Abstract
ObjectivesTo evaluate participant reactions and attitudes to crew resource management teamwork classroom-based training by comparing Likert responses before and after the intervention and exploring potential differences in attitudes across the different healthcare professionals. MethodsBetween 26 January and 27 March, 2015, a randomly selected sample of 240 frontline healthcare professionals offering direct patient care were recruited to undergo a 4-hour crew resource management classroom-based training programme. Participants were asked to complete a 22-item human factors attitude survey before and after training and a 10-item end-of-programme evaluation. Paired samples t-test was used to assess differences between the participants' pretest and posttest scores on each item. ResultsA total of 167 (70%) from 17 different specialties underwent the training and 164 (68.3%) completed (139 nurses, 25 doctors) the survey. The nurses were of similar age to the doctors (38.2 vs 36.9, p=0.83) and were more likely to be women (75.6% vs 24.6%, p <0.001). Human factors attitude survey findings indicated that nurses valued the experience highly compared to doctors. The responses among the nurses revealed significant attitude shifts (p <0.05) in 20 of the 22 items whereas this was the case only for 9 items among the doctors. ConclusionsOverall, the crew resource management classroom-based training programme appeared to have a positive effect on frontline healthcare professionals’ attitudes. The implementation of such programme is feasible and acceptable, especially for nurses, in a public hospital setting in Hong Kong.
Highlights
Effective teamwork is found to play an important role in the healthcare industry and many underlying causes of adverse events in healthcare are due to the absence of non-technical skills, such as teamwork and communication, rather than technical skills.[1,2]
The items related to team leader were viewed as significantly improved at decisionmaking skills, encouraging team members to raise questions, explicitly telling team members that he/she wants their input, verbalizing plans, and providing specific instruction and feedback on teamwork skill attainment (p
Participant responses to the ability to detect adverse situations, the importance of debriefing, “speaking up”, and decision-making, and to control the event by team members were shown to have significantly improved after the training (p
Summary
Effective teamwork is found to play an important role in the healthcare industry and many underlying causes of adverse events in healthcare are due to the absence of non-technical skills, such as teamwork and communication, rather than technical skills.[1,2] This has been found and well recognized in the aviation industry. Specialized training programmes, such as Crew Resources Management (CRM), was developed to improve safety behaviour and minimize human error related to air transport accidents.[3] Since it has high face validity, many healthcare organizations have adopted these principles and applied them to their training to help improve patient safety. CRM emphasizes are communication, decision-making, teamwork, situational awareness, leadership and performance feedback.[4]. A recent study found that classroom-based training in hospitals resulted in improvement of knowledge (mean difference=1.5, p=0.002) and teamwork behaviour (mean difference=2.69, p=0.027).[5] Other studies have found that CRM training improves clinical team performance[6] and patient outcomes (e.g. a decrease in mortality).[7,8] In relation to healthcare, the value of CRM has been demonstrated in various clinical depart-
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