clinical practice, whereas medical leadership is performed by EM physicians who work at the management level within a hospital, in addition to or instead of their clinical practice. The focus of EM physician leadership and ED leadership research is team leadership, with much less attention given to wider organisation leadership. Consistent with the focus on team leadership, clinical knowledge and skill in orchestrating teams, especially trauma and resuscitation teams, emerged as the most important factors underpinning leadership effectiveness. Future research and training should make better use of existing leadership theory and research designs to illuminate the forms, dynamics, antecedents, moderators and consequences of EM physician leadership.
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Affiliation(s)
- Samuel Wilson
- Department of Management and Marketing, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Andrew Rixon
- Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Stephanie Hartanto
- Department of Business Technology and Entrepreneurship, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Peter White
- Australasian College for Emergency Medicine, Melbourne, Victoria, Australia
| | - Simon Judkins
- Australasian College for Emergency Medicine, Melbourne, Victoria, Australia
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Hautz SC, Oberholzer DL, Freytag J, Exadaktylos A, Kämmer JE, Sauter TC, Hautz WE. An observational study of self-monitoring in ad hoc health care teams. BMC MEDICAL EDUCATION 2020; 20:201. [PMID: 32576185 PMCID: PMC7313223 DOI: 10.1186/s12909-020-02115-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Working in ad hoc teams in a health care environment is frequent but a challenging and complex undertaking. One way for teams to refine their teamwork could be through post-resuscitation reflection and debriefing. However, this would require that teams have insight into the quality of their teamwork. This study investigates (1) the accuracy of the self-monitoring of ad hoc resuscitation teams and their leaders relative to external observations of their teamwork and (2) the relationship of team self-monitoring and external observations to objective performance measures. METHODS We conducted a quantitative observational study of real-world ad hoc interprofessional teams responding to a simulated cardiac arrest in an emergency room. Teams consisting of residents, consultants, and nurses were confronted with an unexpected, simulated, standardized cardiac arrest situation. Their teamwork was videotaped to allow for subsequent external evaluation on the team emergency assessment measure (TEAM) checklist. In addition, objective performance measures such as time to defibrillation were collected. All participants completed a demographic questionnaire prior to the simulation and a questionnaire tapping their perceptions of teamwork directly after it. RESULTS 22 teams consisting of 115 health care professionals showed highly variable performance. All performance measures intercorrelated significantly, with the exception of team leaders' evaluations of teamwork, which were not related to any other measures. Neither team size nor cumulative experience were correlated with any measures, but teams led by younger leaders performed better than those led by older ones. CONCLUSION Team members seem to have better insight into their team's teamwork than team leaders. As a practical consequence, the decision to debrief and the debriefing itself after a resuscitation should be informed by team members, not just leaders.
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Affiliation(s)
- Stefanie C Hautz
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland
| | - Daniel L Oberholzer
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland
| | - Julia Freytag
- Simulated Patient Program, Office of the Vice Dean for Teaching and Learning, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Aristomenis Exadaktylos
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland
| | - Juliane E Kämmer
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland
- Max Planck Institute for Human Development, Center for Adaptive Rationality (ARC), Lentzeallee 94, 14195, Berlin, Germany
| | - Thomas C Sauter
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland
- Lernzentrum, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Wolf E Hautz
- Department of Emergency Medicine, Inselspital University Hospital Bern, Freiburgstrasse 16c, 3010, Bern, Switzerland.
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Clinical News. Br J Hosp Med (Lond) 2019; 80:128-131. [DOI: 10.12968/hmed.2019.80.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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