San Diego Universities Collaborate Using TeamSTEPPS® to Boost Professional Education
About 900 students at two San Diego universities have been instructed in the team-based methods of TeamSTEPPS®, AHRQ's evidence-based patient safety training program for health care professionals. The training occurred at the medical and pharmacy schools at the University of California, San Diego (UCSD), and the nursing school at the University of San Diego (USD).
Amy Zheng, M.D., a staff physician at the Veteran's Healthcare Administration (VA) in San Diego and assistant clinical professor at the UCSD School of Medicine, first learned of TeamSTEPPS at a 2012 Society for Simulation in Healthcare conference. She incorporated elements of TeamSTEPPS at the VA, where she was responsible for simulation training of medical residents.
"It was great finding TeamSTEPPS," Dr. Zheng said. Students "were coming here without training in how to work together." Using TeamSTEPPS, Dr. Zheng saw a way to effectively train residents. Since it launched in 2013, the UCSC/USD training has involved more than 200 faculty members as facilitators.
TeamSTEPPS trains health care professionals to communicate effectively and use teamwork skills to prevent medical errors. The program, developed by AHRQ and the Department of Defense, is used in hospitals, primary care practices, dental practices, nursing homes, and other settings. Hands-on training scenarios are used to teach effective communication among health care teams, patients, and caregivers.
After adopting elements from TeamSTEPPS into the San Diego VA's resident training program, Dr. Zheng said, "We had such good results at the VA that local schools took notice." UCSD and USD staff asked her to develop similar initiatives. UCSD's efforts were part of a National Institutes of Health study on changing medical school education among a 16-school consortium.
The three schools at UCSD and USD integrated TeamSTEPPS training into their Rapid Response System (a tool that coordinates critical care teams) and other training materials. Dr. Zheng developed a handout gearing TeamSTEPPS toward a student audience.
"We have a week called 'Transitions Week' to prepare medical students for working in the wards," Dr. Zheng explained. TeamSTEPPS and "SBAR" (Situation-Background-Assessment-Recommendation) content were essential components to prepare students for clinical settings.
As part of the training, students worked in teams to transition a hypothetical patient with chest pain from a primary care clinic to an emergency department. The emergency department team then handed the patient off to a team of inpatient providers. "It requires a team, because not one person can do it all," said Dr. Zheng. "We want students to get used to working in teams as soon as possible."
"Our goal was to make this a successful, memorable learning exercise for students," added Linda Awdishu, Pharm.D., assistant clinical professor of pharmacy at UCSD's Skaggs School of Pharmacy and Pharmaceutical Sciences. "We had to ensure our students had the knowledge and skills that would be called upon during this exercise."
"We reviewed and assessed our curricular gaps," Dr. Awdishu said. "We then instituted workshops or lectures to supplement any gaps that could have jeopardized the learning experience. As an example, for the pharmacy students, we implemented a workshop on sterile product preparation to ensure students had basic skills in preparing a sterile drug."
Dr. Awdishu explained that training also included a workshop on interprofessional communication, exercises in situation assessment, and a review of cardiac pharmacotherapy. The School of Medicine also provided a workshop on interpreting electrocardiograms.
Karen Macauley, Ph.D., A.P.R.N., associate professor of nursing at USD's Hahn School of Nursing and Health Science, said the training was the first time that nursing students worked with physicians. "After the simulation exercise, teams debriefed based on patient feedback and focused on care devoid of traditional role hierarchies."