In-situ simulation-based intervention for enhancing teamwork in the emergency department

Abstract

Simulation-based learning activities in the emergency department (ED) improve communication and teamwork and familiarise personnel with existing protocols. The authors' objective was to develop standardised in-situ simulations and to assess their effects on team performance during simulated patient care. The study was a prospective, single-centre pre-in-situ and post-in-situ simulation-based intervention in the ED of an academic hospital between March 2017 and February 2018. Teams of three to five participants (n=46) were in two simulation interventions 2 weeks apart; each simulation was followed by debriefing with good judgement. The adapted Simulation Team Assessment Tool (STAT) Score was the primary measure for team performance. Skills are measured on a scale of 2-0 based on the complete and timely performance of tasks for a total (adapted) score of 171. Overall STAT scores improved significantly between simulations I (60.5 (28.3)) and II (81.1 (24.6)), p=029; notably in airway and teamwork domains, p=022 and p=023, respectively. A sub-analysis showed that participants performed significantly better when treating adult versus paediatric simulated patients (87.9 (20.1)), p=003, particularly in teamwork, p=01. The study yielded statistically significant improvement in clinical management, teamwork and resource management skills among ED personnel.