Special Article
Introducing Teamwork Challenges in Simulation Using Game Cards Todd P. Chang, MD, MAcM; Karen Y. Kwan, MD; Danica Liberman, MD, MPH; Eric Song, BS; Eugene H. Dao, BS; Dayun Chung, BS; Inge Morton, RN, BSN, CPN; Ara Festekjian, MD, MS
Summary Statement: Poor teamwork and communication during resuscitations are linked to patient safety problems and poorer outcomes. We present a novel simulationbased educational intervention using game cards to introduce challenges in teamwork. This intervention uses sets of game cards that designate roles, limitations, or communication challenges designed to introduce common communication or teamwork problems. Game cards are designed to be applicable for any simulation-based scenario and are independent from patient physiology. In our example, participants were pediatric emergency medicine fellows undergoing simulation training for orientation. We describe the use of card sets in different scenarios with increasing teamwork challenge and difficulty. Both postscenario and summative debriefings were facilitated to allow participants to reflect on their performance and discover ways to apply their strategies to real resuscitations. In this article, we present our experience with the novel use of game cards to modify simulation scenarios to improve communication and teamwork skills. (Sim Healthcare 10:223Y226, 2015)
Key Words: Pediatric, Emergency medicine, Teamwork, Communication, Simulation, Training, Medical education, Resuscitation, Gamification, Serious game.
O
ptimal team dynamics and leadership skills are important, trainable factors in patient resuscitations.1Y3 Although patient physiology plays a big role in successful resuscitations, strong leadership, early planning, and role allocation benefit team performance,4,5 which has been correlated with improved medical outcomes.3,6 This is particularly important for rising trainees in emergency medicine, critical care, and other specialties that train for the code team leader role. Multiple methods to quickly train trainees to an acceptable level of competency have been implemented to prevent the ‘‘July effect,’’7 including boot camps and intensive orientation sessions.8,9 As part of the orientation exercise, we introduced a unique game modification using game cards that provided private information to participants. The content of the cards could specify a predetermined code team roleVboth in a constructive and in a destructive mannerVas well as instructions on how to behave during the code. The game cards acted independent of the scenario, patient physiology, or medical outcome as they rapidly created communication problems that required problem solving in addition to the clinical care required. The purpose of this article was twofold: to summarize the theoretical underpinnings on why and how these game cards teach teamwork and communication and to
From the Division of Emergency Medicine and Transport, (T.P.C., K.Y.K., D.L., I.M., A.F.), Children’s Hospital Los Angeles, University of Southern California (E.H.D., D.C.), Los Angeles, CA; George Washington University (E.S.), Washington, DC. Reprints: Todd P. Chang, MD, MAcM, Children’s Hospital Los Angeles, Division of Emergency Medicine and Transport, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027 (e
Introducing Teamwork Challenges in Simulation Using Game Cards Todd P. Chang, MD, MAcM; Karen Y. Kwan, MD; Danica Liberman, MD, MPH; Eric Song, BS; Eugene H. Dao, BS; Dayun Chung, BS; Inge Morton, RN, BSN, CPN; Ara Festekjian, MD, MS
Summary Statement: Poor teamwork and communication during resuscitations are linked to patient safety problems and poorer outcomes. We present a novel simulationbased educational intervention using game cards to introduce challenges in teamwork. This intervention uses sets of game cards that designate roles, limitations, or communication challenges designed to introduce common communication or teamwork problems. Game cards are designed to be applicable for any simulation-based scenario and are independent from patient physiology. In our example, participants were pediatric emergency medicine fellows undergoing simulation training for orientation. We describe the use of card sets in different scenarios with increasing teamwork challenge and difficulty. Both postscenario and summative debriefings were facilitated to allow participants to reflect on their performance and discover ways to apply their strategies to real resuscitations. In this article, we present our experience with the novel use of game cards to modify simulation scenarios to improve communication and teamwork skills. (Sim Healthcare 10:223Y226, 2015)
Key Words: Pediatric, Emergency medicine, Teamwork, Communication, Simulation, Training, Medical education, Resuscitation, Gamification, Serious game.
O
ptimal team dynamics and leadership skills are important, trainable factors in patient resuscitations.1Y3 Although patient physiology plays a big role in successful resuscitations, strong leadership, early planning, and role allocation benefit team performance,4,5 which has been correlated with improved medical outcomes.3,6 This is particularly important for rising trainees in emergency medicine, critical care, and other specialties that train for the code team leader role. Multiple methods to quickly train trainees to an acceptable level of competency have been implemented to prevent the ‘‘July effect,’’7 including boot camps and intensive orientation sessions.8,9 As part of the orientation exercise, we introduced a unique game modification using game cards that provided private information to participants. The content of the cards could specify a predetermined code team roleVboth in a constructive and in a destructive mannerVas well as instructions on how to behave during the code. The game cards acted independent of the scenario, patient physiology, or medical outcome as they rapidly created communication problems that required problem solving in addition to the clinical care required. The purpose of this article was twofold: to summarize the theoretical underpinnings on why and how these game cards teach teamwork and communication and to
From the Division of Emergency Medicine and Transport, (T.P.C., K.Y.K., D.L., I.M., A.F.), Children’s Hospital Los Angeles, University of Southern California (E.H.D., D.C.), Los Angeles, CA; George Washington University (E.S.), Washington, DC. Reprints: Todd P. Chang, MD, MAcM, Children’s Hospital Los Angeles, Division of Emergency Medicine and Transport, 4650 Sunset Blvd, Mailstop 113, Los Angeles, CA 90027 (e
