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Are We on the Same Page? Shared Mental Models to Support Clinical Teamwork Among Health Professions Learners: A Scoping Review

Floren, Leslie, Carstensen, PharmD, MA; Donesky, DorAnne, RN, PhD, ANP-BC; Whitaker, Evans, MD; Irby, David, M., PhD; ten Cate, Olle, PhD; O’Brien, Bridget, C., PhD

doi: 10.1097/ACM.0000000000002019
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Purpose To conduct a scoping review to explore the construct of shared mental models (SMMs) in the context of clinical teamwork among health professions learners.

Method The authors searched the PubMed, ERIC, CINAHL, Scopus, Web of Science, PsychINFO, and EMBASE databases for English-language articles published between 2000 and 2016. Eligible articles mentioned SMMs in relation to clinical teamwork and included health professions learners. Two reviewers screened studies for eligibility and extracted data to determine the depth and breadth of the literature on SMMs. The authors examined definitions of the SMM construct in the context of clinical teams, educational interventions using SMMs, and the measurement of SMMs.

Results Of the 1,273 articles retrieved, 23 met the inclusion criteria. SMMs were defined in less than two-fifths of the articles (9/23). All articles applied the construct to improvements in hospital-based patient safety, often in high-intensity settings (14/23). Most articles included graduate-level physicians (21/23) within clinical teams (18/23). Interventions designed to foster SMMs (6/23) included teamwork curricula/training and teamwork supportive tools. Measurements of SMMs (7/23) included a qualitative task analysis, quantitative analyses of speech, a concept mapping, and Likert-type surveys.

Conclusions In health professions education, the SMM construct lacks clear definition. Few studies described educational interventions aimed at SMM development, and few attempted to measure the construct. The authors propose an operational definition of SMMs in health care and illustrate how interventions intended to foster SMMs, such as team trainings or planning exercises and communication tools, could be developed, implemented, and assessed.

L.C. Floren is associate professor, Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, and advanced fellow in health professions education evaluation and research, Department of Veterans Affairs, San Francisco, California.

D. Donesky is codirector, Palliative Care Educational Program, School of Nursing, University of California, San Francisco, San Francisco, California.

E. Whitaker is research librarian, Medical Library, University of California, San Francisco, San Francisco, California.

D.M. Irby is professor, Department of Medicine, School of Medicine, and research faculty member, Center for Faculty Educators, University of California, San Francisco, San Francisco, California.

O. ten Cate is professor, School of Medicine, Utrecht University, Utrecht, The Netherlands, and adjunct professor, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California.

B.C. O’Brien is associate professor, Department of Medicine, and research faculty member, Center for Faculty Educators, School of Medicine, University of California, San Francisco, San Francisco, California.

Funding/Support: Leslie Carstensen Floren was supported by the United States Department of Veterans Affairs Advanced Fellowship in Health Professions Education Evaluation and Research.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A496.

An AM Rounds blog post on this article is available at academicmedicineblog.org.

Correspondence should be addressed to Leslie Carstensen Floren, UCSF School of Pharmacy, Department of Bioengineering and Therapeutic Sciences, 513 Parnassus Ave., Room S840, San Francisco, CA 94117-0150; telephone: (415) 514-3559; e-mail: leslie.floren@ucsf.edu.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

© 2018 by the Association of American Medical Colleges