Abstract 10112: Who is Leading the Code? Assessing Team Dynamics and Communication Skills During Mock Codes

Abstract

Background: The Resuscitation Education Initiative (REdI) is a national mock code program for the Veteran Health Administration. We used the REdI rollout to study team dynamics for participants in mock codes. Methods: Mock code evaluation data was obtained from 8 Veterans Affairs Medical Centers across the nation in 2019-2020. Sites utilized a standardized templated evaluation sheet, which was modifiable to meet the needs of each mock code session (i.e., using a BLS score system rather than ACLS for a BLS code). Facilitators scored participants with a binary system of inclusion, reflecting successful or unsuccessful completion of a task. Eight categories assessed team dynamics: designating responsibilities, closed loop communication, clear messaging, knowing one’s limitations, knowledge sharing, constructive intervention, mutual respect, and summarizing. Results: Forty-four surveys representing unique mock codes were used in analysis. BLS was more often implemented during mock codes (34 vs 12 for ACLS); two codes used both ACLS and BLS, (n=44). In half of the mock code evaluations, participants did not clearly identify responsibilities or engage in closed loop communication (22/44, 50%). Notably mutual respect, which was described as speaking in a professional tone to others, was successfully met by 86.4% of participants (38/44). Participants performed poorly in the remaining categories, not meeting standards by 25% or more on evaluation (see Table). Conclusion: Mock codes are used for teaching skills involved in cardiac resuscitation. Participants did not perform well in areas involving team dynamics, and this could be an area for future attention when designing effective mock code programs.