Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training

Detalhes bibliográficos
Autor(a) principal: Martinho, Bárbara
Data de Publicação: 2023
Outros Autores: Ferreira, Luís, Koch, Maria João, Madeira, Filipa, Santos, Eva, Baptista, Sérgio, Alexandrino, Henrique
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021
Resumo: Introduction: Recently, simulation as an educational method has gained increasing importance in Medicine. However, medical education has favored the acquisition of individual knowledge and skills, while overlooking the development of teamwork skills. Since most errors in clinical practice are due to human factors, i.e., non-technical skills, the aim of this study was to assess the impact that training in a simulation environment has on teamwork in an undergraduate setting.Material and Methods: This study took place in a simulation center, with a study population of 23 participants, fifth year undergraduate students, randomly divided into teams of four elements. Twenty simulated scenarios of teamwork in the initial assessment and resuscitation of critically ill trauma patients were recorded. Video recordings were made at three distinct learning moments (before training, end of the semester, and six months after the last training), and a blinded evaluation was performed by two independent observers, who applied the Trauma Team Performance Observation Tool (TPOT). Additionally, the Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) was applied to the study population before and after the training to assess any change in individual attitudes towards non-technical skills. A 5% (or 0.05) significance level was considered for statistical analysis.Results: With a moderate level of inter-observer agreement (Kappa = 0.52, p = 0.002), there was a statistically significant improvement in the team's overall approach, evidenced by the TPOT scores (median of 4.23, 4.35 and 4.50, in the three time-points assessed, respectively, p = 0.003). In the T-TAQ, there was an improvement in non-technical skills, that was statistically significant for "Mutual Support” (median from 2.50 to 3.00, p = 0.010).Conclusion: In this study, incorporating non-technical skills education and training in undergraduate medical education was associated with sustained improvement in team performance in the approach to the simulated trauma patient. Consideration should be given to introducing non-technical skills training and teamwork in the emergency setting during undergraduate training.
id RCAP_723d289b37733b5803e3a8fada35c4bc
oai_identifier_str oai:ojs.www.actamedicaportuguesa.com:article/19021
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical TrainingEstudo Observacional Sobre o Impacto do Treino de Competências Não Técnicas no Trabalho de Equipa: Rumo a uma Mudança de Paradigma na Educação MédicaEducation, Medical, UndergraduateEmergency Medicine/educationSimulation TrainingStudents, MedicalEducação de Graduação em MedicinaEstudantes de MedicinaMedicina de Emergência/educaçãoTreino por SimulaçãoIntroduction: Recently, simulation as an educational method has gained increasing importance in Medicine. However, medical education has favored the acquisition of individual knowledge and skills, while overlooking the development of teamwork skills. Since most errors in clinical practice are due to human factors, i.e., non-technical skills, the aim of this study was to assess the impact that training in a simulation environment has on teamwork in an undergraduate setting.Material and Methods: This study took place in a simulation center, with a study population of 23 participants, fifth year undergraduate students, randomly divided into teams of four elements. Twenty simulated scenarios of teamwork in the initial assessment and resuscitation of critically ill trauma patients were recorded. Video recordings were made at three distinct learning moments (before training, end of the semester, and six months after the last training), and a blinded evaluation was performed by two independent observers, who applied the Trauma Team Performance Observation Tool (TPOT). Additionally, the Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) was applied to the study population before and after the training to assess any change in individual attitudes towards non-technical skills. A 5% (or 0.05) significance level was considered for statistical analysis.Results: With a moderate level of inter-observer agreement (Kappa = 0.52, p = 0.002), there was a statistically significant improvement in the team's overall approach, evidenced by the TPOT scores (median of 4.23, 4.35 and 4.50, in the three time-points assessed, respectively, p = 0.003). In the T-TAQ, there was an improvement in non-technical skills, that was statistically significant for "Mutual Support” (median from 2.50 to 3.00, p = 0.010).Conclusion: In this study, incorporating non-technical skills education and training in undergraduate medical education was associated with sustained improvement in team performance in the approach to the simulated trauma patient. Consideration should be given to introducing non-technical skills training and teamwork in the emergency setting during undergraduate training.Introdução: Recentemente, a simulação como método educacional ganhou uma importância crescente na Medicina. No entanto, a educação médica tem favorecido a aquisição de conhecimentos e competências individuais, ao mesmo tempo que ignora o desenvolvimento de competências de trabalho em equipa. Uma vez que a maioria dos erros na prática clínica se deve a fatores humanos, ou seja, a competências não técnicas, o objetivo deste estudo foi avaliar o impacto que a formação num ambiente de simulação tem no trabalho de equipa num ambiente de licenciatura.Material e Métodos: Este estudo teve lugar num centro de simulação com uma população de 23 participantes, alunos pré-graduados do quinto ano de Medicina, divididos aleatoriamente em equipas de quatro elementos. Foram simulados um total de 20 cenários de trabalho em equipa na avaliação inicial e de ressuscitação de doentes com traumatismo crítico. Três momentos de aprendizagem distintos (antes do treino, final do semestre, e seis meses após o último treino) foram gravados em vídeo, seguindo-se uma avaliação duplamente cega por dois observadores independentes, que aplicaram a ferramenta de observação de desempenho de equipas de trauma TPOT. Além disso, foi aplicado o questionário de atitudes de trabalho em equipa STEPPS (T-TAQ) à população do estudo antes e depois da formação, a fim de avaliar qualquer mudança nas atitudes individuais em relação às competências não técnicas. Considerou-se um nível de significância a 5% (ou 0.05) para a análise estatística.Resultados: Houve um nível moderado de acordo entre observadores (Kappa = 0,52, p = 0,002). Obteve-se uma melhoria estatisticamente significativa na abordagem global da equipa, evidenciada pelas pontuações do TPOT (mediana de 4,23, 4,35 e 4,50, nos três momentos de avaliação respetivamente, p = 0,003). No T-TAQ, houve uma melhoria estatisticamente significativa num grupo de competências não técnicas, "Apoio Mútuo" (mediana de 2,50 para 3,00, p = 0,010), que não foi observado nos restantes grupos de competências não técnicas.Conclusão: Neste estudo, a incorporação da educação e formação não técnica no ensino médico pré-graduado foi associada a uma melhoria sustentada do desempenho da equipa na abordagem ao paciente do trauma simulado. Deve ser considerada a introdução, no ensino pré-graduado, da formação de competências não-técnicas e do trabalho em equipa no contexto de emergência.Ordem dos Médicos2023-03-27info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021Acta Médica Portuguesa; Vol. 37 No. 2 (2024): February; 83-89Acta Médica Portuguesa; Vol. 37 N.º 2 (2024): Fevereiro; 83-891646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15321https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15088https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15089Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessMartinho, BárbaraFerreira, LuísKoch, Maria JoãoMadeira, FilipaSantos, EvaBaptista, SérgioAlexandrino, Henrique2024-02-04T03:00:35Zoai:ojs.www.actamedicaportuguesa.com:article/19021Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:48:25.432084Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
Estudo Observacional Sobre o Impacto do Treino de Competências Não Técnicas no Trabalho de Equipa: Rumo a uma Mudança de Paradigma na Educação Médica
title Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
spellingShingle Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
Martinho, Bárbara
Education, Medical, Undergraduate
Emergency Medicine/education
Simulation Training
Students, Medical
Educação de Graduação em Medicina
Estudantes de Medicina
Medicina de Emergência/educação
Treino por Simulação
title_short Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
title_full Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
title_fullStr Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
title_full_unstemmed Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
title_sort Observational Study About the Impact of Simulation Training of Non-Technical Skills on Teamwork: Towards a Paradigm Shift in Undergraduate Medical Training
author Martinho, Bárbara
author_facet Martinho, Bárbara
Ferreira, Luís
Koch, Maria João
Madeira, Filipa
Santos, Eva
Baptista, Sérgio
Alexandrino, Henrique
author_role author
author2 Ferreira, Luís
Koch, Maria João
Madeira, Filipa
Santos, Eva
Baptista, Sérgio
Alexandrino, Henrique
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Martinho, Bárbara
Ferreira, Luís
Koch, Maria João
Madeira, Filipa
Santos, Eva
Baptista, Sérgio
Alexandrino, Henrique
dc.subject.por.fl_str_mv Education, Medical, Undergraduate
Emergency Medicine/education
Simulation Training
Students, Medical
Educação de Graduação em Medicina
Estudantes de Medicina
Medicina de Emergência/educação
Treino por Simulação
topic Education, Medical, Undergraduate
Emergency Medicine/education
Simulation Training
Students, Medical
Educação de Graduação em Medicina
Estudantes de Medicina
Medicina de Emergência/educação
Treino por Simulação
description Introduction: Recently, simulation as an educational method has gained increasing importance in Medicine. However, medical education has favored the acquisition of individual knowledge and skills, while overlooking the development of teamwork skills. Since most errors in clinical practice are due to human factors, i.e., non-technical skills, the aim of this study was to assess the impact that training in a simulation environment has on teamwork in an undergraduate setting.Material and Methods: This study took place in a simulation center, with a study population of 23 participants, fifth year undergraduate students, randomly divided into teams of four elements. Twenty simulated scenarios of teamwork in the initial assessment and resuscitation of critically ill trauma patients were recorded. Video recordings were made at three distinct learning moments (before training, end of the semester, and six months after the last training), and a blinded evaluation was performed by two independent observers, who applied the Trauma Team Performance Observation Tool (TPOT). Additionally, the Team STEPPS Teamwork Attitudes Questionnaire (T-TAQ) was applied to the study population before and after the training to assess any change in individual attitudes towards non-technical skills. A 5% (or 0.05) significance level was considered for statistical analysis.Results: With a moderate level of inter-observer agreement (Kappa = 0.52, p = 0.002), there was a statistically significant improvement in the team's overall approach, evidenced by the TPOT scores (median of 4.23, 4.35 and 4.50, in the three time-points assessed, respectively, p = 0.003). In the T-TAQ, there was an improvement in non-technical skills, that was statistically significant for "Mutual Support” (median from 2.50 to 3.00, p = 0.010).Conclusion: In this study, incorporating non-technical skills education and training in undergraduate medical education was associated with sustained improvement in team performance in the approach to the simulated trauma patient. Consideration should be given to introducing non-technical skills training and teamwork in the emergency setting during undergraduate training.
publishDate 2023
dc.date.none.fl_str_mv 2023-03-27
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15321
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15088
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19021/15089
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 37 No. 2 (2024): February; 83-89
Acta Médica Portuguesa; Vol. 37 N.º 2 (2024): Fevereiro; 83-89
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799131566867218432