title: Improving teamwork, confidence, and collaboration among members of a pediatric cardiovascular intensive care unit multidisciplinary team using simulation-based team training.
abstract: Findings show that simulation-based team training (SBTT) is effective at increasing teamwork skills. Postpediatric cardiac surgery cardiac arrest (PPCS-CA) is a high-risk clinical situation with high morbidity and mortality. Whereas adult guidelines managing cardiac arrest after cardiac surgery are available, little exists for pediatric cardiac surgery. The authors developed a post-PPCS-CA algorithm and used SBTT to improve identification and management of PPCS-CA in the pediatric cardiovascular intensive care unit. Their goal was to determine whether participation aids in improving teamwork, confidence, and communication during these events. The authors developed a simulation-based training course using common postcardiac surgical emergency scenarios with specific learning objectives. Simulated scenarios are followed by structured debriefings. Participants were evaluated based on critical performance criteria, key elements in the PPCS-CA algorithm, and Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) principles. Surveys performed before, immediately after, and 3 months after participation evaluated perception of skill, knowledge, and confidence. The study had 37 participants (23 nurses, 5 cardiology/critical care trainees, 5 respiratory therapists, and 4 noncategorized subjects). Confidence and skill in the roles of team leader, advanced airway management, and cardioversion/defibrillation were increased significantly (p < 0.05) immediately after training and 3 months later. A significant increase (p < 0.05) also was observed in the use of Team STEPPS concepts immediately after training and 3 months later. This study showed SBTT to be effective in improving communication and increasing confidence among members of a multidisciplinary team during crisis scenarios. Thus, SBTT provides an excellent tool for teaching and implementing new processes.
authors.affiliation: Departments of Pediatric Cardiology, University of Tennessee Health Science Center/Le Bonheur Children's Hospital, 50 North Dunlap Street, 3rd Floor Research Tower, Memphis, TN 38103, USA. Mayte.Figueroa@lebonheur.org
authors.forename: Mayte I
authors.initials: MI
authors.lastname: Figueroa
authors.forename: Robert
authors.initials: R
authors.lastname: Sepanski
authors.forename: Steven P
authors.initials: SP
authors.lastname: Goldberg
authors.forename: Samir
authors.initials: S
authors.lastname: Shah
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003299:Cooperative Behavior; D003422:Critical Care / Q000379:methods; D004635:Emergency Medicine / Q000193:education; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration*; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D058996:Quality Improvement; D014481:United States