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TeamSTEPPS online simulation: expanding access to teamwork training for medical students
  1. Rebekah Burns1,2,
  2. Megan Gray1,3,
  3. Dana Peralta4,
  4. Andrew Scheets5,
  5. Rachel Umoren1,3
  1. 1Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2Division of Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA
  3. 3Division of Neonatology, Seattle Children's Hospital, Seattle, Washington, USA
  4. 4Pediatrics, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA
  5. 5Simulation, Seattle Children's Hospital, Seattle, Washington, USA
  1. Correspondence to Dr Rebekah Burns, Pediatrics, Division of Emergency Medicine, Seattle Children's Hospital, Seattle, Washington, USA; rebekah.burns{at}


Background The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) programme is an evidence-based approach to teamwork training. In-person education is not always feasible for medical student education. The aim of this study was to evaluate the impact of online, interactive TeamSTEPPS simulation versus an in-person simulation on medical students’ TeamSTEPPS knowledge and attitudes.

Methods Fourth-year medical students self-selected into an in-person or online training designed to teach and evaluate teamwork skills. In-person participants received didactic sessions, team-based medical simulations and facilitated debriefing sessions. The online group received an equivalent online didactic session and participated in an interactive software-based simulation with immediate, personalised performance-based feedback and scripted debriefing. Both trainings used three iterations of a case of septic shock, each with increasing medical complexity. Participants completed a demographic survey, a preintervention/postintervention TeamSTEPPS Benchmarks test and a retrospective preintervention/postintervention TeamSTEPPS teamwork attitudes questionnaire. Data were analysed using descriptive statistics and repeated measures analysis of variance.

Results Thirty-one students (18 in-person, 13 online) completed preintervention/postintervention surveys, tests and questionnaires. Gender, age and exposure to interprofessional education, teamwork training and games were similar between groups. There were no statistical differences in preintervention knowledge or teamwork attitude scores between in-person and online groups. Postintervention knowledge scores increased significantly from baseline (+2.0% p=0.047), and these gains did not differ significantly based on whether participants received in-person versus online training (+1.5% vs +2.9%; p=0.49). Teamwork attitudes scores also showed a statistically significant increase with training (+0.9, p<0.01) with no difference in the effect of training by group (+0.8 vs +1.0; p=0.64).

Conclusions Graduating medical students who received in-person and online teamwork training showed similar increases in TeamSTEPPS knowledge and attitudes. Online simulations may be used to teach and reinforce team communication skills when in-person, interprofessional simulations are not feasible.

  • teamwork training
  • pediatric simulation
  • interprofessional teams
  • simulation for teamwork training

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  • Presented at This work was presented in part at the 2018 International Meeting on Simulation in Healthcare, the 2018 American Heart Association Team Training National Conference, and the 2018 and 2019 International Pediatric Simulation Symposia and Workshops.

  • Contributors RB, MG and RU made substantial contributions to the conception and design of work, as well as the acquisition, analysis and interpretation of the data. DP made substantial contributions to the acquisition and analysis of data. AS made significant contributions to the conception and design of the work and acquisition of data. All authors contributed to the drafting of the manuscript and critical revision. All authors have approved the final version.

  • Funding This project was supported by a grant from the University of Washington School of Medicine Center for Leadership and Innovation in Medical Education.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the UW Institutional Review Board (approval #STUDY00001772).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Deidentified participant data is not available for sharing outside of our institution.

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