Crisis Resource Management training: Impact on team process and team effectiveness.

摘要

Team process is vital to patient safety and patient care quality (Kohn, Corrigan, & Donaldson, 2000). During a patient crisis, team process is unique due to the dynamic nature of the unstable patient, need for rapid decisions, and team member coordination among providers who may be unfamiliar with one another. The purpose of this experimental, statistically-powered study was to evaluate the effects of Crisis Resource Management (CRM) training on the team process variables of teamworking, task management, situation awareness, and inter-professional attitude on the team effectiveness variables of team error rate and team response time among 24 interdisciplinary teams of two student nurses and two medical students. The team effectiveness conceptual framework described by Kozlowski and Ilgen (2006) served as the theoretical framework. The experimental group demonstrated a significant improvement in team process variables compared to the control group. CRM training predicted 13% of the variance in task management (p = 0.05), 15% of the variance in teamworking (p = 0.04) and 18% of the variance in situation awareness (p = 0.03). CRM training and task management predicted 22% of the variance (p = 0.04) in team error rate; CRM training and teamworking predicted 35% of the variance (p = 0.01) while CRM and situation awareness predicted 20% of the variance (p = 0.04) in response time to chest compressions. Both control and experimental groups demonstrated a significant improvement (p 0.001) in each variable of team process and team effectiveness from pretest to posttest demonstrating a definitive practice effect of interdisciplinary training. Results of this study have implications for health care administration, clinical practice, educational design of team training, and team effectiveness theory.