Defining Team Performance for Simulation-based Training: Methodology, Metrics, and Opportunities for Emergency Medicine

Authors

  • Marc J. Shapiro MD,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • Roxane Gardner MD, MPH,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • Steven A Godwin MD,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • Gregory D. Jay MD, PhD,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • David G. Lindquist MD,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • Mary L. Salisbury RN, MSN,

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • Eduardo Salas PhD

    1. From the Department of Emergency Medicine (MJS, GDJ, DGL), the Department of Medicine (GDJ), and the Department of Engineering (GDJ), Warren Alpert School of Medicine, Brown University, Providence, RI; the Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School (RG), Boston, MA; the Department of Emergency Medicine, Simulation Education, University of Florida (SAG), Jacksonville, FL; The Cedar Institute, Inc. (MLS), North Kingstown, RI; and the Department of Psychology, Institute for Simulation & Training (ES), Orlando, FL.
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  • This is a proceeding from a workshop session of the 2008 Academic Emergency Medicine Consensus Conference, “The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise,” Washington, DC, May 28, 2008.

Address for correspondence and reprints: Marc J. Shapiro, MD; e-mail: mshapiro@mvhospital.org.

Abstract

Across health care, teamwork is a critical element for effective patient care. Yet, numerous well-intentioned training programs may fail to achieve the desired outcomes in team performance. Hope for the improvement of teamwork in health care is provided by the success of the aviation and military communities in utilizing simulation-based training (SBT) for training and evaluating teams. This consensus paper 1) proposes a scientifically based methodology for SBT design and evaluation, 2) reviews existing team performance metrics in health care along with recommendations, and 3) focuses on leadership as a target for SBT because it has a high likelihood to improve many team processes and ultimately performance. It is hoped that this discussion will assist those in emergency medicine (EM) and the larger health care field in the design and delivery of SBT for training and evaluating teamwork.

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