Florida Atlantic University Adapts TeamSTEPPS® in Its Interprofessional Education Program
Florida Atlantic University (FAU) has incorporated and adapted TeamSTEPPS® into its curricula for students in its colleges of medicine, nursing, and social work and uses the resource as a basis for the university's interprofessional education program. As a result, nearly 700 medical, nursing, and social work students and 59 faculty members have been trained in team-based care and communication.
Research shows that patient care quality improves when members of the health care team work in collaboration to share their unique patient care perspectives; however, physicians, nurses, and other health professionals enter into practice with different skill sets, knowledge, and professional identities. To reduce barriers between professions, FAU nursing faculty sought a tool to remove barriers to effective interprofessional care and facilitate the use of a common language for team communication. When two faculty members attended a 2009 TeamSTEPPS training session sponsored by AHRQ, they found the tools and techniques for this work.
"For starters, it's the only evidence-based team curriculum out there," says Kathryn Keller, PhD, RN, an associate professor in FAU's College of Nursing. Keller and Terry Eggenberger, PhD, RN, an assistant professor in the college, attended the 2009 TeamSTEPPS master trainer workshop. TeamSTEPPS, a program developed by AHRQ and the Department of Defense, is an evidence-based system aimed at optimizing patient outcomes and promoting a culture of team-driven care. The program establishes interdisciplinary team training systems to serve as the foundation for a patient safety strategy. "It's very positive and it gives students structure and comfort," adds Keller. "It boosts their confidence."
After attending the TeamSTEPPS training session, Keller and Eggenberger approached FAU medical school faculty about collaboration on team training. "The goal was to promote respectful and open communication between the disciplines and an understanding of each other's scope of practice," says Eggenberger. An early challenge was moving the objectives beyond appropriate medical treatment and nursing responses to the professional interaction between the disciplines.
A pilot education workshop was conducted, which included an overview of the various TeamSTEPPS communication tools for students and faculty. Participants also engaged in a high-fidelity simulation experience using new communication tools for the telephone and direct communication. Enthusiasm and support were extensive, and the team began to explore ways to introduce these concepts to larger groups of people. "It was so costly to do simulation, so we came up with the idea of role play," says Keller.
Over the next 2 years, Keller and Eggenberger made adaptations as the TeamSTEPPS-inspired coursework was expanded to more nursing and medical students. "Because of the volume of students, the amount of clinical hours available, and the limited resources allotted for the experience, these sessions had to switch from high-tech to low-tech," says Eggenberger.
For example, faculty developed different scenarios around opportunities for improved communication and the use of TeamSTEPPS tools and techniques, including:
- A child admitted from a physician's office who develops an anaphylactic reaction in the hospital after an ineffective handoff.
- Interprofessional students who encounter a faculty member who is giving inadequate compressions to a nursing home resident who requires cardiopulmonary resuscitation.
- An early morning phone conversation between a nurse and a physician about a patient's arterial blood gas levels.
- A video clip from a popular television medical series illustrating poor communication between the disciplines.
Students are asked to identify challenges and ways to improve the interaction using the tools and techniques. Students work in small groups to develop role playing scenarios using TeamSTEPPS communication tools and then present them to the larger group for a debriefing.
In 2011, a FAU steering group was formed to identify more opportunities for interprofessional education, including inviting members of the School of Social Work to join the activities. Workshops were developed to include quality, health care policy, and ethics, in addition to teambuilding and communication.
Today, TeamSTEPPS content, including videos, has been embedded throughout coursework offered to nursing, medical, and social work students. Keller and Eggenberger have also spread the impact of TeamSTEPPS at FAU through presentations at the International Meeting on Simulation in Healthcare, "Collaborating Across Borders IV: Transformative Change From the Classroom to Practice," and other forums. They are also lead authors on a study, "Implementing Successful Interprofessional Communication Opportunities in Health Care Education: A Qualitative Analysis," which has been published in the International Journal of Medical Education.
In addition to influencing the next generation of clinicians, FAU nursing school leaders are trying to change practice. "I think some of our faculty has evolved over time," says Keller. "There has been a shift to more interdisciplinary work." With many faculty members also practicing in nearby Boca Raton, FL, "Our hope is to impact the practice environment," she says.
TeamSTEPPS®: Strategies and Tools to Enhance Performance and Patient Safety. November 2007. Agency for Healthcare Research and Quality, Rockville, MD. http://teamstepps.ahrq.gov/abouttoolsmaterials.htm.
Keller KB, Eggenberger TL, Belkowitz J, et al, Implementing successful interprofessional communication opportunities in health care education: a qualitative analysis. Int J Med Educ 2013;4:253-9.