Background: Interdisciplinary trauma teams perform critical patient resuscitations under highly dynamic, time- pressured situations. As a result, they are particularly susceptible to safety threats resulting from poor teamwork. Several studies demonstrate that trauma team leaders perform a pivotal role and therefore may be an important leverage point for improving patient safety. Simulation-based training has been proposed as an effective method to improve team leadership;however, no studies have systematically assessed the effectiveness of simulation-based leadership training at the patient level. Objective: The overall objective of the proposed project is to evaluate the impact of simulation-based team leadership training on patient care during trauma resuscitations. The work is organized into three aims: (1) develop and assess the content validity of comprehensive trauma team leadership measures, (2) assess the impact of simulation-based team leadership training on leadership, teamwork, and patient care during trauma resuscitations, and (3) determine the feasibility of assessing the effect of simulation-based leadership training on patient outcomes. Methods: This project uses a randomized controlled design to evaluate the impact of simulation-based leadership training on patient care during trauma resuscitations. Briefly, 70 second- and third-year resident trauma team leaders will be randomized to either training (intervention) or no training (control) conditions. Those in the intervention group will receive a 6-hour team simulation-based leadership curriculum. Primary outcomes for training effectiveness will be (a) team leadership behavior, (b) teamwork behaviors, and (c) patient care during actual trauma resuscitations. Secondary outcomes include the feasibility of assessing patient outcomes (e.g., mortality, adverse events, length of stay). Multivariate linear regression analysis will be used to examine the effects of training on primary outcomes. Implications and Impact: This study will advance the patient safety mission of AHRQ by systematically evaluating simulation-based training outcomes at the individual (leader), team, and patient levels. The proposed project brings together experts in team and simulation science, resuscitation outcomes, and patient safety. The findings will be widely applicable to healthcare teams from multiple disciplines and will fill an important gap in simulation-based research.

Public Health Relevance

Trauma is a major public health burden;it is the fifth most common cause of mortality overall in the US and accounts for the majority of deaths in patients younger than 45. Most trauma resuscitation-related errors are directly related to teamwork failures. The proposed research will be the first to evaluate the impact of simulation-based trauma team leadership training on trauma patient care and patient outcomes.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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HSR Health Care Research Training SS (HCRT)
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Henriksen, Kerm
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University of Washington
Internal Medicine/Medicine
Schools of Medicine
United States
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Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M et al. (2018) A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study. Acad Emerg Med 25:196-204
Fernandez, Rosemarie; Shah, Sachita; Rosenman, Elizabeth D et al. (2017) Developing Team Cognition: A Role for Simulation. Simul Healthc 12:96-103
Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie (2016) Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond. J Grad Med Educ 8:332-40
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