Does teamwork and communication improve with simulation training? An evaluation of simulation training videos in Bihar, India

BACKGROUND High rates of medical error – attributed to ineffective communication among health care providers – poses a threat to patient safety. We embedded Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS™) concepts within a simulation-based curriculum and trained clinical teams providing intrapartum care in low-income settings. We evaluated whether simulation can be used to improve teamwork and communication among clinical teams. METHODS Nurse mentors facilitated and video-recorded simulated clinical scenarios to give health care providers (mentees) the opportunity to practice both technical and non-technical skills. Independent evaluators reviewed video-recorded simulation scenarios at midpoint and endpoint to evaluate changes in use of evidence-based practices. Semi-structured interviews were also conducted with nurse mentors to explore their experiences teaching non-technical skills to clinical teams. RESULTS Five hundred and sixty-six simulated clinical scenarios were included in the final analysis. Adoption of techniques to improve communication and teamwork, such as the ‘SBAR’ technique and ‘think out loud’, increased from midpoint to endpoint in all simulated scenarios. CONCLUSION Incorporation of TeamSTEPPS™ concepts into a simulation training program for health care providers improved teamwork and communication in simulated scenarios and can potentially be extended to actual emergency cases.