title: Classroom and simulation team training: a randomized controlled trial.
abstract: OBJECTIVE
  To test the hypotheses that classroom and simulation-based crew resource management (CRM) training interventions improve teamwork attitudes and behaviours of participants and that classroom training combined with simulation-based training provide synergistic improvements.
  
  
  METHODS
  A randomized controlled trial.
  
  
  METHODS
  Area Health Service in New South Wales, Australia.
  
  
  METHODS
  A total of 157 doctors, nurses and midwives randomized into one of four groups, consisting of three intervention groups and a control group.
  
  
  METHODS
  One-day CRM-based classroom course; one-day CRM style simulation-based training or classroom training followed by simulation-based training.
  
  
  METHODS
  Pre- and post-test quantitative participant teamwork attitudes, and post-test quantitative trainee reactions, knowledge and behaviour.
  
  
  RESULTS
  Ninety-four doctors, nurses and midwives completed pre-intervention attitude questionnaires and 60 clinicians completed post-intervention assessments. No positive changes in teamwork attitudes were found associated with classroom or simulation training. Positive changes were found in knowledge (mean difference 1.50, 95% confidence interval (CI) 0.58-2.43, P = 0.002), self-assessed teamwork behaviour (mean difference 2.69, 95% CI 0.90-6.13, P = 0.009) and independently observed teamwork behaviour (mean difference 2.30, 95% CI 0.30-4.30, P = 0.027) when classroom-only trained group was compared with control; however, these changes were not found in the group that received classroom followed by simulation training.
  
  
  CONCLUSIONS
  Classroom-based training alone resulted in improvements in participant knowledge and observed teamwork behaviour. The study found no additional impact of simulation training.
authors.affiliation: Faculty of Medicine, Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney NSW 2052, Australia. r.clay-williams@unsw.edu.au
authors.forename: Robyn
authors.initials: R
authors.lastname: Clay-Williams
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McIntosh
authors.forename: Ross
authors.initials: R
authors.lastname: Kerridge
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
mesh_terms: D001291:Attitude of Health Personnel; D006126:Group Processes; D006282:Health Personnel / Q000193:education* / Q000523:psychology; D006801:Humans; D007318:Inservice Training / Q000379:methods; D010348:Patient Care Team / Q000592:standards; D014584:User-Computer Interface
keywords: competency-based education; crew resource management; needs assessment; teamwork