APPENDIX 2.Description of team training program.
The team training consists of a 2-day base course and a 1-day follow up course once every 2 years. In the base course the theoretical aspects of teamwork are discussed in the first day and a half, the second afternoon the theory is put into practice with a simulation training. The theoretical part is made up of the following components: information management, communication, stress management, group processes, leadership, decision making and risk management.
The session on information management explains how information is processed and how this effects teamwork. The focus is on creating team situational awareness, and how this can be achieved, threatened and maintained. By providing examples of how information can be interpreted in different ways by different people, and how this might impact how we look at our patients and/or situations, we invite discussion between the trainees on how they can improve their (team) situational awareness.
Communication is the logical next step of the training as communication is necessary to achieve team situational awareness. The trainees are provided with theoretical background on verbal and non-verbal communication. Mostly however they are encouraged to openly discusshow difficulties with communication might have effected their work and how that might be resolved or prevented in the future. The use of briefings, debriefings and feedback are explained and the trainees are invited to bring this into their daily practice.
In stressmanagement the causes and effects of stress on the individual healthcare worker, the team and the teamwork are discussed, as well as potential measures to counter these effects. The use of checklists, standard operating procedures and cross checks are examples of stress-reducing safety measures.
Group processes intends to create awareness of the effects on people of being part of a group or team. Working in a team can have very positive effects but there is also a downside to it, such as the risk of groupthink. By using examples of both non-medical nature (such as hooligans, cults) and examples from their own medical setting, the dangers of groupthink are explored and preventive measures are discussed.
Different situations require different types and styles of leadership, so the trainees are requested to relate their experiences where the leadership went very well or where there was a problem with leadership. Also the tasks, roles and responsibilities of followers are discussed.
In decision making we discuss the theoretical background and how it can be influenced by problems in any of the previous topics. For instance how situational awareness is necessary for proper decision making, how group think can have a negative impact on decisions, or how stress can effect decisions.
In risk management we discuss with the trainees what patient safety instruments (such as incident reporting, safety walk rounds) are in place in their unit, how they are working, what needs to be improved etc. Also, the trainees are invited to reflect on what they themselves can do or change in order to improve the safety and quality of the care they provide.
The follow up course consist of a theoretical interactive part where topics concerning teamwork and patient safety are discussed, and a practical part in the afternoon where simulation training and video feedback is used to train the teamwork.