- Email: [email protected]
A Comparison of Observed vs Self-Rated Teamwork During Simulated Cardiac Arrest and Rapid Response Scenarios
Education, Research, and Quality Improvement SESSION TITLE: Education SESSION TYPE: Original Investigation Slide
EDUCATION, RESEARCH, AND QUALITY IMPROVEMENT
PRESENTED ON: Tuesday, October 25, 2016 at 02:45 PM - 04:15 PM
A Comparison of Observed vs Self-Rated Teamwork During Simulated Cardiac Arrest and Rapid Response Scenarios Alfredo Lee Chang MD* Akiva Dym BS Maneesha Bangar MD Adam Keene MD Marjan Rahmanian MD Nida Qadir MD; and Lewis Eisen MD Albert Einstein College of Medicine, Bronx, NY PURPOSE: The process of individual learning includes recognizing one’s own deficiencies. Likewise, identification of team deficiencies is fundamental to remediate them, in order to improve team performance especially for critical situations. Little is known regarding self-assessment of team leadership and teamwork skills. We hypothesized that physicians overestimate their leadership and teamwork skills when managing critical scenarios such as cardiac arrest and rapid response scenarios (CA/RRS), as compared to trained external observers. METHODS: First-year Internal Medicine residents (n¼48) were divided into seven groups and each participated in 8 simulated RR/CA cases using high-fidelity simulation. Residents alternated between team leader and other team member roles. Each group participated in 2 cases, followed by a lecture on teamwork during CA/RRS, and then participated in 6 additional simulated cases. The 16-item validated Mayo High Performance Teamwork Scale was completed independently by an experienced faculty member observer and by each individual resident for each case. RESULTS: A total of 55 simulated cases were run, with a total of 55 observer and 269 resident self-assessment scores collected. Overall, the self-assessed teamwork score was significantly higher as compared to the experienced observer-graded teamwork score (1.541 +/- 0.36 vs 1.183 +/- 0.47, p-value <0.01). On 11 of the 16 Mayo scale items, self-assessment was significantly higher than observed scoring. There was no significant difference noted only in identifying team leadership, understanding own role in the team, good communication practices, solving conflicts without losing situation awareness, and demonstrating appropriate task management skills. CONCLUSIONS: Internal residents overestimate their teamwork and leadership skills when compared to an external observer’s assessment. However, there is good agreement between objective and self-assessment in identifying a leader, clarifying team roles, use of good communication and effective task management. CLINICAL IMPLICATIONS: Residents inflated self-assessment of their teamwork and leadership skills may produce false selfconfidence and potentially hinder the learning of effective teamwork skills. DISCLOSURE: The following authors have nothing to disclose: Alfredo Lee Chang, Akiva Dym, Maneesha Bangar, Adam Keene, Marjan Rahmanian, Nida Qadir, Lewis Eisen No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.692
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
600A
[
150#4S CHEST OCTOBER 2016
]
EDUCATION, RESEARCH, AND QUALITY IMPROVEMENT
PRESENTED ON: Tuesday, October 25, 2016 at 02:45 PM - 04:15 PM
A Comparison of Observed vs Self-Rated Teamwork During Simulated Cardiac Arrest and Rapid Response Scenarios Alfredo Lee Chang MD* Akiva Dym BS Maneesha Bangar MD Adam Keene MD Marjan Rahmanian MD Nida Qadir MD; and Lewis Eisen MD Albert Einstein College of Medicine, Bronx, NY PURPOSE: The process of individual learning includes recognizing one’s own deficiencies. Likewise, identification of team deficiencies is fundamental to remediate them, in order to improve team performance especially for critical situations. Little is known regarding self-assessment of team leadership and teamwork skills. We hypothesized that physicians overestimate their leadership and teamwork skills when managing critical scenarios such as cardiac arrest and rapid response scenarios (CA/RRS), as compared to trained external observers. METHODS: First-year Internal Medicine residents (n¼48) were divided into seven groups and each participated in 8 simulated RR/CA cases using high-fidelity simulation. Residents alternated between team leader and other team member roles. Each group participated in 2 cases, followed by a lecture on teamwork during CA/RRS, and then participated in 6 additional simulated cases. The 16-item validated Mayo High Performance Teamwork Scale was completed independently by an experienced faculty member observer and by each individual resident for each case. RESULTS: A total of 55 simulated cases were run, with a total of 55 observer and 269 resident self-assessment scores collected. Overall, the self-assessed teamwork score was significantly higher as compared to the experienced observer-graded teamwork score (1.541 +/- 0.36 vs 1.183 +/- 0.47, p-value <0.01). On 11 of the 16 Mayo scale items, self-assessment was significantly higher than observed scoring. There was no significant difference noted only in identifying team leadership, understanding own role in the team, good communication practices, solving conflicts without losing situation awareness, and demonstrating appropriate task management skills. CONCLUSIONS: Internal residents overestimate their teamwork and leadership skills when compared to an external observer’s assessment. However, there is good agreement between objective and self-assessment in identifying a leader, clarifying team roles, use of good communication and effective task management. CLINICAL IMPLICATIONS: Residents inflated self-assessment of their teamwork and leadership skills may produce false selfconfidence and potentially hinder the learning of effective teamwork skills. DISCLOSURE: The following authors have nothing to disclose: Alfredo Lee Chang, Akiva Dym, Maneesha Bangar, Adam Keene, Marjan Rahmanian, Nida Qadir, Lewis Eisen No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.692
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
600A
[
150#4S CHEST OCTOBER 2016
]