Simulation activities that include multiple healthcare disciplines are thought to be effective in improving communication among disciplines and, ultimately, in improving patient outcomes. However, a recent article in the British Journal of Surgery1 should at least lead us to further evaluate the outcomes of simulation activities designed to include multiple healthcare disciplines.
The British group examined 1,036 articles related to teamwork training for clinical staff. Fourteen of these articles were analyzed for outcomes including staff attitudes, teamwork skills, technical performance and efficiency, and clinical outcomes. Of these 14 studies, 4 included randomized trials and 10 were not randomized. The literature review described the studies as of poor quality with frequent evidence of the Hawthorne effect and research designs that did not use participant blinding. Most studies reported “better teamwork” as the major outcome of the simulation-based training activities. Five studies reported evidence of improved technical performance, improved efficiency, or reduced errors. Only 3 studies reported evidence of clinical benefit. None of the nonrandomized trials reported technical or clinical benefit.
Nurse educators need to carefully consider and evaluate this report. As we move forward with the use of simulation, we need to plan our educational strategies to identify measurable outcomes related to skills, technical performance, and efficiency, as well as improved communication. Evidence to support these educational efforts is critical to further utilization of simulation activities.
1. McCulloch P, Rathbone J, Catchpole K. Interventions to improve teamwork and communications among healthcare staff. Br J Surg. 2011;98(4):469-479. ISSN: 1365-2168.
Source: Nurses Best Evidence Newsletter. June 22, 2011. Available at http://reference.medscape.com/medline/abstract/21305537?src=nlbest. Accessed June 23, 2011.
Submitted by: Robin E. Pattillo, PhD, RN, CNL, News Editor at [email protected].