title: Does classroom-based Crew Resource Management training improve patient safety culture? A systematic review.
abstract: OBJECTIVE
  To evaluate the evidence of the effectiveness of classroom-based Crew Resource Management training on safety culture by a systematic review of literature.
  
  
  METHODS
  Studies were identified in PubMed, Cochrane Library, PsycINFO, and Educational Resources Information Center up to 19 December 2012. The Methods Guide for Comparative Effectiveness Reviews was used to assess the risk of bias in the individual studies.
  
  
  RESULTS
  In total, 22 manuscripts were included for review. Training settings, study designs, and evaluation methods varied widely. Most studies reporting only a selection of culture dimensions found mainly positive results, whereas studies reporting all safety culture dimensions of the particular survey found mixed results. On average, studies were at moderate risk of bias.
  
  
  CONCLUSIONS
  Evidence of the effectiveness of Crew Resource Management training in health care on safety culture is scarce and the validity of most studies is limited. The results underline the necessity of more valid study designs, preferably using triangulation methods.
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Verbeek-van Noord
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Martine C
authors.initials: MC
authors.lastname: de Bruijne
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Nicolien C
authors.initials: NC
authors.lastname: Zwijnenberg
authors.affiliation: Medical Library, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Elise P
authors.initials: EP
authors.lastname: Jansma
authors.affiliation: Department of Organization Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Cathy
authors.initials: C
authors.lastname: van Dyck
authors.affiliation: Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
keywords: Crew Resource Management training; Patient safety (MeSH); hospitals (MeSH); safety culture; systematic review