Skip to main content
Log in

Integration and Improvement of Teamwork Skills in First Year Medical Students by Using Physiology-Based High Fidelity Patient Simulations

  • Original Research
  • Published:
Medical Science Educator Aims and scope Submit manuscript

Abstract

Communication errors between team members underlie many of the preventable patient errors within the US healthcare system. Medical students do not get the opportunity to take advantage of TeamSTEPPS® training because they are not consistently a part of hospital-based teams. Most of their communication skills training are focused on the doctor and patient relationship and less focus on teamwork (TW) skills. Developing TW skills earlier in medical education may help lead to better communication and patient safety; however, there is little time in preclinical medical education due to full curricula. The purpose of this study was to integrate TW skills development into existing physiology-based high fidelity patient simulations (HFPS) by using strategic triggers. A mixed-methods approach was used with the use of an evaluation tool and qualitative interviews to determine student perceptions of learning in these HFPS. Furthermore, since HFPS is costly in terms of faculty time, we aimed to find ways to reduce faculty time involvement. One hundred twenty first year medical students participated in three HFPS and observed one. The data show that TW skills are significantly improved between the first and last HFPS for most teams of students. There were no differences between learner-observer-led and faculty-led debriefs in development of TW skills. Qualitative student interviews show that they believe TW skills were learned by the HFPS and also that observing HFPS was beneficial in their learning. Overall, these data suggest that TW skills can be improved by integrating these into physiology-based HFPS with strategically placed triggers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. To err is human: building a safer health system. Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, editors. National Academy Press, 2000. http://iom.nationalacademies.org/Reports/1999/To-Err-is-Human-Building-A-Safer-Health-System.aspx.

  2. Clancy CM, Tornberg DN. TeamSTEPPS: assuring optimal teamwork in clinical settings. Am J Med Qual. 2007;22(3):214–7.

    Article  Google Scholar 

  3. Cima RR, Kollengode A, Storsveen AS, Weisbrod CA, Deschamps C, Koch MB, et al. A multidisciplinary team approach to retained foreign objects. Jt Comm J Qual Patient Saf. 2009;35(3):123–32.

    Google Scholar 

  4. Awad SS, Fagan SP, Bellows C, Albo D, Green-Rashad B, De la Garza M, et al. Bridging the communication gap in the operating room with medical team training. Am J Surg. 2005;190(5):770.

    Article  Google Scholar 

  5. Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf. 2006;32(3):167–75.

    Google Scholar 

  6. Clancy CM. Ten years after To Err is Human. Am J Med Qual. 2009;24(6):525–8.

    Article  Google Scholar 

  7. Morrison G, Goldfarb S, Lanken PN. Team training of medical students in the 21st century: would Flexner approve? Acad Med. 2010;85(2):254–9.

    Article  Google Scholar 

  8. Lerner S, Magrane D, Friedman E. Teaching teamwork in medical education. Mt Sinai J Med. 2009;76(4):318–29.

    Article  Google Scholar 

  9. Chakraborti C, Boonyasai RT, Wright SM, Kern DE. A systematic review of teamwork training interventions in medical student and resident education. J Gen Intern Med. 2008;23(6):846–53.

    Article  Google Scholar 

  10. Association of American Medical Colleges. Medical simulation in medical education: results of an AAMC survey. September 2011.

  11. Cronenwett L, Sherwood G, Barnsteiner J, Disch J, Johnson J, Mitchell P, et al. Quality and safety education for nurses. Nurs Outlook. 2007;55(3):122–31.

    Article  Google Scholar 

  12. Hobgood C, Sherwood G, Frush K, Hollar D, Maynard L, Foster B, et al. Teamwork training with nursing and medical students: does the method matter? Results of an interinstitutional, interdisciplinary collaboration. Qual Saf Health Care. 2010;19(6), e25.

    Google Scholar 

  13. Salas E, Frush K. Improving patient safety through teamwork and team training. Oxford: Oxford University Press; 2012.

    Google Scholar 

  14. Harris DM, Bellew C, Cheng ZJ, Cendan JC, Kibble JD. High-fidelity patient simulators to expose undergraduate students to the clinical relevance of physiology concepts. Adv Physiol Educ. 2014;38(4):372–5.

    Article  Google Scholar 

  15. Oriol NE, Hayden EM, Joyal-Mowschenson J, Muret-Wagstaff S, Faux R, Gordon JA. Using immersive healthcare simulation for physiology education: initial experience in high school, college, and graduate school curricula. Adv Physiol Educ. 2011;35(3):252–9.

    Article  Google Scholar 

  16. Gordon JA, Oriol NE, Cooper JB. Bringing good teaching cases “to life”: a simulator-based medical education service. Acad Med. 2004;79(1):23–7.

    Article  Google Scholar 

  17. Brown JF. Applications of simulation technology in psychiatric mental health nursing education. J Psychiatr Ment Health Nurs. 2008;15(8):638–44.

    Article  Google Scholar 

  18. Bray BS, Schwartz CR, Weeks DL, Kardong-Edgren S. Human patient simulation technology: perceptions from a multidisciplinary sample of health care educators. Clin Simul Nurs. 2009;6(4):e145–e50.

    Article  Google Scholar 

  19. Irby DM, Cooke M, O’Brien BC. Calls for reform of medical education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010. Acad Med. 2010;85(2):220–7.

    Article  Google Scholar 

  20. Adamson K. Integrating human patient simulation into associate degree nursing credentials. Clin Simul Nurs. 2010;6(3):e75–81.

    Article  Google Scholar 

  21. Fountain RA, Alfred D. Student satisfaction with high-fidelity simulation: does it correlate with learning styles? Nurs Educ Perspect. 2009;30(2):96–8.

    Google Scholar 

  22. Miller A, Bull RM. Do you want to play? Factors influencing nurse academics’ adoption of simulation in their teaching practices. Nurse Educ Today. 2013;33(3):241–6.

    Article  Google Scholar 

  23. Bloom BS. Taxonomy of educational objectives: the classification of educational objectives. Handbook 1: the cognitive domain. New York: McKay; 1964.

    Google Scholar 

  24. Bandura A. Social learning theory and personality development. New York: Rinerhart and Winston; 1963.

    Google Scholar 

  25. Wright MC, Taekman JM, Endsley MR. Objective measures of situation awareness in a simulated medical environment. Qual Saf Health Care. 2004;13 Suppl 1:i65–71.

    Article  Google Scholar 

  26. Ostergaard HT, Ostergaard D, Lippert A. Implementation of team training in medical education in Denmark. Qual Saf Health Care. 2004;13 Suppl 1:i91–5.

    Article  Google Scholar 

  27. Kutzin JM. Communication and teamwork focused simulation-based education for nursing students. Scholarworks@UMASS Amherst, 2010. http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1003&context=nursing_dnp_capstone

  28. Dale E. Audiovisual methods in teaching. New York: Dryden Press; 1969.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David M. Harris.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 19 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reinemann, J., LaBell, K., Bellew, C. et al. Integration and Improvement of Teamwork Skills in First Year Medical Students by Using Physiology-Based High Fidelity Patient Simulations. Med.Sci.Educ. 25, 503–512 (2015). https://doi.org/10.1007/s40670-015-0161-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-015-0161-3

Keywords

Navigation