Interprofessional Learning in Multidisciplinary Healthcare Teams Is Associated With Reduced Patient Mortality: A Quantitative Systematic Review and Meta-analysis

Interprofessional teaching rounds in medical education: improving clinical problem-solving ability and interprofessional collaboration skills

Interprofessional teaching rounds are a practical application of interprofessional education in bedside teaching, yet there is a lack of research on how interprofessional teaching rounds should be implemented into medical education. This study aimed to describe our experience in developing and implementing interprofessional teaching rounds during a clerkship rotation for medical students, and compares its strengths and weaknesses relative to traditional teaching rounds. Medical students were assigned to either the interprofessional teaching round group (n = 24) or the traditional teaching round group (n = 25), and each group participated in their assigned type of teaching round. A quiz including medical knowledge of gynecological and obstetric diseases was used to assess the students' diagnostic and treatment abilities after teaching rounds. Additionally, a survey was conducted among students to evaluate whether the interprofessional teaching rounds were helpful. The results showed that when using interprofessional teaching rounds, the test score for medical knowledge related to the diagnosis and treatment of gynecological and obstetric diseases was significantly higher than the traditional teaching round group (85.5 ± 11.2 vs 78.3 ± 12.5, p = 0.038). Additionally, the interprofessional teaching rounds significantly enhanced understanding of clinical application, identification, and appropriate problem-solving in cases, as well as examination of different disciplinary aspects of a case, and improvement of interdisciplinary collaboration skills compared to traditional teaching rounds. Our study demonstrates that interprofessional teaching rounds can serve as an effective teaching method for enhancing medical students' ability to collaborate interprofessionally and to solve clinical problems comprehensively.

Creating diversity, equity, inclusion, and accessibility statements for your CV: a resource guide to effectiveness and comprehensiveness

Diversity in academic medicine and research enhances the quality of the science produced and the efficacy of patient care. Diversity, equity, inclusion, and accessibility (DEIA) statements have recently been suggested or required by academic job postings as a way to measure candidate's commitments to fostering DEIA in their role. In this perspective, we discuss steps to craft effective DEIA statements that convey your actions in, and commitment to, DEIA. We recognize that mandating DEIA statements may actually result in inauthentic or disingenuous statements and offer solutions to encouraging academics to arrive at a meaningful statement that represents their own perspectives on diversity. Last, we provide examples of DEIA statements from three academics at different career points.

Handoff Mnemonics Used in Perioperative Handoff Intervention Studies: A Systematic Review

BACKGROUND

Perioperative handoffs are known to present unique challenges to safe and effective patient care. Numerous national accrediting bodies have called for standardized, structured handoff processes. Handoff mnemonics provide a memory aid and standardized structure, as well as promote a shared mental model. We set out to identify perioperative handoff intervention studies that included a handoff mnemonic; critically assess process and patient outcome improvements that support specific mnemonics; and propose future recommendations.

METHODS

We conducted a systematic review of the English language perioperative handoff intervention literature designed to identify handoff mnemonic interventions. A comprehensive protocol was developed and registered (CRD42022363615). Searches were conducted using PubMed, Scopus, ERIC (EBSCO), Education Full Text (EBSCO), EMBASE (Elsevier), and Cochrane (January 1, 2010 to May 31, 2022). Pairs of trained reviewers were involved in all phases of the search and extraction process.

RESULTS

Thirty-seven articles with 23 unique mnemonics met the inclusion criteria. Most articles were published after 2015 (29/37; 78%). Situation, Background, Assessment, Recommendation (SBAR), and SBAR variants were used in over half of all studies (22/37; 59%), with 45% (10/22) reporting at least 1 statistically significant process improvement. Seventy percent of handoff mnemonics (26/37) were expanded into lists or checklists. Fifty-seven percent of studies (21/37) reported using an interdisciplinary/interprofessional team to develop the intervention. In 49% of all studies (18/37) at least 1 measurement tool was either previously published or the authors conducting some form of measurement tool validation. Forty-one percent of process measurement tools (11/27) had some form of validation. Although most studies used training/education as an implementation strategy (36/37; 97%), descriptions tended to be brief with few details and no study used interprofessional education. Twenty-seven percent of the identified studies (10/37) measured perception alone and 11% (4/37) measured patient outcomes.

CONCLUSIONS

While the evidence supporting one handoff mnemonic over others is weak, SBAR/SBAR variants have been studied more often in the perioperative environment demonstrating some process improvements. A key finding is that 70% of included studies converted their handoff mnemonic to a list or checklist. Finally, given the essential nature of effective handoffs to perioperative patient safety, it is crucial that handoff interventions are well developed, implemented, and evaluated. We propose 8 recommendations for future perioperative handoff mnemonic clinical interventions and research.

Transforming the delivery of care from "I" to "We" by developing the crisis resource management skills in pediatric interprofessional teams to handle common emergencies through simulation

BACKGROUND

The healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment.

METHODS

This study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick's Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training.

RESULTS

Thirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants' pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing.

CONCLUSIONS

The study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.

Teamwork matters: team situation awareness to build high-performing healthcare teams, a narrative review

Healthcare today is the prerogative of teams rather than of individuals. In acute care domains such as anaesthesia, intensive care, and emergency medicine, the work is complex and fast-paced, and the team members are diverse and interdependent. Three decades of research into the behaviours of high-performing teams provides us with clear guidance on team training, demonstrating positive effects on patient safety and staff wellbeing. Here we consider team performance through the lens of situation awareness. Maintaining situation awareness is an absolute requirement for safe and effective patient management. Situation awareness is a dynamic process of perceiving cues in the environment, understanding what they mean, and predicting how the situation may evolve. In the context of acute clinical care, situation awareness can be improved if the whole team actively contributes to monitoring the environment, processing information, and planning next steps. In this narrative review, we explore the concept of situation awareness at the level of the team, the conditions required to maintain team situation awareness, and the relationship between team situation awareness, shared mental models, and team performance. Our ultimate goal is to help clinicians create the conditions required for high-functioning teams, and ultimately improve the safety of clinical care.