Loyola University Health Sciences Division Employs TeamSTEPPS® in Curricula
Loyola University Chicago now requires that all students in its schools of medicine and nursing—about 300 annually—be introduced to AHRQ's TeamSTEPPS® patient safety training program.
At the 2012 International Meeting for Simulation in Healthcare, university faculty found inspiration in a session on simulation for interprofessional education, something Loyola's Health Sciences Division wanted in its strategic plan.
"That session was a watershed moment for promoting interprofessional education and training," said Keith Muccino, S.J., M.D., executive director for Loyola's Center for Simulation Education.
Members of the Loyola simulation team subsequently attended TeamSTEPPS training in 2012. TeamSTEPPS, a patient safety training program developed by AHRQ and the Department of Defense, is an evidence-based system to improve communication and teamwork skills among health care professionals. Following the training, Loyola colleagues submitted a proposal that incorporated TeamSTEPPS into simulation training—a technique that allows participants to practice appropriate clinical protocols by participating in hypothetical scenarios.
"By July 2012, we were ready to pilot the project," noted Trent Reed, D.O., director of medical simulation at Loyola's Center for Simulation Education, and one of the architects of the project. "Quality team training using TeamSTEPPS was the focus; simulated patient management exercises were the vehicle."
Selecting students whose schedules allowed for the training was a challenge at first. "We also had to secure a commitment from both schools to incorporate an interprofessional simulation activity into the curricula," noted Leann Horsley, Ph.D., R.N., lead nurse investigator.
Students learn TeamSTEPPS using an online module created for this project. Each year during orientation, teams of fourth-year medical and nursing students are formed. Teams are then put through a high-fidelity, crisis-management simulation scenario followed by a debriefing session. High-fidelity simulation features mannequins that can be programmed with vital signs and that respond to interventions.
A faculty-led team helps students make connections between TeamSTEPPS principles and the behaviors expected in delivering quality care. The process is then repeated with another patient simulation and debriefing.
Students experience scenarios involving two patients:
- A patient injured in a motor vehicle collision who is unconscious, intubated, and has a rapid heart rate and low blood pressure.
- A stabbing victim who has penetrating abdominal trauma, a rapid heart rate, and low blood pressure but is able to communicate.
"In both scenarios, students determine why the patient is hypotensive and tachycardic and provide appropriate management. The case management aspects are important to learn, but the students' ability to perform as a team according to TeamSTEPPS is the focus," Dr. Reed explained.
Student feedback has been positive. "Our learners recognize the value of TeamSTEPPS training beyond the simulation lab. We're challenging them to be change agents," Dr. Horsley said.
"When students go into clinical environments and don't see team dynamics being employed, they realize that they represent the cutting edge of a needed transformation in health care delivery," Dr. Muccino noted. "Rather than getting discouraged over the absence of quality teamwork in the hospital, they can draw strength knowing that they possess information and skills that allow them to become advocates for better care."