Enhancing team development in an internal medicine resident continuity clinic

Interprofessional teamwork is important for the provision of safe, high value patient care and is recognized as essential by the ACGME. We aimed to assess the impact of an interprofessional continuity clinic teamwork curriculum on perceptions of team development and patient safety. This project was conducted in an IM Resident Continuity Clinic where 96 residents, supported by 28 faculty and 48 interprofessional team members, attended continuity clinic two afternoons per week during alternating months of a 50/50 outpatient-inpatient training model. Teams were configured into two groups of residents, faculty and interprofessional team members. The randomly selected intervention group participated in strategically-timed TeamSTEPPS training. The control group received usual clinic education. Teamwork and safety climate were measured using the Team Development Measure (TDM) and Safety Attitudes Questionnaire (SAQ) collected before and after the intervention. Following the teamwork curriculum, team development improved in the intervention group as compared to control [mean change (95% CI) +13.9 (+9.3, +18.6) versus + 4.8 (+0.4, +9.1), p = 0.007]. Though 30% of the individual items on the SAQ improved significantly in the faculty intervention group as compared to control, the overall improvement in SAQ [intervention mean change + 0.4 (+0.2, +0.5), control mean change + 0.2 (-0.1, +0.5)] was not statistically significant (p = 0.36). It is feasible to implement a TeamSTEPPs-based interprofessional teamwork curriculum among IM residents in a block clinic model and achieve enhanced teamwork and safety attitudes. Additional assessment of clinical and educational outcomes is ongoing.

TeamSTEPPS Curricular-Wide Integration: Baccalaureate Nursing Students' Knowledge, Attitudes, and Perceptions

BACKGROUND

To promote safe patient care, nurses must work collaboratively with members of the interprofessional health care team.

PURPOSE

The purposes of this study were to explore the effect of a curricular-wide integration of TeamSTEPPS training on baccalaureate nursing students' teamwork knowledge and attitudes and to describe students' perceptions of TeamSTEPPS curricular-wide integration.

METHODS

In this quasi-experimental, mixed-methods study, the experimental group engaged in a curricular-wide integration of TeamSTEPPS throughout the baccalaureate nursing program, whereas the control group received no TeamSTEPPS training.

RESULTS

The experimental group had significantly higher teamwork knowledge than the control group after training. The curricular-wide integration of TeamSTEPPS was positively received by students.

CONCLUSIONS

This study demonstrated the feasibility and benefits of integrating TeamSTEPPS teamwork training throughout a baccalaureate nursing curriculum, as well as the knowledge gained by students because of this curricular-wide integration. With further research, TeamSTEPPS could offer an evidence-based approach to promote the interprofessional teamwork knowledge and skills nursing students need for safe patient care.

Simulated Participants as Health Care Providers: An Innovative Approach to Interprofessional Simulation

ABSTRACT

With the increased attention to patient safety and quality care in health care, it is imperative that prelicensure health care provider students are taught to collaborate effectively to decrease medical errors. For this project, simulated participants were utilized as health care providers for a simulation in a stand-alone nursing school without affiliation to a medical or allied health school. Both simulated participants and students reacted positively to the experience. This project demonstrated that utilizing simulated participants to portray health care providers in simulation scenarios is a feasible and well-received method of providing learning experiences that emphasize the importance of collaboration.

Outcomes of TeamSTEPPS Training in Prelicensure Health Care Practitioner Programs: An Integrative Review

BACKGROUND

Patient safety, morbidity, and mortality are directly correlated with interprofessional collaboration among health care practitioners. TeamSTEPPS offers a standardized curriculum for interprofessional teamwork training that can be incorporated into prelicensure education. This article describes the current state of the science related to the quantitative literature exploring the outcomes of TeamSTEPPS training in prelicensure health care practitioner students' education.

METHOD

The Whittemore's and Knafl's method guided this integrative review. The CINAHL and PubMed databases were queried and ancestral searches of the reference lists of all retrieved articles were conducted.

RESULTS

Nine quantitative research studies were identified for inclusion in this integrative review.

CONCLUSION

The available literature suggests that using TeamSTEPPS within prelicensure education supports the development of teamwork knowledge and attitudes in interdisciplinary health care practitioner students. Most of the reviewed studies focused on nursing and medical students; thus, further research is needed on allied health care practitioner students. [J Nurs Educ. 2020;59(11):610-616.].

Monitoring teamwork: a narrative review

A narrative review was carried out to identify articles on monitoring of teamwork, with particular relevance to anaesthetists. The papers reviewed showed that team monitoring takes place both implicitly and explicitly in the anaesthetic environment. No single optimal model of teamwork monitoring for all situations was identified. Most of the studies identified were of a pre-intervention, post-intervention design, without randomisation or control group. Information shared during a formal briefing is more likely to be recalled, and provides a basis for a shared team mental model. A number of studies appeared to show that targeted teamwork training has a positive impact on both teamwork and patient safety.

Using interprofessional medication management simulations to impact student attitudes toward teamwork to prevent medication errors

BACKGROUND

We developed and implemented a project incorporating ACPE Standard 11 and all Core IPEC competencies at a public University located at a medical center. The project was a collaboration between the colleges of nursing, pharmacy, and medicine at a distance campus location.

INTERPROFESSIONAL EDUCATION ACTIVITY

Our Interprofessional Education Activity, which targeted all three elements of ACPE Standard 11, provided TeamSTEPPS^® training followed by four medical error simulations. A debriefing took place after each scenario within a team as well as with all four groups following each simulation session. The Teamwork Attitudes Questionnaire (TTAQ) was used to evaluate the activity.

DISCUSSION

Findings from our interprofessional education activity indicate that while students entered the activity already perceiving teamwork as a positive aspect of safe care delivery, significant improvement in attitudes post training toward specific team constructs was seen across all five domains. The project helped inform the structure of a replication of this effort that is currently underway, with a focus on embedding it in the curricula of all three programs (medicine, pharmacy, and nursing) across campuses.

IMPLICATIONS

In summary, working collaboratively in a team while being exposed to a series of medication management scenarios enhances teamwork attitudes as well as potentially improving performance. Based on the positive initial results, plans have begun to extend the experience to other campuses and include a wider group of students.

Recovery-Based Interprofessional Distance Education (RIDE): Graduate Student Responses

Graduate student attitudes (n = 28) were assessed before and after participation in interprofessional practitioner education (IPE). Twenty-eight graduate students participated (14 mental health nursing, 6 pharmacy, 4 nutrition, 4 exercise physiology); most had at least some health care experience. Posttest scores indicated gains on a majority of constructs measured. These results suggest that online-blended IPE content yields gains in team skills and attitudes. This study adds to a very small body of literature on IPE in graduate programs. More research is needed in examining online versus face-to-face delivery.