title: The anatomy of health care team training and the state of practice: a critical review.
abstract: OBJECTIVE
  As the U.S. health care system enters a new era, the importance of team-based care approaches grows. How is the health care community ensuring that providers and administrators are equipped with the knowledge, skills, and attitudes (KSAs) foundational for effective teamwork? Are these KSAs transferring into daily practice? This review summarizes the present state of practice for health care team training described in published literature. Drawing from empirical investigations of training effectiveness, the authors explore training design, implementation, and evaluation to provide insight into the shape, structure, and anatomy of team training in health care.
  
  
  METHODS
  A 2009 literature search yielded 40 peer-reviewed articles detailing health care team training evaluations. Guided by 11 focal questions, two trained raters extracted details regarding training design, implementation, evaluation metrics, and outcomes.
  
  
  RESULTS
  Findings indicate that team training is being implemented across a wide spectrum of providers and is primarily targeting communication, situational awareness, leadership, and role clarity. Relatively few details indicate how training needs were established. Most studies collected data immediately posttraining; however, less than 30% collected data six months or more posttraining. Content analyses highlight the need for enhanced detail in published training evaluation reports.
  
  
  CONCLUSIONS
  In many respects, health care team training implementation and evaluation align with best practices suggested from the science of training, adult learning, and human performance; however, opportunities for improvement exist. The authors suggest several mechanisms for furthering the health care team training evidence base to enhance patient safety and work environment quality for clinicians.
authors.affiliation: Department of Psychology and Institute for Simulation and Training, University of Central Florida, Orlando, Florida 32826, USA.
authors.forename: Sallie J
authors.initials: SJ
authors.lastname: Weaver
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lyons
authors.forename: Deborah
authors.initials: D
authors.lastname: DiazGranados
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rosen
authors.forename: Eduardo
authors.initials: E
authors.lastname: Salas
authors.forename: James
authors.initials: J
authors.lastname: Oglesby
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Augenstein
authors.forename: David J
authors.initials: DJ
authors.lastname: Birnbach
authors.forename: Donald
authors.initials: D
authors.lastname: Robinson
authors.forename: Heidi B
authors.initials: HB
authors.lastname: King
mesh_terms: D003142:Communication; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D010348:Patient Care Team / Q000458:organization & administration*; D011361:Professional Competence; D014481:United States