simulation based training program for improving team communication in the emergency department : A scoping review

Abstract

Background: Patients receive high-quality and safe care when specialists in the emergency department work as an effective team. Failure to communicate and work as a team is commonly cited as a major contributor to adverse events and medical errors in ED. Simulation-based team training programs are typical solutions for dealing with the dynamic setting of clinical ED. Aim: The aim of the current scoping review is to evaluate the effectiveness of simulation-based training interventions in encouraging interdisciplinary/interprofessional team communication in the emergency department. Method: The review includes searching in four databases, PubMed, OVID, EMBASE, and Cochrane Library to identify articles dealing with the search question. The search included the following search terms: simulation-based training, virtual training, group communication, interdisciplinary communication, inter-professional communication, and emergency situations. The search was limited to papers published in English between January 2000 and April 2020 and those that deal with simulation-based training interventions aimed at improving team communication among emergency department personnel. The results of the studies were evaluated in line with Kirkpatrick levels 2A,2B, 3 and 4B. Results and discussion: Twelve studies that met the eligibility criteria for a scoping review were selected for pooling. The qualitative synthesis demonstrated that simulation-based team training delivered in the form of a short or long-term intervention based on evidence-based communication models. Conclusion: The synthesis of findings demonstrated a direct positive effect of simulation-based training on team communication and a secondary impact on patient outcomes. The diverse simulated educational interventions grounded on standardized communication procedures, such as CRM, TeamSTEPPS, closed-loop-communication. There was no difference between the effect of low versus high fidelity simulators, therefore, low fidelity simulators are suggested, especially in low-resource settings. The use of low-fidelity simulators should be based on evidence-based team training frameworks, like TeamSTEPPS, CRM, and CLC. Although a large share of the reviewed studies focused on teamwork and not interdisciplinary communication, this scoping review recommends the incorporation of simulation-based training in the routine development of ED personnel.