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Two Hours of Teamwork Training Improves Teamwork in Simulated Cardiopulmonary Arrest Events

Mahramus, Tara L. MSN, CNS, CCNS, CCRN; Penoyer, Daleen A. PhD, RN, CCRP, FCCM; Waterval, Eugene M.E. MSN, RN, NE-BC; Sole, Mary L. PhD, RN, CCNS, CNL, FAAN, FCCM; Bowe, Eileen M. BSN, RN, MBA

doi: 10.1097/NUR.0000000000000237
Feature Article

Purpose/Aim: Teamwork during cardiopulmonary arrest events is important for resuscitation. Teamwork improvement programs are usually lengthy. This study assessed the effectiveness of a 2-hour teamwork training program.

Design: A prospective, pretest/posttest, quasi-experimental design assessed the teamwork training program targeted to resident physicians, nurses, and respiratory therapists.

Methods: Participants took part in a simulated cardiac arrest. After the simulation, participants and trained observers assessed perceptions of teamwork using the Team Emergency Assessment Measure (TEAM) tool (ratings of 0 [low] to 4 [high]). A debriefing and 45 minutes of teamwork education followed. Participants then took part in a second simulated cardiac arrest scenario. Afterward, participants and observers assessed teamwork.

Results: Seventy-three team members participated—resident physicians (25%), registered nurses (32%), and respiratory therapists (41%). The physicians had significantly less experience on code teams (P < .001). Baseline teamwork scores were 2.57 to 2.72. Participants’ mean (SD) scores on the TEAM tool for the first and second simulations were 3.2 (0.5) and 3.7 (0.4), respectively (P < .001). Observers’ mean (SD) TEAM scores for the first and second simulations were 3.0 (0.5) and 3.7 (0.3), respectively (P < .001). Program evaluations by participants were positive.

Conclusions: A 2-hour simulation-based teamwork educational intervention resulted in improved perceptions of teamwork behaviors. Participants reported interactions with other disciplines, teamwork behavior education, and debriefing sessions were beneficial for enhancing the program.

Author Affiliations: Clinical Nurse Specialist (Ms Mahramus); Director, Center for Nursing Research (Dr Penoyer); Manager for Nursing & Special Projects and Magnet Program (Mr Waterval), Orlando Health; Dean and Professor, University of Central Florida College of Nursing (Dr Sole); and National Clinical and Compliance Manager, DySIS Medical, Tampa, Florida (Ms Bowe).

The authors report no conflicts of interest.

Correspondence: Tara L. Mahramus, MSN, CNS, CCNS, CCRN, Orlando Health, 1414 Kuhl Ave, MP 126, Orlando, FL 32806 (

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