title: Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training.
abstract: OBJECTIVE
  To determine whether interdisciplinary simulation team training can positively affect registered nurse and/or physician perceptions of collaboration in clinical decision making.
  
  
  METHODS
  Between March 1 and April 21, 2009, a convenience sample of volunteer nurses and physicians was recruited to undergo simulation training consisting of a team response to 3 clinical scenarios. Participants completed the Collaboration and Satisfaction About Care Decisions (CSACD) survey before training and at 2 weeks and 2 months after training. Differences in CSACD summary scores between the time points were assessed with paired t tests.
  
  
  RESULTS
  Twenty-eight health care professionals (19 nurses, 9 physicians) underwent simulation training. Nurses were of similar age to physicians (27.3 vs 34.5 years; p = .82), were more likely to be women (95.0% vs 12.5%; p < .001), and were less likely to have undergone prior simulation training (0% vs 37.5%; p = .02). The pretest showed that physicians were more likely to perceive that open communication exists between nurses and physicians (p = .04) and that both medical and nursing concerns influence the decision-making process (p = .02). Pretest CSACD analysis revealed that most participants were dissatisfied with the decision-making process. The CSACD summary score showed significant improvement from baseline to 2 weeks (4.2 to 5.1; p < .002), a trend that persisted at 2 months (p < .002).
  
  
  CONCLUSIONS
  Team training using high-fidelity simulation scenarios promoted collaboration between nurses and physicians and enhanced the patient care decision-making process.
authors.affiliation: Department of Nursing, Mayo Clinic, Rochester, MN 55905, USA. maxson.pamela@mayo.edu
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Maxson
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Dozois
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Holubar
authors.forename: Diane M
authors.initials: DM
authors.lastname: Wrobleski
authors.forename: Joyce A Overman
authors.initials: JA
authors.lastname: Dube
authors.forename: Janee M
authors.initials: JM
authors.lastname: Klipfel
authors.forename: Jacqueline J
authors.initials: JJ
authors.lastname: Arnold
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D003657:Decision Making; D005260:Female; D006801:Humans; D007318:Inservice Training; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D019555:Physician-Nurse Relations; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires