Patient safety; Anesthesia; Non-technical skills; Training; Evaluation; Teamwork
Weiss Mona, Kolbe Michaela, Grote Gudela, Spahn Donat R., Grande Bastian (2016), Why didn’t you say something? Using after-event reviews to affect voice behavior and hierarchy beliefs in multi-professional action teams, in European Journal of Work and Organization Psychology
, Advanced online publication, 1-2016.
Grande Bastian, Weiss Mona, Biro Peter, Grote Gudela, Steiger Peter, Spahn Donat R., Kolbe Michaela (2015), Ist Reden wichtig? Technisches versus kombiniert technisches / nicht-technisches Atemwegstraining in der Anästhesie und Intensivmedizin, in Anästhesiologie & Intensivmedizin
, 56, 5-12.
Schick Carl J., Weiss Mona, Kolbe Michaela, Marty Adrian, Dambach Micha, Knauth Axel, Spahn Donat R., Grote Gudela, Grande Bastian (2015), Simulation With PARTS (Phase-Augmented Research and Training Scenarios)A Structure Facilitating Research and Assessment in Simulation, in Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare
, 10(3), 178-187.
Weiss Mona, Kolbe Michaela, Grote Gudela, Dambach Micha, Marty Adrian, Spahn Donat R., Grande Bastian (2014), Agency and communion predict speaking up in acute care teams, in Small Group Research
, 45, 290-313.
Kolbe Michaela (2013), Five simple processes that improve high-risk team effectiveness, in Salas Eduardo, Tannenbaum Scott, Cohen Debra & Latham Gary (ed.), Jossey-Bass, San Francisco, CA, 609-643.
Kolbe Michaela, Grande Bastian (2013), Team coordination during cardiopulmonary resuscitation, in JOURNAL OF CRITICAL CARE
, 28(4), 522-523.
Kolbe Michaela, Weiss Mona, Grote Gudela, Knauth Axel, Dambach Micha, Spahn Donat R., Grande Bastian (2013), TeamGAINS: a tool for structured debriefings for simulation-based team trainings, in BMJ QUALITY & SAFETY
, 22(7), 541-553.
Kolbe Michaela, Grote Gudela (2011), Human factors training in aviation and healthcare: What we know works best and how to put it into practice, in Proceedings of the Human Factors and Ergonomics Society 55th Annual Meeting
, Las Vegas, NEHuman Factors and Ergonomics Society, Santa Monica.
Improving patient safety is a major concern in healthcare, especially in high-risk medical domains such as anesthesia. Although there is abundant evidence that teamwork plays a central role in improving patient safety and much is known about effective teamwork in anesthesia, this has not yet been adequately considered in the actual management of anesthesia emergencies like unanticipated difficult airway situations. Current unanticipated difficult intubation literature discusses how its severe risks of injury and death can be technically managed. The major shortcoming of this literature is that the difficult intubation situation is not considered a team task. Likewise, there is no evaluated training available yet for anesthesia that addresses the task-specific coordination demands in combination with technical skills training, as most of the respective training literature focuses either on very specific technical aspects or on general non-technical skills and addresses either physicians or nurses. This project will contribute to evidence-based patient safety research by applying and verifying research findings on effective anesthesia teamwork through training development and evaluation. In an extensive prestudy we developed a training that addresses all team members, that is, physicians and nurses, and focuses on the technical as well as non-technical skills for the management of unanticipated difficult intubation. In this project, we will evaluate the training in order to allow for prospectively defining its impact on team performance. The training design combines state-of-the-art training techniques such as simulation-based learning and structured debriefing involving guided team self-correction, advocacy and inquiry, and systemic questions. It includes two specific interventions focusing on assertiveness and cross-training. The training aims at improving outcomes on three levels: cognitive, skill, and affective. The training evaluation design involves three treatment and control groups in order to evaluate effects of the different training components. There will be four measurement points: one pretest before the training intervention (t1), a post-test immediately after the second (t2) and third training scenario (t3), and one follow up three months after the training (t4). Corresponding to the three main training objectives we will evaluate the training outcome on the cognitive, skill-based and affective level, measuring outcome variables linked to both technical and non-technical skills.From the results we expect to extent our previous findings on the relationship between teamwork in anesthesia and clinical performance. Specifically we expect to learn (a) to what extent our previous findings about effective teamwork in anesthesia can be transferred into team training, (b) how technical and non-technical medical skills can be meaningfully trained together, and (c) to what extent anesthesia team training improves actual performance. In doing so, we contribute to evidence-based patient safety research and to the design of effective team training in medicine. Besides the scientific impact, we also foresee a significant practical impact of our project. A combined training for technical and non-technical skills and instruments for assessing its effects will be implemented and evaluated, which will directly benefit the anesthesia staff. The situation-specific training interventions are expected to improve the effective handling of unanticipated difficult intubations in real-life. Furthermore, using training strategies that also focus on general rules of teamwork we will enable anesthesia staff to learn and apply skills that transcend the specifics of difficult intubations.