title: Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial.
abstract: OBJECTIVE
  To add a team training and human error curriculum to the Neonatal Resuscitation Program (NRP) and measure its effect on teamwork. We hypothesized that teams that received the new course would exhibit more teamwork behaviors than those in the standard NRP course.
  
  
  METHODS
  Interns were randomized to receive NRP with team training or standard NRP, then video recorded when they performed simulated resuscitations at the end of the day-long course. Outcomes were assessed by observers blinded to study arm allocation and included the frequency or duration of six team behaviors: inquiry, information sharing, assertion, evaluation of plans, workload management and vigilance.
  
  
  RESULTS
  The interns in the NRP with team training group exhibited more frequent team behaviors (number of episodes per minute (95% CI)) than interns in the control group: information sharing 1.06 (0.24, 1.17) vs 0.13 (0.00, 0.43); inquiry 0.35 (0.11, 0.42) vs 0.09 (0.00, 0.10); assertion 1.80 (1.21, 2.25) vs 0.64 (0.26, 0.91); and any team behavior 3.34 (2.26, 4.11) vs 1.03 (0.48, 1.30) (P-values <0.008 for all comparisons). Vigilance and workload management were practiced throughout the entire simulated code by nearly all the teams in the NRP with team training group (100% for vigilance and 88% for workload management) vs only 53 and 20% of the teams in the standard NRP. No difference was detected in the frequency of evaluation of plans.
  
  
  CONCLUSIONS
  Compared with the standard NRP, NRP with a teamwork and human error curriculum led interns to exhibit more team behaviors during simulated resuscitations.
authors.affiliation: The University of Texas Center of Excellence for Patient Safety Research and Practice, Houston, TX 77030, USA. Eric.Thomas@uth.tmc.edu
authors.forename: E J
authors.initials: EJ
authors.lastname: Thomas
authors.forename: B
authors.initials: B
authors.lastname: Taggart
authors.forename: S
authors.initials: S
authors.lastname: Crandell
authors.forename: R E
authors.initials: RE
authors.lastname: Lasky
authors.forename: A L
authors.initials: AL
authors.lastname: Williams
authors.forename: L J
authors.initials: LJ
authors.lastname: Love
authors.forename: J B
authors.initials: JB
authors.lastname: Sexton
authors.forename: J E
authors.initials: JE
authors.lastname: Tyson
authors.forename: R L
authors.initials: RL
authors.lastname: Helmreich
mesh_terms: D003479:Curriculum; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010348:Patient Care Team / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012151:Resuscitation / Q000193:education*; D014481:United States; D014743:Videotape Recording