Systematic simulation-based team training in a Swedish intensive care unit: a diverse response among critical care professions

BACKGROUND Teamwork-that is, collaboration and communication-is an important factor for safe healthcare, but professions perceive the quality of teamwork differently. OBJECTIVE To examine the relationship between simulation-based team training (SBTT) and different professions' self-efficacy, experienced quality of collaboration and communication, perceptions of teamwork and safety, together with staff turnover. METHODS All staff (n=151; physicians, nurses and nurse assistants) in an intensive care unit (ICU) at a university hospital were systematically trained over 2 years. Data on individual self-efficacy were measured using the self-efficacy questionnaire; the experienced quality of collaboration and communication, teamwork climate, safety climate and perception of working conditions were sampled using the ICU version of the safety attitudes questionnaire (SAQ). Staff turnover and sick leave was measured using the hospital's staff administration system for the intervention ICU and a control ICU in the same hospital. RESULTS The perception of safety differed between professions before training. Nurses' and physicians' mean self-efficacy scores improved, and nurse assistants' perceived quality of collaboration and communication with physician specialists improved after training. Nurse assistants' perception of the SAQ factors teamwork climate, safety climate and working conditions were more positive after the project as well as nurses' perception of safety climate. The number of nurses quitting their job and nurse assistants' time on sick leave was reduced in comparison to the control ICU during the study period. LIMITATIONS Results for SAQ factors must be interpreted with caution given that Cronbach's α and inter-correlations for the SAQ factors showed lower values than benchmarking data. CONCLUSIONS All team members benefited from the SBTT in an authentic composed team, but this was expressed differently for the respective professions.