title: Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.
abstract: OBJECTIVE
  We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes.
  
  
  METHODS
  Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI.
  
  
  RESULTS
  Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, p<0.001). Previous research suggests that this improved teamwork score would translate into a clinically important reduction in complications and mortality in surgical patients.
  
  
  CONCLUSIONS
  We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.
authors: Associate Professor and Head of Centre for Medical and Health Sciences Education, University of Auckland and Anesthesiologist, Auckland City Hospital, New Zealand.
authors: Jennifer M
authors: JM
authors: Weller
authors: Lecturer, Department of Anesthesiology, University of Auckland, Auckland.
authors: David
authors: D
authors: Cumin
authors: Professor of Surgery, University of Auckland, and Trauma and Vascular Surgeon Auckland City Hospital, New Zealand.
authors: Ian D
authors: ID
authors: Civil
authors: Senior Lecturer, Department of Anesthesiology, University of Auckland and Anesthesiologist, Auckland City Hospital.
authors: Jane
authors: J
authors: Torrie
authors: Adjunct Professor, Victoria University of Wellington, Anesthesiologist, Capital and Coast Health, Wellington, New Zealand.
authors: Alexander
authors: A
authors: Garden
authors: Department of Surgery, University of Auckland, General Surgeon, Counties Manukau Health, Auckland, New Zealand.
authors: Andrew D
authors: AD
authors: MacCormick
authors: Department of Surgery, Launceston Hospital, Tasmania, Australia.
authors: Nishanthi
authors: N
authors: Gurusinghe
authors: National Health Committee, New Zealand Ministry of Health, and Adapt Research Ltd, Wellington.
authors: Matthew J
authors: MJ
authors: Boyd
authors: Professor, Psychological Medicine, University of Otago, Christchurch; Ludvig Selander, Medical Student, Linköping University, Linköping, Sweden.
authors: Christopher
authors: C
authors: Frampton
authors: Medical Student, Linköping University, Linköping, Sweden.
authors: Martina
authors: M
authors: Cokorilo
authors: Medical Student, Linköping University, Linköping, Sweden.
authors: Magnus
authors: M
authors: Tranvik
authors: Medical Student, Linköping University, Linköping, Sweden.
authors: Lisa
authors: L
authors: Carlsson
authors: Auckland City Hospital, Auckland.
authors: Tracey
authors: T
authors: Lee
authors: Anesthesiologist, Counties Manukau Health, Auckland, New Zealand.
authors: Wai Leap
authors: WL
authors: Ng
authors: Teaching Fellow, School of Nursing, University of Auckland, Auckland.
authors: Michael
authors: M
authors: Crossan
authors: Professor of Anesthesiology, University of Auckland and Anesthesiologist, Auckland City Hospital, Auckland.
authors: Alan F
authors: AF
authors: Merry
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006761:Hospitals; D006801:Humans; D033183:Interdisciplinary Communication; D009520:New Zealand; D009873:Operating Rooms / Q000458:organization & administration*; D010348:Patient Care Team / Q000592:standards*; D000066908:Simulation Training