Objectives

1. Discuss the team unique competencies that enable individuals to perform safely.

2. Understand experiential learning tools such as simulation in enhancing the learning of health care providers.

3. Learn about how team training and simulation can enable safer and more reflective health care providers.

4. Explore the role of microsystems in health care.

5. Explore the role of simulation in training and assessment of health care providers.

INTRODUCTION AND BACKGROUND

The role of effective teamwork in accomplishing complex tasks is well accepted in many domains. Similarly, there is good evidence that outcome in trauma care depends on effective trauma team performance. Teamwork during trauma care can be deficient in a number of different ways (Table 37.1), and multiple deficiencies may interact to impair team success and patient outcomes. This chapter focuses on understanding, assessing, and improving trauma team performance. The need to train and evaluate the performance of trauma teams has emerged as an important topic during the past decade [1]. It is generally accepted that to ensure high-quality trauma care, institutions must establish and continuously assess their team-based processes for acute trauma resuscitation. This iterative evaluation must include the review of the secondary management including careful delineation of team structure, thorough and ongoing team training, effective support structures, and continuous quality improvement. Valuable tools for trauma team training and performance improvement, discussed in this chapter, include reflective learning and debriefing, simulation and videotape-based analysis.

Team training has a long history in aviation and the military, and, more recently, these experiences have been translated to health care.