Lay summary

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 in anesthesia, this has not yet been adequately considered in the actual management of anesthesia emergencies like unanticipated difficult airway situations. We seek to fill this gap by applying and verifying research findings on effective anesthesia teamwork through training development and evaluation. Based on findings of an extensive prestudy, we seek to evaluate a training that address physicians and nurses and focuses on the technical as well as non-technical skills for the management of unanticipated difficult intubation. Specifically, the training design consists of 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. Additional interventions involve measures of assertiveness and cross-training. The training evaluation design involves three treatment and control groups in order to assess 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 these interventions are expected to positively impact team performance and improve individual outcomes on three levels: cognitive, skill, and affective. From the results 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 both evidence-based patient safety research and to the design of effective team training in medicine.