Interprofessional Simulation and Improvement in Teamwork, Collaboration and Communication

Background: Interprofessional development and team behaviors have become a key point of interest over the last ten years. Simulation growth has influenced a variety of different settings in healthcare. Mock code simulation uses high fidelity technology and a variety of debriefing techniques. By joining the two, simulation helps assimilate knowledge demonstrating effectiveness of team dynamics. This educational approach supports students entering the workforce to be more prepared for crisis situations.

Purpose: To analyze and demonstrate mock code simulation effects on perception and team behaviors using providers, nurses, and respiratory therapists regarding teamwork, collaboration and communication. A debrief session was used between code simulations.

Design: A retrospective review with mixed method of descriptive, correlational and quantitative statistics from a convenience sample. A linear regression was used to determine effect of an overall team score (Q12).

Methods: Twelve teams comprised of providers, nurses, and respiratory therapists performed two independent mock codes. Each team was composed of n=5-10 members involving an overall total of 85. The TeamSTEPPS® questionnaire was given prior to and post each mock code for the participants (n=85). The facilitator rated video recordings of the mock code simulations using the T.E.A.M. tool. T.E.A.M. scores were compared between interprofessional teams and all-nurse teams.

Results: The TeamSTEPPS®, 30 item questionnaire had 12 significant pre-post differences (p<0.05), with all but one showing improvement. The T.E.A.M. tool had two significant pre-post differences out of 12 team behaviors, both showing improvement (p<0.05). When team behavior scores for codes one and two (12 each) were combined and compared for interprofessional presence versus all-nurse teams, 6 out of 12 teams in the interprofessional teams scored statistically significantly better than the all-nurse teams (p<0.05). In the same group of scores, a linear regression of an overall effect of team score on Code (one or two) and Interprofessional presence (yes/no) found that the latter was significant (p=.004).

Conclusion: The use of mock code simulations with subsequent debriefing can contribute to increased teamwork behaviors, collaboration and communication.