Further development of crew resource management training: Needs assessment by means of teamwork-context analysis in anesthesia and intensive care teams

Abstract

Background: Teams in anesthesia and intensive care work as high responsibility teams (HRT). Success in this environment partly depends on the use of nontechnical skills which can be learned through simulation-based training. A teamwork context analysis could help to identify training requirements for crew resource management training. Material and methods: We used a multicentric observational cross-sectional study design utilizing survey methodology to evaluate the teamwork context of different work environments, using the 62-item TAKAI inventory. We surveyed anesthesia and intensive care staff from nine hospitals in Germany which provide varying levels of care. Results: In total, 128 people (44.5% male, 53.9% female) from 9 German hospitals participated in the study. The topics “interconnectedness: departments”, “interconnectedness: information flow”, “dynamics”, “polytely”, “velocity of the team’s movement”, “velocity of system changes”, “hierarchy” and “hierarchy: leadership”, “shared task mental model”, “shared team mental model” and all aspects of the scale “adaptive behaviors” were identified as focal aspects to be implemented into Crew-Resource-Management (CRM) training for the evaluated work environments. Conclusion: The TAKAI scales meet quality criteria (Cronbach’s alpha > 0.6) and are appropriate for use in the analysis of the teamwork environment. The results indicate many similarities between the work contexts surveyed but also slight differences. TAKAI can be an additional method to design an appropriate simulation training program for HRT in anesthesia and intensive care medicine as there does not seem to be a one-size-fits-all simulation concept. For a special focus on the needs of a work context, the easy to perform TAKAI analysis in the needs analysis step is worthwhile.