Measuring Team Performance in Simulation-Based Training: Adopting Best Practices for Healthcare

Department of Psychology, University of Central Florida, Florida, USA.
Simulation in healthcare: journal of the Society for Simulation in Healthcare (Impact Factor: 1.48). 02/2008; 3(1):33-41. DOI: 10.1097/SIH.0b013e3181626276
Source: PubMed


Team performance measurement is a critical and frequently overlooked component of an effective simulation-based training system designed to build teamwork competencies. Quality team performance measurement is essential for systematically diagnosing team performance and subsequently making decisions concerning feedback and remediation. However, the complexities of team performance pose a challenge to effectively measuring team performance. This article synthesizes the scientific literature on this topic and provides a set of best practices for designing and implementing team performance measurement systems in simulation-based training.

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    • "During CPR, the team of health care providers typically functions in a setting characterized by high levels of stress [4], time pressure, and impending danger to the patient [5]. It is because of these inherent characteristics of CPR—highstakes , complex, team-administered, and clarity of shared goal—that we conduct a systematic literature review of team coordination in CPR to establish how team coordination contributes to the quality of CPR. "
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    ABSTRACT: Effective team leadership in cardiopulmonary resuscitation (CPR) is well recognized as a crucial factor influencing performance. Generally, leadership training focuses on task requirements for leading as well as non-leading team members. We provided crisis resource management (CRM) training only for designated team leaders of advanced life support (ALS) trained teams. This study assessed the impact of the CRM team leader training on CPR performance and team leader verbalization. Forty-five teams of four members each were randomly assigned to one of two study groups: CRM team leader training (CRM-TL) and additional ALS-training (ALS add-on). After an initial lecture and three ALS skill training tutorials (basic life support, airway management and rhythm recognition/defibrillation) of 90-min each, one member of each team was randomly assigned to act as the team leader in the upcoming CPR simulation. Team leaders of the CRM-TL groups attended a 90-min CRM-TL training. All other participants received an additional 90-min ALS skill training. A simulated CPR scenario was videotaped and analyzed regarding no-flow time (NFT) percentage, adherence to the European Resuscitation Council 2010 ALS algorithm (ADH), and type and rate of team leader verbalizations (TLV). CRM-TL teams showed shorter, albeit statistically insignificant, NFT rates compared to ALS-Add teams (mean difference 1.34 (95 % CI -2.5, 5.2), p = 0.48). ADH scores in the CRM-TL group were significantly higher (difference -6.4 (95 % CI -10.3, -2.4), p = 0.002). Significantly higher TLV proportions were found for the CRM-TL group: direct orders (difference -1.82 (95 % CI -2.4, -1.2), p < 0.001); undirected orders (difference -1.82 (95 % CI -2.8, -0.9), p < 0.001); planning (difference -0.27 (95 % CI -0.5, -0.05) p = 0.018) and task assignments (difference -0.09 (95 % CI -0.2, -0.01), p = 0.023). Training only the designated team leaders in CRM improves performance of the entire team, in particular guideline adherence and team leader behavior. Emphasis on training of team leader behavior appears to be beneficial in resuscitation and emergency medical course performance.
    Full-text · Article · Jul 2015 · BMC Medical Education
    • "The current study adhered to best practices by capturing teamwork competencies, focusing on observable behaviors , measuring multiple levels of performance, employing trained observers, and using structured, guided, and nonjudgmental debriefings (Fanning & Gaba, 2007; Rosen et al., 2008). Delivery of postoperative surgical care is a complex task, with many individuals responsible for providing care. "
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    ABSTRACT: Many adverse events in health care are caused by teamwork and communication breakdown. This study was conducted to investigate the effect of a point-of-care simulation-based team training curriculum on measurable teamwork and communication skills in staff caring for postoperative patients. Twelve facilities involving 334 perioperative surgical staff underwent simulation-based training. Pretest and posttest self-report data included the Self-Efficacy of Teamwork Competencies Scale. Observational data were captured with the Clinical Teamwork Scale. Teamwork scores (measured on a five-point Likert scale) improved for all eight survey questions by an average of 18% (3.7 to 4.4, p < .05). The observed communication rating (scale of 1 to 10) increased by 16% (5.6 to 6.4, p < .05). Simulation-based team training for staff caring for perioperative patients is associated with measurable improvements in teamwork and communication. J Contin Educ Nurs 2013;44(X):xx-xx.
    No preview · Article · Sep 2013 · The Journal of Continuing Education in Nursing
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    • "In addition, SBT methods replicate 'real world' events whilst maintaining a safe learning environment (Alison and Crego 2008). This includes allowing participants to reflect on their performance in order to learn from their mistakes (Rosen et al. 2008). Furthermore, immersive simulated learning environments (ISLEs) such as the Hydra system developed by Crego (1996) provide a type of SBT which is designed to both train participants whilst allowing for reliable data collection (Alison et al. 2012). "
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    ABSTRACT: This study presents a narrative synthesis of a systematic literature review relating to multi-agency interoperability and major incident decision-making in high risk, high stake environments. The review methodology includes the identification of relevant studies, a critical appraisal of the concepts inherent in the main review question and a narrative synthesis of the central themes that relate to the study as a whole. The review firstly outlines what, currently, appear to be the perceived defining features of successful interoperability by using the SAFE-T phase model of major incident decision-making. It then considers whether these defining features are realistically achievable in major incident practice. Findings suggest that the current definition of an interoperable network is too demanding for the inherent complexity and dynamic nature of the major incident task environment. Individual teams tend to focus on agency-specific behaviour, as opposed to coordinated multi-team functioning, and so collective interoperability is not achieved. Inevitably, this reduces the ability to perform collaborative behaviours, including decision-making and action implementation. The paper concludes that aiming for the current conceptualisation of interoperability along a hierarchical command structure may actually inhibit effective decision-making. Instead, multi-agency systems would do better to work towards an improved understanding of a non-hierarchical and decentralised yet interoperable major incident management network. Recommendations include the need to relate theory and practice in the development of multi-agency decision-making via simulation-based training and to deepen our understanding of interoperability to prevent inertia in high risk, high stake major incident environments.
    Full-text · Article · Aug 2013 · Cognition Technology and Work
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