title: Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum?
abstract: OBJECTIVE
  To determine if high fidelity simulation based team training can improve clinical team performance when added to an existing didactic teamwork curriculum.
  
  
  METHODS
  Level 1 trauma center and academic emergency medicine training program.
  
  
  METHODS
  Emergency department (ED) staff including nurses, technicians, emergency medicine residents, and attending physicians.
  
  
  METHODS
  ED staff who had recently received didactic training in the Emergency Team Coordination Course (ETCC) also received an 8 hour intensive experience in an ED simulator in which three scenarios of graduated difficulty were encountered. A comparison group, also ETCC trained, was assigned to work together in the ED for one 8 hour shift. Experimental and comparison teams were observed in the ED before and after the intervention.
  
  
  METHODS
  Single, crossover, prospective, blinded and controlled observational study. Teamwork ratings using previously validated behaviorally anchored rating scales (BARS) were completed by outside trained observers in the ED. Observers were blinded to the identification of the teams.
  
  
  RESULTS
  There were no significant differences between experimental and comparison groups at baseline. The experimental team showed a trend towards improvement in the quality of team behavior (p = 0.07); the comparison group showed no change in team behavior during the two observation periods (p = 0.55). Members of the experimental team rated simulation based training as a useful educational method.
  
  
  CONCLUSIONS
  High fidelity medical simulation appears to be a promising method for enhancing didactic teamwork training. This approach, using a number of patients, is more representative of clinical care and is therefore the proper paradigm in which to perform teamwork training. It is, however, unclear how much simulator based training must augment didactic teamwork training for clinically meaningful differences to become apparent.
authors.affiliation: Department of Emergency Medicine, 1 Hoppin Street, Suite 106, Providence, RI 02903, USA. Mshapiro@Lifespan.org
authors.forename: M J
authors.initials: MJ
authors.lastname: Shapiro
authors.forename: J C
authors.initials: JC
authors.lastname: Morey
authors.forename: S D
authors.initials: SD
authors.lastname: Small
authors.forename: V
authors.initials: V
authors.lastname: Langford
authors.forename: C J
authors.initials: CJ
authors.lastname: Kaylor
authors.forename: L
authors.initials: L
authors.lastname: Jagminas
authors.forename: S
authors.initials: S
authors.lastname: Suner
authors.forename: M L
authors.initials: ML
authors.lastname: Salisbury
authors.forename: R
authors.initials: R
authors.lastname: Simon
authors.forename: G D
authors.initials: GD
authors.lastname: Jay
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D018592:Cross-Over Studies; D003479:Curriculum; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D016544:Patient Simulation; D011446:Prospective Studies