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A Systematic Review of Teamwork Training Interventions in Medical Student and Resident Education

Abstract

Background

Teamwork is important for improving care across transitions between providers and for increasing patient safety.

Objective

This review’s objective was to assess the characteristics and efficacy of published curricula designed to teach teamwork to medical students and house staff.

Design

The authors searched MEDLINE, Education Resources Information Center, Excerpta Medica Database, PsychInfo, Cumulative Index of Nursing and Allied Health Literature, and Scopus for original data articles published in English between January 1980 and July 2006 that reported descriptions of teamwork training and evaluation results.

Measurements

Two reviewers independently abstracted information about curricular content (using Baker’s framework of teamwork competencies), educational methods, evaluation design, outcomes measured, and results.

Results

Thirteen studies met inclusion criteria. All curricula employed active learning methods; the majority (77%) included multidisciplinary training. Ten curricula (77%) used an uncontrolled pre/post design and 3 (23%) used controlled pre/post designs. Only 3 curricula (23%) reported outcomes beyond end of program, and only 1 (8%) >6weeks after program completion. One program evaluated a clinical outcome (patient satisfaction), which was unchanged after the intervention. The median effect size was 0.40 (interquartile range (IQR) 0.29, 0.61) for knowledge, 0.38 (IQR 0.32, 0.41) for attitudes, 0.41 (IQR 0.35, 0.49) for skills and behavior. The relationship between the number of teamwork principles taught and effect size achieved a Spearman’s correlation of .74 (p = .01) for overall effect size and .64 (p = .03) for median skills/behaviors effect size.

Conclusions

Reported curricula employ some sound educational principles and appear to be modestly effective in the short term. Curricula may be more effective when they address more teamwork principles.

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Acknowledgements

The authors are indebted to Ms. Cheri Smith from the Harrison Medical Library, Johns Hopkins Bayview Medical Center, for her library assistance and to Ms. Ming An from the Bloomberg School of Public Health for assistance with statistical analysis. Dr. Scott Wright is an Arnold P. Gold Associate Professor of Medicine and a Miller-Coulson Family Scholar. At the time this review was conducted, Dr. Chayan Chakraborti was supported by National Research Service Award Institutional Grant (#5-T-32-HP10025). Dr. Romsai Boonyasai was supported by Behavioral Research in Heart and Vascular Disease Grant (#T32HL07180). Dr. Chakraborti had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Dr. Boonyasai was involved in data collection, interpretation, and analysis. Dr. Wright and Dr. Kern provided methodological advice, data interpretation, and edited the manuscript. Material from this manuscript was presented at the 2007 Society of General Internal Medicine National Conference in Toronto, Canada.

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Correspondence to Chayan Chakraborti MD.

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Chakraborti, C., Boonyasai, R.T., Wright, S.M. et al. A Systematic Review of Teamwork Training Interventions in Medical Student and Resident Education. J GEN INTERN MED 23, 846–853 (2008). https://doi.org/10.1007/s11606-008-0600-6

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Key words

  • teamwork
  • cooperation
  • medical education
  • curricula
  • medical student
  • house staff
  • resident
  • residency