Validating the Team Emergency Assessment Measure (TEAM) in obstetric and gynaecologic resuscitation teams.

BACKGROUND: Simulation-based training is an effective method of enhancing the knowledge, skill, and technical abilities of individuals and teams encountering obstetric and gynaecologic emergencies. Simulation may also enhance the non-technical performance of teams resulting in improved patient outcomes. Although simulation-based training is widely recognised as an effective educational approach, issues around feasibility - the lack of simulation experts and malleable outcome measures of team performance - remain critical barriers to their implementation. AIM: To evaluate the psychometric properties of the Team Emergency Assessment Measure (TEAM) when used by medical professionals in simulated obstetric and gynaecological emergencies. METHODS: There were 151 participants (63% female; 60% consultants; 69% no previous simulation-based training) who observed three live high-fidelity obstetric and gynaecological resuscitation simulations and completed the TEAM. RESULTS: Confirmatory factor analysis evaluated the construct validity of the TEAM, yielding a second-order structure identified by 'leadership', 'teamwork', and 'team management'. Convergent validity was supported by the average item-to-scale total correlation which was 0.75, P < 0.001 and the average analysis of variance extracted (AVE) 0.88. The individual factors also yielded high factor-to-scale total correlations (mean [M] = 0.87), and AVE (M = 0.89). The internal reliability was high for the whole scale (average alpha = 0.92) and across the sub-factors (average alpha = 0.80). The inter-rater reliability was excellent (inter-class correlation coefficient 1 = 0.98). Participants with differing levels of simulation training experience did not significantly differ. CONCLUSION: The TEAM is a viable instrument for the assessment of non-technical performance during simulated obstetric and gynaecologic emergencies, thus enhancing the feasibility of simulation-based training.

Pharmacists and Mental Health First Aid training: A comparative analysis of confidence, mental health assistance behaviours and perceived barriers.

BACKGROUND: Pharmacists are aptly positioned to provide first aid-level assistance to patients experiencing a mental health problem or crisis, yet often lack confidence or perceive barriers to intervention. One potential solution is Mental Health First Aid (MHFA) training-an evidence-based psycho-educational programme. This study evaluates MHFA training within pharmacy by (1) assessing pharmacists' perceptions of the prevalence of patients experiencing a mental health-related problem or crisis, (2) investigating whether MHFA is associated with increased confidence, intervention and assistance quality and (3) examining perceived intervention barriers. METHODS: Pharmacists working in Australia were surveyed. The survey included validated measures and research objectives were assessed using descriptives and ANOVAs. RESULTS: One hundred sixty-one pharmacists were included; 90 MHFA trained and 71 untrained. Overall, 86% of reported encountering at least one patient perceived to be experiencing a mental health problem or crisis in the last year. MHFA trained pharmacists reported being more confident, with notable differences in their confidence to recognize signs, approach and ask someone about suicide. Pharmacists did not intervene ~25% of the time in which a problem/ crisis was identified. When they did intervene, results suggest the assistance was similar in content. Intervention barriers were reported to impede MHFA trained pharmacists significantly less than untrained pharmacists. CONCLUSION: Results suggest pharmacists frequently encounter patients experiencing a mental health problem or crisis and that MHFA training may support pharmacists in helping these patients. Future research can utilize experimental methods to provide causal evidence as to the utility of MHFA training for pharmacists and patients.

Mental health first aid by Australian tertiary staff: Application rates, modes, content, and outcomes.

AIM: Mental health problems are a growing challenge in tertiary institutions warranting psycho-educational intervention programmes such as mental health first aid (MHFA) that provide training to identify and support affected individuals. The present study assesses the impact of MHFA interventions on tertiary students and staff. Specifically, we examine (1) MHFA application rates and the types of mental health issues encountered, (2) how MHFA was provided, (3) application of the MHFA action plan, and (4) perceived outcomes of MHFA. METHODS: MHFA-trained staff within a tertiary institution were electronically surveyed. Quantitative data were analysed using descriptive statistics, whereas abductive coding yielded qualitative themes. RESULTS: Ninety participants completed the questionnaire (26%). Fifty-seven percentage of respondents had applied MHFA within the tertiary context. All participants reported applying MHFA in response to anxiety or depression at least once. Anxiety (37%) and depression (27%) were the most frequently encountered mental health issues. All participants had administered MHFA face-to-face, with telephone calls (35%) and text messaging (33%) also frequently employed. On average, participants reported completing 4.2 (out of 5) MHFA action plan actions, with 47% completing all actions. Most participants believed that their intervention was helpful (88%) with 65% of recipients seeking professional assistance. Recipients experienced perceived positive affective responses, which were also associated with approach strategies. CONCLUSIONS: MHFA is widely applied in the tertiary context through a variety of modes. Most interventions featured at least four of the recommended MHFA action plan actions. The outcomes of MHFA were largely positive, suggesting that MHFA is an effective early intervention in the tertiary context.