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There Is No “I” in “TEAM”: Comment on “A Surgical Simulation Curriculum for Senior Medical Students Based on TeamSTEPPS”

There Is No “I” in “TEAM”: Comment on “A Surgical Simulation Curriculum for Senior Medical... During the past 2 decades we have witnessed a paradigm shift in surgery. We once saw a proud profession of individual accomplishment and ultimate accountability, but we now recognize that small missteps along a patient's path often represent cumulative system errors. A multidisciplinary team approach has been shown to reduce medical errors, leading to better outcomes.1 Recently, the TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) approach has been used in the operating room with good results2,3 and has been implemented in the highly stressful environment of a combat hospital with an associated reduction in medical errors.4 In 2010, Robertson et al5 adapted TeamSTEPPS for medical and nursing students as a 4-hour workshop with a structured postintervention review and observed increased knowledge regarding the beneficial effects of attitude and communication on patient safety–oriented team function. Here, in a well-written narrative, Meier et al6 show that the TeamSTEPPS model can be productively incorporated in the formal fourth-year medical school curriculum as an elective course. Moreover, they observed improvements in subjective and objective postintervention scoring across all parameters studied. We would add that, based on the findings of Hamad et al,7 the inclusion of a posttraining debriefing may further potentiate TeamSTEPPS as a useful tool in preparation for surgical residency. In the future, it surely will be interesting to evaluate whether such training translates into improved job performance for junior surgical residents. The transition from student to physician brings with it great satisfaction but also a huge increase in responsibility, and the restructuring of many surgical residencies now has junior-level residents squarely on the “front line” of patient care. Fostering multidisciplinary communication among junior team members early in their training promises to make their transition to adulthood more seamless, less overwhelming, and safer for patients. Back to top Article Information Correspondence: Dr Carty, Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Kaufmann Medical Bldg, 3471 Fifth Ave, Ste 101, Pittsburgh, PA 15213 (cartyse@upmc.edu). Financial Disclosure: None reported. References 1. Braithwaite RS, DeVita MA, Mahidhara R, Simmons RL, Stuart S, Foraida M.Medical Emergency Response Improvement Team (MERIT). Use of medical emergency team (MET) responses to detect medical errors. Qual Saf Health Care. 2004;13(4):255-25915289627PubMedGoogle ScholarCrossref 2. Weaver SJ, Rosen MA, DiazGranados D, et al. Does teamwork improve performance in the operating room? a multilevel evaluation. Jt Comm J Qual Patient Saf. 2010;36(3):133-14220235415PubMedGoogle Scholar 3. Forse RA, Bramble JD, McQuillan R. Team training can improve operating room performance. Surgery. 2011;150(4):771-77822000190PubMedGoogle ScholarCrossref 4. Deering S, Rosen MA, Ludi V, et al. On the front lines of patient safety: implementation and evaluation of team training in Iraq. Jt Comm J Qual Patient Saf. 2011;37(8):350-35621874970PubMedGoogle Scholar 5. Robertson B, Kaplan B, Atallah H, Higgins M, Lewitt MJ, Ander DS. The use of simulation and a modified TeamSTEPPS curriculum for medical and nursing student team training. Simul Healthc. 2010;5(6):332-33721330818PubMedGoogle ScholarCrossref 6. Meier AH, Boehler ML, McDowell CM, et al. A surgical simulation curriculum for senior medical students based on TeamSTEPPS. Arch Surg. 2012;147(8):761-767Google ScholarCrossref 7. Hamad GG, Brown MT, Clavijo-Alvarez JA. Postoperative video debriefing reduces technical errors in laparoscopic surgery. Am J Surg. 2007;194(1):110-11417560921PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

There Is No “I” in “TEAM”: Comment on “A Surgical Simulation Curriculum for Senior Medical Students Based on TeamSTEPPS”

McCoy, Kelly L.; Carty, Sally E.
Archives of Surgery , Volume 147 (8) – Aug 1, 2012
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References (8)

Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.2012.1573
Publisher site
See Article on Publisher Site

Abstract

During the past 2 decades we have witnessed a paradigm shift in surgery. We once saw a proud profession of individual accomplishment and ultimate accountability, but we now recognize that small missteps along a patient's path often represent cumulative system errors. A multidisciplinary team approach has been shown to reduce medical errors, leading to better outcomes.1 Recently, the TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) approach has been used in the operating room with good results2,3 and has been implemented in the highly stressful environment of a combat hospital with an associated reduction in medical errors.4 In 2010, Robertson et al5 adapted TeamSTEPPS for medical and nursing students as a 4-hour workshop with a structured postintervention review and observed increased knowledge regarding the beneficial effects of attitude and communication on patient safety–oriented team function. Here, in a well-written narrative, Meier et al6 show that the TeamSTEPPS model can be productively incorporated in the formal fourth-year medical school curriculum as an elective course. Moreover, they observed improvements in subjective and objective postintervention scoring across all parameters studied. We would add that, based on the findings of Hamad et al,7 the inclusion of a posttraining debriefing may further potentiate TeamSTEPPS as a useful tool in preparation for surgical residency. In the future, it surely will be interesting to evaluate whether such training translates into improved job performance for junior surgical residents. The transition from student to physician brings with it great satisfaction but also a huge increase in responsibility, and the restructuring of many surgical residencies now has junior-level residents squarely on the “front line” of patient care. Fostering multidisciplinary communication among junior team members early in their training promises to make their transition to adulthood more seamless, less overwhelming, and safer for patients. Back to top Article Information Correspondence: Dr Carty, Division of Endocrine Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Kaufmann Medical Bldg, 3471 Fifth Ave, Ste 101, Pittsburgh, PA 15213 (cartyse@upmc.edu). Financial Disclosure: None reported. References 1. Braithwaite RS, DeVita MA, Mahidhara R, Simmons RL, Stuart S, Foraida M.Medical Emergency Response Improvement Team (MERIT). Use of medical emergency team (MET) responses to detect medical errors. Qual Saf Health Care. 2004;13(4):255-25915289627PubMedGoogle ScholarCrossref 2. Weaver SJ, Rosen MA, DiazGranados D, et al. Does teamwork improve performance in the operating room? a multilevel evaluation. Jt Comm J Qual Patient Saf. 2010;36(3):133-14220235415PubMedGoogle Scholar 3. Forse RA, Bramble JD, McQuillan R. Team training can improve operating room performance. Surgery. 2011;150(4):771-77822000190PubMedGoogle ScholarCrossref 4. Deering S, Rosen MA, Ludi V, et al. On the front lines of patient safety: implementation and evaluation of team training in Iraq. Jt Comm J Qual Patient Saf. 2011;37(8):350-35621874970PubMedGoogle Scholar 5. Robertson B, Kaplan B, Atallah H, Higgins M, Lewitt MJ, Ander DS. The use of simulation and a modified TeamSTEPPS curriculum for medical and nursing student team training. Simul Healthc. 2010;5(6):332-33721330818PubMedGoogle ScholarCrossref 6. Meier AH, Boehler ML, McDowell CM, et al. A surgical simulation curriculum for senior medical students based on TeamSTEPPS. Arch Surg. 2012;147(8):761-767Google ScholarCrossref 7. Hamad GG, Brown MT, Clavijo-Alvarez JA. Postoperative video debriefing reduces technical errors in laparoscopic surgery. Am J Surg. 2007;194(1):110-11417560921PubMedGoogle ScholarCrossref

Journal

Archives of Surgery – American Medical Association

Published: Aug 1, 2012

Keywords: students, medical,surgical procedures, operative

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