Republished: Interprofessional education in team communication: working together to improve patient safety
Tóm tắt
Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication.
Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours.
One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001).
Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.
Từ khóa
Tài liệu tham khảo
Joint Commission, Sentinal Events
Kohn, 2000, To err is human: building a safer health system
Rogers, 2006, Analysis of surgical errors in closed malpractice claims at 4 liability insurers, Surgery, 140, 25, 10.1016/j.surg.2006.01.008
Leonard, 2004, The human factor: the critical importance of effective teamwork and communication in providing safe care, Qual Saf Health Care, 13, i85, 10.1136/qshc.2004.010033
Greenberg, 2007, Patterns of communication breakdowns resulting in injury to surgical patients, J Am Coll Surg, 204, 533, 10.1016/j.jamcollsurg.2007.01.010
Spath, 1999, Error reduction in health care: a systems approach to improving patient safety
Kyrkjebo, 2006, Improving patient safety by using interprofessional simulation training in health professional education, J Interprof Care, 20, 507, 10.1080/13561820600918200
Anderson, 2009, Medical students benefit from learning about patient safety in an interprofessional team, Med Educ, 43, 542, 10.1111/j.1365-2923.2009.03328.x
DeSilets, 2010, The institute of medicine's redesigning continuing education in the health professions, J Contin Educ Nurs, 41, 340, 10.3928/00220124-20100726-02
Robertson, 2010, The use of simulation and a modified TeamSTEPPS curriculum for medical and nursing student team training, Simulation in Healthcare: J Soc Simulation Healthcare, 5, 332, 10.1097/SIH.0b013e3181f008ad
King, 2008, Advances in patient safety: new directions and alternative approaches (vol 3: performance and tools)
McGreevy, 2006, The challenge of changing roles and improving surgical care now: crew resource management approach, Am Surg, 72, 1082, 10.1177/000313480607201117
Powell, 2006, My copilot is a nurse–using crew resource management in the OR, Aorn J, 83, 179, 10.1016/S0001-2092(06)60239-1
Capella, 2010, Teamwork training improves the clinical care of trauma patients, J Surg Educ, 67, 439, 10.1016/j.jsurg.2010.06.006
Weaver, 2010, Does teamwork improve performance in the operating room? A multilevel evaluation, Jt Comm J Qual Patient Saf, 36, 133
Mayer, 2011, Evaluating efforts to optimize TeamSTEPPS implementation in surgical and pediatric intensive care units, Jt Comm J Qual Patient saf, 37, 365
Gaba, 2007, The future vision of simulation in healthcare, Simul Healthc, 2, 126, 10.1097/01.SIH.0000258411.38212.32
Gaba, 2004, The future vision of simulation in health care, Qual Saf Health Care, 13, i2, 10.1136/qshc.2004.009878
Rosen, 2008, Measuring team performance in simulation-based training: adopting best practices for healthcare, Simul Healthc, 3, 33, 10.1097/SIH.0b013e3181626276
Parsell, 1999, The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS), Med Educ, 33, 95, 10.1046/j.1365-2923.1999.00298.x
Bandura, 1997, Self efficacy: the exercise of control
Baker, 2010, Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire, Qual Saf Health Care, 19, e49
Leucht, 1990, Assessing professional perceptions: design and validation of an interdisciplinary education perception scale, J Allied Health, 19, 181
McFadyen, 2006, The test-retest reliability of a revised version of the Readiness for Interprofessional Learning Scale (RIPLS), J Interprof Care, 20, 633, 10.1080/13561820600991181
Reid, 2006, Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL?, Med Educ, 40, 415, 10.1111/j.1365-2929.2006.02442.x
McFadyen, 2005, The readiness for interprofessional learning scale: a possible more stable sub-scale model for the original version of RIPLS, J Interprof Care, 19, 595, 10.1080/13561820500430157
Bandura, 2006, Self-efficacy, beliefs of adolescents, 307
Bandura, 1989, Human agency in social cognitive theory, Am Psychol, 44, 1175, 10.1037/0003-066X.44.9.1175
World Health Organization, Patient Safety Curriculum Guide: Multi-professional Editional
Lapkin, 2011, A systematic review of the effectiveness of interprofessional education in health professional programs, Nurse Educ Today
Reeves, 2009, An overview of continuing interprofessional education, J Contin Educ Health Prof, 29, 142, 10.1002/chp.20026
Eppich, 2011, Simulation-based team training in healthcare, Simul Healthc, 6, S14, 10.1097/SIH.0b013e318229f550
Mann, 2011, Development of a scale to measure health professions students' self-efficacy beliefs in interprofessional learning, J Interprof Care
Rosenfield, 2011, Perceptions versus reality: a qualitative study of students' expectations and experiences of interprofessional education, Med Educ, 45, 471, 10.1111/j.1365-2923.2010.03883.x
Joint Commission, 2006, Measurement: the heart of patient safety, Jt Comm Benchmark, 8, 4