Facilitator's Notes (continued, 2)

Training Guide: Using Simulation in TeamSTEPPS Training

TeamSTEPPS is a teamwork system developed jointly by the Department of Defense (DoD)and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety.

Training Guide: Using Simulation in TeamSTEPPS® Training


Participant Handouts


Your Expectations for this Training

Directions: Picture yourself at the end of this training course. It has been a successful and worthwhile experience for you because you have learned new information. Make a note of two things you hope to learn and take with you from this training.

1. ____________________________________________________________________

2. ____________________________________________________________________

You have just listed your expectations for this course! Now share these with the group so that the course facilitator(s) can either address your expectations during the course or refer you to appropriate print and Web-based resources as well as additional training courses, if appropriate.

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Objectives of Simulation Training Course

At the end of this training, participants will be able to:

  • Apply the Event-Based Approach to Training.
  • Develop TeamSTEPPS training scenarios.
  • Develop TeamSTEPPS performance measures.
  • Conduct effective debriefs of team performance.
  • [When rolling out this training, add here content objectives related to the procedure that is the focus of the training course you are offering].

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Developing Learning Objectives


Think about a simulation course that you plan to deliver in the near future and what you want the participants to learn. Also consider the teamwork skills you want participants to learn. Now, take approximately 10 minutes to write some learning objectives for this course: At least two content objectives related to the simulation and at least two process objectives related to teamwork skills. Be sure that your objectives are explicit and written in measurable terms. They should include statements of performance, conditions, and standards, as in the following example.

Upon completion of this training on team leadership, participants, when using the debrief checklist, will be able to summarize lessons learned and set goals for improvement.

Learning Objective #1 (Content)  
Learning Objective #2 (Content)  
Learning Objective #3 (Content)  
Learning Objective #4 (Process)  
Learning Objective #5 (Process)  

After you have developed your course's learning objectives, form a group with two or three other training participants and take turns sharing learning objectives. Listen to your team members' learning objectives and, as appropriate, identify ways to strengthen each other's objectives. Do the objectives include statements of performance, conditions, and standards? Your group has 20 minutes for this activity. Then, as a group, select two learning objectives (one content and one process) to share with the larger group.

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Writing A Scenario For Your Learning Objectives


Although you may select a scenario from Tab I of the TeamSTEPPS Instructor Guide, you may at times wish to develop your own scenarios. Thinking about the learning objectives you developed in the last exercise (H-3), define the clinical context for these learning objectives. First develop a scenario and then define the clinical context. You have approximately 10 minutes to work on your scenario. Be prepared to share your scenario with the group. As others share their scenarios, ask question to clarify the scenario or offer suggestions for how to strengthen it.















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Developing Scenarios


Form a small group with two other course participants. Using Tab I of the TeamSTEPPS Instructor Guide, select a scenario and to identify and develop the six elements below for your scenario.

Scenario Elements
1. TeamSTEPPS Skill  
2. TeamSTEPPS Tool or Strategy  
3. Learning Objective(s)  
4. Clinical Context  
5. Event Set With Trigger and Distracters  
6. Targeted Responses  

You have approximately 25 minutes for this activity. Your small group should be prepared to make a 3-minute presentation to share your results with the total group.

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Adams, K.A., Goodwin, G.F., Searcy, C.A., Norris, D.G., and Oppler, S.H. Development of a Performance Model of the Medical Education Process. Technical report commissioned by the Association of American Medical Colleges. Washington, DC: American Institutes for Research. 2001.

American Institutes for Research. Tool for the training, assessment, analyses, and debriefing of medical teams' performance: Labor and delivery content. Washington, DC: American Institutes for Research. 2008.

Baker, D.P., Salas, E., Barach, P., Battles, J., and King, H. “The relation between teamwork and patient safety.” Handbook of Human Factors and Ergonomics in Health Care and Patient Safety. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. 2006.

Baker, D.P., Gustafson, S., Beaubien, J.M., and Salas, E. Medical Teamwork and Patient Safety: The Evidence-Based Relation. Literature Review. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Publication No. 05-0053. April 2005.

Beaubien, J.M., and Baker, D.P. “The use of simulation for training teamwork skills in health care: How low can you go?” Quality and Safety in Health Care. October 2004. 13(Suppl. 1).

Cannon-Bowers, J.A., Tannenbaum, S.I., Salas, E., and Volpe, C.E. “Defining competencies and establishing team training requirements.” In R.A. Guzzo and E. Salas and Associates (eds.), Team Effectiveness and Decision-Making in Organizations. San Francisco: Jossey-Bass Publishers. 1995. pp. 330-380.

Costar, D.M., Baker, D.P., Calderon, R. Scenario-Based Training: Understanding the Requirements for Human Performance Measurement. Washington, DC: American Institutes for Research. 2003.

Fanning, R.M., and Gaba, D.M. “The role of debriefing in simulation-based learning.” Simulation in Healthcare. 2007. 2(1).

Fowlkes, J.E., Dwyer, D.J., Oser, R.L., and Salas, E. “Event-based approach to training (EBAT).” International Journal of Aviation Psychology. 1998. 8, pp. 209-221.

Gaba, D.M., Howard, S.K., Fish, K.J., Smith, B.E., and Sowb, Y.A. “Simulation-based training in anesthesia crisis resource management (ACRM): A decade of experience.” Simulation and Gaming. 2001. 32, pp. 175-193.

Haig, K.M., Sutton, S., and Whittington, J. “SBAR: A shared mental model for improving communication between clinicians.” Journal on Quality and Patient Safety. March 2006. 32(1).

Jha, A.K., Duncan. B.W., and Bates, D.W. “Simulator-based training and patient safety.” In K.G. Shojana, B.W. Duncan, K.M. McDonald, and R.M. Wachter (eds.). Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Rockville, MD: Agency for Health care Research and Quality. 2001. pp. 511-518.

Johnston, J.H., Smith-Jentsch, K.A., Cannon-Bowers, J.A. “Performance measurement tools for enhancing team decision making.” In M.T. Brannick, E. Salas, and C. Prince (eds.). Team Performance Assessment and Measurement: Theory, Methods, and Applications. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. 1997. pp. 311-327.

McIntyre, R.M. and Salas, E. “Measuring and managing for team performance: Emerging principles from complex environments.” In R.A. Guzzo and E. Salas and Associates (eds.). Team Effectiveness and Decision Making in Organizations. San Francisco: Jossey-Bass Publishers. 1995. pp. 9-45.

Oser, R.L., Cannon-Bowers, J.A., Salas, E., and Dwyer, D.J. “Enhancing human performance in technology-rich environments: Guidelines for scenario-based training.” In E. Salas (ed.), Human/Technology Interaction in Complex Systems. Stamford, CT: JAI Press. 1999. 9, pp. 175-202.

Rosen, M.A., Salas, E., Silvestri, S., Wu, T., and Lazzara, E.H. “An assessment tool for simulation-based training in emergency medicine: The simulation modules for assessment of resident targeted event responses (SMARTER) approach.” Simulation in Healthcare. In press.

Rosen, M.A., Salas, E., Wu, T.S., Silvestri, S., Lassara, E.H., Lyons, R., Weaver, S., and King, H. “Promoting teamwork: An event-based approach to simulation-based teamwork training for emergency medicine residents.” Academic Emergency Medicine. 2008. 15(11), pp. 1190-1198.

Rudolph, J. W., Simon, R., Dufresne, R. L., and Raemer, D. B. “There's no such thing as ‘nonjudgmental' debriefing: A theory and method for debriefing with good judgment.” Simulation in Healthcare. 2006. 1(1), pp. 49-55.

Rudolph, J., Simon, R., Rivard, P., Dufresne, R., and Raemer, D. “Debriefing with good judgment: Combining rigorous feedback with genuine inquiry.” Anesthesiology Clinics. 2007. 25(2), pp. 361-376.

Salas, E., Klein, C., King, H. B., Salisbury, M., Augenstein, J. S., Birnbach, D. J., et al. “Debriefing medical teams: 12 evidence-based best practices and tips.” Joint Commission Journal on Quality and Patient Safety. 2008. 34(9), pp. 518-527.

Salas, E,. Rosen, M., and King, H. “Integrating teamwork into the ‘DNA' of graduate medical education: Principles for simulation-based training.” Journal of Graduate Medical Education. December 2009. pp. 243-244.

Smith, P.C. and Kendall, L.M. “Retranslation of expectations: An approach to the construction of unambiguous anchors for rating scales.” Journal of Applied Psychology. 1963. 47, pp. 149-155.

Stout, R.J., Cannon-Bowers, J.A., and Salas, E. “The role of shared mental models in developing team situational awareness: Implications for team training.” Training Resource Journal. 1996. 2, pp. 85-116.

Stout, R.J., Salas, E., and Fowlkes, J.E. “Enhancing teamwork in complex environments through team training.” Group Dynamics: Theory, Research, and Practice. 1997. 1(2), pp. 169-182.

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Several organizations have collaborated to design and further refine this TeamSTEPPS guide to make it available for all health care organizations. For their expert input to this guide, we would like to thank:

Agency for Healthcare Research and Quality
James B. Battles, Ph.D.

Department of Defense Patient Safety Program
Heidi B. King, M.S.
Michael Rosen, Ph.D.
Wendy Martin, R.N.

American Institutes for Research
Contract to AIR with AHRQ, Contract # HHSA290200600019
Deborah Milne, R.N., M.P.A.
David Baker, Ph.D.
Alexander Alonso, Ph.D.
Mary Ann Corley, Ph.D.
Timothy Clayton, M.S.
Rachel Greenberg
Alexa Doerr

Carilion Clinic
Charlotte Hubbard, R.N.
Beth Harber

Creighton University
Chad Bauerly, M.D.
Amy Tegeder

Duke Medicine
Bryan Sexton, Ph.D.
Laura Maynard, M.Div.
Pamela Bivens, M.A.

University of Minnesota
Karyn Baum, M.D., M.S.Ed.
Marnie Huss, R.N.
Mary Tramel

University of Washington Medicine
Brian Ross, Ph.D., M.D.
Kurt O'Brien, M.H.R.O.D.
Megan Sherman

U.S. Department of Veterans Affairs National Center for Patient Safety
Lisa M. Mazzia, M.D.

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Page last reviewed October 2014
Internet Citation: Facilitator's Notes (continued, 2): Training Guide: Using Simulation in TeamSTEPPS Training. October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/teamstepps/simulation/traininggd2.html
Internet Citation: Facilitator's Notes (continued, 2). Content last reviewed July 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/teamstepps/simulation/traininggd2.html