title: The blindfolded code training exercise.
abstract: Communication errors are the leading cause of preventable patient harm in medicine. There is little description in the literature of advanced techniques to teach crisis resource management (CRM) communication strategies, or how to improve real-time ineffective behaviour or habits that may persist despite appropriate behaviour and leadership witnessed in the simulation lab.
  
  
  
  This article presents an advanced teaching technique to force the adoption of closed-loop communication strategies. This technique is typically reserved for more advanced learners involved in acute care, or for those struggling to effectively lead medical resuscitations.
  
  
  
  We describe a relatively well-established, yet not well-described, teaching technique that blindfolds the team leader, known as the blindfolded code training exercise. This advanced method of instruction is cost-effective and does not require special equipment.
  
  
  
  This was both a successful and popular method of instruction for closed-loop communication. The simple method of blindfolding requires the learner to use both critical thinking skills and a conceptual framework to organise their management of the resuscitation. This provides an avenue for instructors to further develop advanced learners' skills for high-risk communication. Communication errors are the leading cause of preventable patient harm in medicine.
authors.affiliation: Department of Medical Education, Summa Health System, Akron, Ohio, USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Ahmed
authors.affiliation: Michigan State University, East Lansing, Michigan, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Hughes
authors.affiliation: Emergency Medicine Department, Florida Atlantic University, Boca Raton, Florida, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hughes
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D006801:Humans; D007318:Inservice Training; D019300:Medical Errors / Q000517:prevention & control*; D013663:Teaching