TeamSTEPPS Teamwork Attitudes Questionnaire Research Articles

Stop the Line: Interventions to Prevent Retained Surgical Items.

The surgical team works collaboratively to prevent the occurrence of retained surgical items (RSIs). The purpose of this quality improvement project was to increase compliance with facility policies and improve teamwork skills to prevent the occurrence of RSIs. The project team implemented an evidence-based communication protocol, updated hospital network policies, introduced just-in-time job aids, and facilitated leader support through a daily huddle to address identified practice gaps. The TeamSTEPPS Teamwork Attitudes Questionnaire was used to measure the change in staff members' attitudes about teamwork before and after project implementation. Additional process and outcome measures included the number of near misses and actual RSIs, compliance with the daily huddle, and completion of the communication training. Results included improved perceived teamwork attitude scores and zero reports of actual RSI events over 7.5weeks.

Converting an interprofessional opioid use disorder simulation from high-fidelity to an online branching pathway scenario

The Covid-19 pandemic caused a disruption in teaching for institutions across the country, particularly for those using simulation-based education. Our team converted a live high-fidelity simulation (HFS) into an online virtual simulation using a storyline and branching pathway approach. The team collaborated with multimedia specialists in video production to create a branching path simulation (BPS), taking interprofessional teams of online students through several decision-making points of a patient's experience in the emergency department (ED). Video vignettes of simulation decision points are incorporated throughout the simulation, with a final outcome eventually emerging. The TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) was administered before and after the online simulation and descriptive data analysis (paired sample t-test) was conducted using SPSS statistical software. A post simulation satisfaction survey was similarly analyzed.

Evaluating Pharmacy Students’ Teamwork Attitudes in Virtual COVID-19 Emergency Department Simulations: A Pilot Study

ObjectiveThis study explores the impact of virtual simulation training on the transformation of teamwork attitudes among pharmacy students in a simulated severe COVID-19 pneumonia scenario in the emergency department. MethodsFrom July 2022 to January 2023, 16 pharmacy students, along with other health care students, participated in interprofessional simulation rounds. Each pharmacy student was assigned specific days for participation, using either a 3-dimensional computer or a virtual reality headset to manage a patient with severe COVID-19 pneumonia in the virtual emergency department. The TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) was used for pre- and post-training assessments. ResultsThe mean baseline T-TAQ score was 119.44 ± 10.63, showing a significant post-training improvement to a mean score of 130.88 ± 8.98 (Hedges’ g = 1.52). Stratification by academic year and device type revealed no significant impact on the learning experience. Remarkable enhancements in teamwork attitudes were observed after training, specifically in team structure, situation monitoring, mutual support, and communication domains. ConclusionThese findings indicate that virtual simulation training in scenarios such as severe COVID-19 effectively augments teamwork attitudes among pharmacy students, preparing them for collaborative practice in high-stakes emergency medicine settings.

Determination of emotional intelligence levels and teamwork attitudes of nursing students: A descriptive-correlational study

ObjectiveThis descriptive-correlational study was carried out to determine the relationship between emotional intelligence levels and teamwork attitudes of nursing students. MethodThe study has a descriptive-correlational design. A total of 469 nursing students participated in this study. To collect the study data, the “Personal Information Form”, “Emotional Intelligence Evaluation Scale” and “TeamSTEPPS-Teamwork Attitudes Questionnaire” were used. Descriptive statistics, correlation and regression analysis were used to analyze the data. ResultsThe emotional intelligence levels of the nursing students were low and the level of their attitudes towards teamwork was above the average. There was a positive and significant relationship between the mean scores they obtained from the overall Emotional Intelligence Evaluation Scale and TeamSTEPPS-Teamwork Attitudes Questionnaire and their sub-scales. ConclusionStudents' emotional intelligence levels are low and their attitude levels towards teamwork are above average. Therefore, emphasis should be placed on increasing students' emotional intelligence and teamwork attitudes during nursing education.

Comprehensive evaluation of medical students' teamwork skills

Background: Teamwork plays a pivotal role in patient care and safety promotion. "TeamSTEPPS Teamwork Attitudes Questionnaire" (T-TAQ) aims to the assessment of attitudes of care providers regarding teamwork when enrolled in a series of TeamSTEPPS-based scenarios; among them, cooperation in mass casualty scenarios, medical error simulations, and other virtual learning experiences. However, the use of T-TAQ could be expanded into the evaluation of medical students' collaboration capacity in a series of educational tasks such as the management of a simulated clinical scenario within the context of a university course. Aim: To prospectively explore teamwork performance of Greek medical students in simulated clinical scenarios in the undergraduate course of Ophthalmology. Methods: This is a prospective, descriptive study. All fifth-year medical students attending the undergraduate course of Ophthalmology were asked to form teams, each one had to select a simulated clinical ophthalmological scenario and present the outcomes of their project. Scenarios were case reports from patients that visited the outpatients’ service of the Department during the previous six months. Α custom Greek version of the T-TAQ containing 29 5-scale Likert-type items in five subscales (team structure, leadership, situation monitoring, mutual support and communication) was used to evaluate students’ attitudes on the overall procedure. T-TAQ scores were evaluated with gender, residence and other parameters. Results: 102 students participated in this project. Students presented average total T-TAQ score (3.48±0.99) with non-significant differences regarding gender (p=0.38) and residence (p=0.58). Non-significant differences were detected for all subscale scores, as well (all p>0.05). Significant correlation was detected between team project performance and team structure (R2=0.375, p=0.04), mutual support (R2=0.463, p=0.02), and total T-TAQ score (R2=0.349, p=0.05). Additionally, readiness to form teams showed significant correlation with total T-TAQ score (R2=0.512, p<0.01) and project performance (R2=0.444, p=0.01). However, non-significant correlation was identified between T-TAQ score and students’ final grades in the Ophthalmology course (R2=0.015, p=0.28). Conclusion: Greek medical students demonstrated average T-TAQ scores. Medical schools should also focus on the development of collaboration skills for their medical students and possibly enroll teamwork initiatives to their curricula.

Validation of a French-language version of TeamSTEPPS® T-TPQ and T-TAQ questionnaires

ABSTRACT Teamwork training and evaluation are essential to enhance safety and quality of care. The lack of the psychometric testing of the TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) and Teamwork Perceptions Questionnaire (T-TPQ) across different language and cultural settings has questioned their widespread use because such attitudes and perceptions are highly subjective and context-bound. The present study aims to translate the T-TAQ and T-TPQ into the French language and validate the psychometric properties of the two questionnaires in a public health context. A forward-backward translation process, panel reviewing, and pilot testing in two rounds were followed to develop the French versions. Confirmatory factor analysis (CFA) and Cronbach’s alpha were used to examine the factor structure and internal consistency, whereas two-way mixed Intraclass Correlation Coefficient (ICC) was performed to assess test-retest reliability. A total of 235 healthcare professionals in the French-speaking community of Belgium completed the T-TAQ and T-TPQ. After two to four weeks, 102 participants took part in the second round. Despite good fit indices as revealed by the CFA and Cronbach’s alpha from 0.53 to 0.75 for the five dimensions of the T-TAQ and 0.76 to 0.79 for the T-TPQ, the squared correlations among the constructs were higher than the average variance extracted. Two-way mixed ICCs indicated fair to good test-retest reliability for all the five constructs of the two questionnaires, except the leadership scale of the T-TAQ. The French-language versions of the T-TAQ and T-TPQ were semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English versions. These two instruments might be used to capture the overall attitude toward teamwork and perceptions of team skills and behaviors. Yet, further research is advisable to refine the scales to establish the discriminant validity of the different dimensions and discriminative power of the instruments.

Using simulation and inter-professional education to teach infection prevention during resuscitation

Introduction: During resuscitations, healthcare professionals (HCPs) find balancing the need for timely resuscitation and adherence to infection prevention (IP) measures difficult. This study explored the effects of an innovative teaching method, using in-situ simulation and inter-professional education to enhance compliance to IP through better inter-professional collaboration. Methods: The study was conducted in the Surgical Intensive Care Unit (SICU) in a 1200-beds teaching hospital. HCPs working in the SICU were conveniently allocated to the intervention or control group based on their work roster. The intervention group attended an in-situ simulated scenario on managing cardiac arrest in an infectious patient. The control group completed the standard institution-wide infection control eLearning module. Outcomes measured were: (a) attitudes towards inter-professional teamwork [TeamSTEPPS Teamwork Attitudes Questionnaire (TAQ)], (b) infection prevention knowledge test, (c) self-evaluated confidence in dealing with infectious patients and (d) intensive care unit (ICU) audits on infection prevention compliance during actual resuscitations. Results: 40 HCPs were recruited. 29 responded (71%) to the pre- and post-workshop questionnaires. There were no significant differences in the TeamSTEPPS TAQ and infection prevention knowledge score between the groups. However, ICU audits demonstrated a 60% improvement in IP compliance for endotracheal tube insertion and 50% improvement in parenteral medication administration. This may be attributed to the debriefing session where IP staff shared useful tips on compliance to IP measures during resuscitation and identified threats that could deter IP compliance in SICU. Conclusion: Learning infection prevention through simulated inter-professional education (IPE) workshops may lead to increased IP compliance in clinical settings.

Reliability and structural validity of the Norwegian version of the TeamSTEPPS Teamwork Attitudes Questionnaire: A cross-sectional study among Bachelor of Nursing students.

AimTo test the reliability and structural validity of the Norwegian version of the TeamSTEPPS® Teamwork Attitudes Questionnaire (T‐TAQ) among Bachelor of Nursing students.DesignCross‐sectional study.MethodsBachelor of Nursing students (N = 1,624) at three campuses in different regions of Norway were invited to complete the survey. The data were analysed with descriptive statistics, Cronbach's alpha and confirmatory factor analysis (CFA). Three models were tested. Model 3 was a post hoc modification with a correlation between four negatively worded items. The data was collected in September 2018 and May‐June 2019.ResultsA total of 509 students were included in the study. Cronbach's alpha ranged from 0.44–0.70 for the dimensions and was 0.79 for the total questionnaire. The fit indexes of model 3 were as follows: RMSEA = 0.043, chi‐square = 724.3 (p < .000), normed chi‐square = 1.862, TLI = 0.812 and CFI = 0.832. The questionnaire shows some potential to display attitudes towards teamwork in health care among Bachelor of Nursing students. Low Cronbach's alpha in the dimensions might indicate that the questionnaire should be considered used as a unidimensional questionnaire.

Conflict management and teamwork in workplace from the perspective of nurses.

To examine the relationship between nurses' conflict management strategies and teamwork attitudes. This cross-sectional, descriptive, and relational study was conducted with 228 nurses in a hospital in southern Turkey. Data were collected through The TeamSTEPPS Teamwork Attitudes Questionnaire and the Rahim Organizational Inventory-II. Of all the nurses, 91.2% reported to have had conflicts. Nurses stated that they mostly used compromising and integrating strategies. Teamwork attitudes questionnaire mean score was 108.28 ± 11.45. Conflict management strategies are significant predictors of teamwork attitudes and these explain 46% (model 1; R2 = 0.46; P <.01), and education, gender, units, years of experience explain 2% of the total variance in teamwork attitudes (model 2; R2 = 0.48; P < .01). Mental health nurses together with manager nurses should focus on improving nurses' teamwork attitudes and constructive conflict management strategies within the team.

An examination of the factor structure of TeamSTEPPS measures in school mental health teams.

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS™) is a tested strategy for improving communication and climate in hospitals. It is a promising but untested tool among school-based mental health teams. We examined the psychometric properties of the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) and Teamwork Attitudes Questionnaire (T-TAQ) among 167 school mental health team members. Team members worked for one of five agencies in 33 K-8 urban public schools. Exploratory factor analyses and descriptive data are presented. For both the T-TPQ and T-TAQ, a unitary factor structure best fit the data for this sample. The T-TPQ and T-TAQ were not significantly correlated with one another and total scores did not significantly differ by staff role. Agencies differed in T-TAQ results, and one agency had lower T-TAQ total scores relative to other agencies. Results suggest that the factor structures are different among school mental health teams than among other healthcare providers.

A Collaborative Partnership for Improving Newborn Safety: Using Simulation for Neonatal Resuscitation Training.

The latest Neonatal Resuscitation Program® (NRP) guidelines suggest the use of team-based training using simulation. Furthermore, psychometric testing of instruments appropriate to measure team performance in NRP is needed. This study evaluated the effects of simulation on the training and performance of the health care team attending deliveries at a rural community hospital. Twenty-three nurses and nurse anesthetists comprised the sample. A pre- and postintervention repeated measures design was used. Data were collected using the Background/Experience Survey, Self-Assessment and Attitudes Survey, and two Agency for Healthcare Research and Quality TeamSTEPPS tools (the Teamwork Perceptions Questionnaire [T-TPQ] and the TeamSTEPPS Teamwork Attitudes Questionnaire [T-TAQ]), the Simulation Effectiveness Tool-Modified (SET-M), and the Individual and Team Performance Survey. Data analysis revealed significant findings in team functioning, situation monitoring, and communication. Prebriefing and debriefing were valuable as measured by the SET-M. This project supports the use of simulation to enhance team-based training, performance, and communication. [J Contin Educ Nurs. 2019;50(7):319-324.].

Psychological impact of traumatic events in rural nursing practice: An Integrative review

Purpose: The purpose of this article is to present findings from a pilot quality improvement evidence-based new nurse transition program that facilitates clinical leadership skills in novice nurses at the point of patient care at a rural critical access hospital. Descriptive data from pre- and post-intervention scores are reported, and the percent change was evaluated. Sample: Due to the solitary nature of rural nursing, new graduate nurses in rural areas need support in transitioning to their new role as registered nurses. The author designed, and pilot tested a quality improvement evidence-based new nurse transition program in a rural critical access hospital utilizing complexity science as a framework. Method: A quality improvement pilot program designed for new graduate nurses was provided at a critical access hospital in a rural Midwestern State. Data was collected using pre- and post- intervention scores on the Leadership Characteristics and Skills Assessment and TeamSTEPPS Teamwork Attitudes Questionnaire. Descriptive data was evaluated. Findings: Participant post- test percent change scores increased in perceptions of ability to lead but decreased in attitudes about teamwork. Observations of participant interactions in the quality improvement project suggested that the new nurses were developing new ideas, patterns and structures regarding their roles as a team member in the healthcare setting. Conclusion: In a rural midwestern critical access hospital a quality improvement leadership program that used a complexity science framework was provided to novice nurses in transition. After the program participant total mean post scores increased in perception of what makes a good leader and in the participant’s perception of their ability to lead. An overall mean score decrease in attitudes about teamwork was noted among the small group of rural novice nurses. Keywords: rural, frontier, new registered nurse graduate, transition program, complexity science, leadership

Team Training of Inter-Professional Students (TTIPS) for improving teamwork

ObjectiveIn surgery, dysfunctional teamwork is perpetuated by a ‘silo’ mentality modelled by students. Interprofessional education using high-fidelity simulation-based training (SBT) may counteract such modelling. We sought to determine whether SBT...

Working together: Using a unique approach to evaluate an interactive and clinic-based longitudinal interprofessional education experience with 13 professions

ABSTRACTInterprofessional education (IPE) involving an interactive and longitudinal clinic experience at an inner-city charitable clinic from September to May 2013/2014 was evaluated. Pre-, mid-, and post-intervention data were collected from students in 13 different professions including medicine (medical and physician assistant), dentistry (dental and dental hygiene), nursing (undergraduate and clinical nurse specialist), public health, pharmacy, physical therapy, occupational therapy, nutritional sciences, speech and language pathology, and social work. To evaluate their interprofessional attitudes, students completed the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Readiness for Interprofessional Learning Scale (RIPLS). They also completed a unique measure, healthcare professionals circles diagrams (HPCDs), that indicated student conceptualisation of a healthcare team caring for a complex patient, along with perception of their team’s progress towards meeting patient goals. Results from the T-TAQ and RIPLS scores indicated small but significant increases from pre- to post-intervention (p = 0.005 and 0.012, respectively). Analysis of the HPCDs revealed significant increases in students’ perceptions of the types of interprofessional team members, relationships, and communication between professions to provide medical care to patients (p < 0.01). Most HPCDs included pharmacists, nurses, and physicians as part of the care team at all time points. Students significantly increased their inclusion of dentistry, public health, social work, and physician assistants as members of the healthcare team from pre- to post-intervention. Implications of our data indicated the importance of IPE interventions that include not only classroom-based sessions, but actual patient care experiences within interprofessional teams. It also reinforced the importance of new and unique methods to assess IPE.

Making an "Attitude Adjustment": Using a Simulation-Enhanced Interprofessional Education Strategy to Improve Attitudes Toward Teamwork and Communication.

Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P < 0.0001, P = 0.029, P = 0.014, and P = 0.003, respectively). For Hospital Survey on Patient Safety Culture, 3 of 6 composites directly related to teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to teamwork and communication.

Virtual TeamSTEPPS(®) Simulations Produce Teamwork Attitude Changes Among Health Professions Students.

The majority of the estimated 400,000 or more patient deaths per year in the United States are from preventable medical errors due to poor communication. Team training programs have been established to teach teamwork skills to health professions students. However, it is often challenging to provide this training at a physical site. A brief intervention using a virtual learning environment with TeamSTEPPS(®)-based scenarios is described. Using a pretest-posttest design, the effects on teamwork attitudes in 109 health professional students from two institutions and multiple disciplines were measured using the TeamSTEPPS Teamwork Attitudes questionnaire. Participants showed significant attitude changes in the categories of leadership, situation monitoring, mutual support, and communication (p ⩽ .05), with significance in four of the six indicator attitudes in the communication section at the p ⩽ .001 level. These findings indicate the potential impact that virtual learning experiences may have on teamwork attitudes in learners across professions on multiple campuses.

A contemporary method to teach collaboration to students.

This pilot study examined the effectiveness of an interprofessional educational intervention in which nursing and medical students were taught collaboration skills through low-fidelity simulation. The intervention included didactic content on the process of collaboration, followed by a simulation of the patient care rounding process. The TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) was administered as a pre- and posttest to seven students who participated in the simulation. Anecdotal and observational data were also collected. Statistically significant differences (p<0.05) were found in three of the five core areas of the T-TAQ: team structure, situation monitoring, and communication. Collaborative behaviors were demonstrated, and anecdotal comments reported by the students revealed an appreciation of the overall experience. These findings suggest that low-fidelity simulation is a valuable and cost-effective method to teach interprofessional educational skills, such as collaboration. These skills are essential to professional practice in the clinical setting.

Teamwork Climate and Patient Safety Attitudes

The TeamSTEPPS Teamwork Attitudes Questionnaire and Safety Attitudes Questionnaire were distributed to the nurses in a county hospital in Taiwan. Nurses (n = 407) had lower scores in Team Structure, Communication, and Situation Monitoring than physicians (n = 76). A structural equation model demonstrated a positive association between teamwork climate and safety attitudes (β = 0.78, P < .01). Teamwork climate is the most important determinant for patient safety attitudes among nurses.

Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire

IntroductionThe report, To Err is Human, indicated that a large number of deaths are caused by medical error. A central tenet of this report was that patient safety was not...