Team management training using crisis resource management results in perceived benefits by healthcare workers.

BACKGROUND: Systems failures and ineffective teamwork can lead to serious errors in practice. Crisis Resource Management (CRM) teaches leadership, effective communication skills, and improved team performance. The impact of CRM taught in a simulation laboratory was evaluated. METHODS: A mail survey was used to examine perceived benefits and application of CRM principles when encountering practice and everyday life crisis situations. All participants completing the course since its inception who could be located received the survey. RESULTS: Fifty-three of 149 participants (35%) responded to the survey. Eighty-three percent had managed a crisis since the course and 68% indicated better practice performance during emergencies. Thirty-eight percent applied CRM to personal crisis experiences. CONCLUSIONS: Findings support that CRM training leads to perceived improvements in performance during critical events.

Implementation of a Web- and simulation-based curriculum to ease the transition from medical school to surgical internship.

BACKGROUND: Starting a surgical internship is a stressful experience. We developed a web and simulation-based curriculum to ease this transition. METHODS: We created an educational website containing a curriculum of commonly encountered on call situations. After match day in 2003, we contacted all of our new surgical interns. We performed a confidence assessment using a Likert-scale questionnaire, and the trainees were given access to the curriculum. In June 2003, we performed human patient simulator sessions. The participants were asked to provide feedback regarding the simulator experience. During the first week of residency, they were again asked to answer the confidence questionnaire. RESULTS: Sixteen residents (94%) used the web curriculum, and 17 (100%) participated in the simulations. Eleven (65%) filled out both questionnaires. The confidence score improved from 5.4 to 6.7 (P < .0001). CONCLUSIONS: A web and simulation-based curriculum for incoming house staff is feasible. Studies are underway to validate this novel method and to expand its use for surgical education.

Crisis resource management: evaluating outcomes of a multidisciplinary team.

Crisis resource management (CRM) is a team-training program that teaches nontechnical skills such as: collaboration, communication, task management, teamwork, and leadership. The purpose of this study was to evaluate improvement in the nontechnical skills of a multidisciplinary team of pediatric residents, anesthesiology residents and pediatric nurses following participation in the CRM educational program. Self-efficacy theory guided the teaching method used in the CRM program. The Collaboration and Satisfaction about Care Decisions instrument and the Anesthetists' Nontechnical Skills System served as outcome measures. Seven multidisciplinary groups were studied with a total of 40 subjects. A significant increase was found in posttest scores for perceived collaboration and satisfaction with care and in numerical ratings of observed team skills following the CRM program. The results suggest multidisciplinary team participation in the CRM program increased perceived team collaboration, satisfaction with care, and observed teamwork skills.

Leadership Training: A New Application of Crisis Resource Management and Distance Education in a Large Group Format at a Medical Simulation Facility.

INTRODUCTION: Leadership and teamwork skills must be practiced to gain full value from a leadership course. The leadership role is one of the main points highlighted during a Crisis Resource Management (CRM) session. While a typical CRM session offered in a medical simulation laboratory uses a medical crisis to elicit behaviors for videotaping and debriefing, the CRM principles are generic and applicable to leadership training outside medical practice. METHODS: The Simulation Development and Cognitive Science Laboratory of the Pennsylvania State University College of Medicine offered a CRM course to high school students using a pediatric full human simulator (M.E.T.I.) The students rotated through two sessions: as hands-on participants in the Simulation Laboratory, and in a remote education mode. During the remote session, they viewed their peers via a video link, discussed the crisis and were able to assist their peers. RESULTS: The 17 students valued the overall session at a high level (4.9 ± 0.2 on a five-point scale; mean ± SD). The majority of students (n=10) indicated that they felt involved in both the hands-on and remote sessions (≥7 on a ten-point scale). CONCLUSION: Based on the results, all participants believed the session was of great value and that they could use CRM principles in everyday situations. We believe that the participants found significant value in the CRM session as a leadership skills resource. Most students also felt involved in the remote sessions, thereby enabling a larger group of trainees to learn about and experience CRM principles.