The Learning Outcome of Resuscitation Teamwork Training in Postgraduate Year Doctors and Nurses

Study Overview
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Brief Summary
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It is challenging for healthcare team to manage emergency patient effectively. Most of these critical patients have medical conditions and need complex medical managements. Research findings have shown that poor healthcare teamwork would result in poor communication, missing information, and insufficient situation monitoring and thus compromise patient safety. Simulation has been proved as an effective method to develop teamwork competency. However, comparing to traditional training model, simulation requires more resources such as funding, spaces, time, administration staffs, schedule, facilitators, and equipment. It would not be easy to delivery in various professional departments. Game-based learning was a known effective and learner-centered learning model which required less resources. Researchers have shown that game-based learning has higher acceptance for the learners and can improve learners' knowledge, attitude, motivation, and performance. Therefore, the aim of this study was to explore the learning effectiveness of resuscitation teamwork training of board game-based learning, simulation-based learning and lecture-based learning in PGY doctors and nurses.

Detailed Description
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This will be a prospective, longitudinal, and randomized controlled trial design. A total number of 180 PGY doctors and nurses will be enrolled from a teaching hospital in northern Taipei City. They will be randomized into board game-based learning, simulation-based learning, and lecture-based learning group. Three groups will receive Emergency Medical Response Teamwork training and all of these contents were developed according to America Heart Association Guidelines for Cardiopulmonary Resuscitation and ECC and TeamSTEPPS curriculum from Agency for Healthcare Research and Quality. We will collect the professional demography, the professional medical knowledge for medical management, the concept of knowledge for teamwork, team performance, team attitude, medical management, course survey, and cognitive load scales. We will compare the learning effectiveness between three groups in pre test, post-test, and three month later after post-test. Statistics including categorical data and between-group test will analyzed by Chi-square test. In addition, we will use repeated measurement ANOVA and Linear mixed model for continuous variables to exam the between group difference from the baseline to the delay test.

Official Title
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The Learning Outcome of Resuscitation Teamwork Training on Developing Teamwork Performance in Postgraduate Year Doctors and Nurses - Comparison of Board Game-based Learning, Simulation-based Learning and Lecture-based Learning

Conditions
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Patient Care Team

Intervention / Treatment
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* Other: board game-based teamwork training
* Behavioral: simulation-based teamwork training
* Other: lecture-based teamwork training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Postgraduate Year doctors who is 20 years old and work in primary care. Postgraduate Year nurses who is 20 years old and work in primary care Exclusion Criteria: Participant do not work in primary care provide. Healthcare provider do not delivery in relative adult care department, such as pediatric department, obstetrics department, and psychiatry department so on.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: board game-based learning<br>game-based learning | Other: board game-based teamwork training<br>* Using board game-based learning to develop resuscitation teamwork competency in PGY doctors and nurses.<br>|
| Active Comparator: simulation-based learning<br>simulation education | Behavioral: simulation-based teamwork training<br>* Using board simulation-based learning to develop resuscitation teamwork competency in PGY doctors and nurses.<br>|
| Placebo Comparator: lecture-based learning<br>lecture education | Other: lecture-based teamwork training<br>* Using board lecture-based learning to develop resuscitation teamwork competency in PGY doctors and nurses.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change of medical team's teamwork performance | The medical team's teamwork performance was assessed by Chinese Version of Team Performance Observation Tool (TPOT) which consisted of 23 items. The team performance observation tool comprised of 5 main aspects including team structure, communication, leadership, situation monitoring, and mutual support. The scale was from 1 (Very disagree) to 5 (strongly agree), and the total score was 115. | The measure assessing change between three time points in medical team's teamwork performance. The pre-test (Baseline), immediate post-test after intervention (Time 2), and three months later after intervention (Time 3), respectively. | 
| The change of healthcare professionals' concept of knowledge for teamwork | The healthcare professionals' concept of knowledge for teamwork was assessed by TeamSTEPPS Learning Benchmarks which consisted of 23 items. TeamSTEPPS Learning Benchmarks' questions focus on medical teamwork and communication and their effect on quality and safety in patient care. Each question have 5 option but only one best answer. The total score was 115. | The measure assessing change between three time points in concept of knowledge for teamwork. The pre-test (Baseline), immediate post-test after intervention (Time 2), and three months later after intervention (Time 3), respectively. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change of healthcare professionals' team attitude | The healthcare professionals' team attitude was assessed by Interprofessional Collaboration Scale (IPC) which consisted of 26 items. IPC comprised of 3 main aspects including communication, accommodation and isolation. We adopted the first 13 items because those were related to medical and nursing professional background. The scale was from 1 (strongly disagree) to 4 (strongly agree), and the total score was between 13 and 52. | The measure assessing change between three time points in healthcare professionals' team attitude. The pre-test (Baseline), immediate post-test after intervention (Time 2), and three months later after intervention (Time 3), respectively. | 
| The change of healthcare professionals' resuscitation medical knowledge for medical management | The healthcare professionals' medical knowledge for medical management was assessed by ACLS Precourse Self-Assessment which consisted of 60 items. ACLS Precourse Self-Assessment comprised of 3 main aspects including rhythm identification, pharmacology and practical application. We selected the 20 items because those were related to resuscitation medical management (VT, VF, Asystole, PEA). The total score was 100. | The measure assessing change between three time points in resuscitation medical knowledge for medical management. The pre-test (Baseline), immediate post-test after intervention (Time 2), and three months later after intervention (Time 3), respectively. | 
| The change of medical team's resuscitation medical management | The medical team's resuscitation medical management was assessed by  medical management checklist . The checklist items is reference from 2020 American Heart Association Guidelines for CPR and ECC. 20 items were identified by our expert panel based on resuscitation guideline including applying adequate oxygen according to patient's dynamic condition, identifying cardiac arrest in time and keep providing high quality cardio-pulmonary resuscitation, identifying shockable rhythm and delivering in-time and correctly shock, administering resuscitation medicine correctly. The checklist was rated on a dichotomous scale with 2 (complete), 1 (patical), and 0 (incomplete).The total score was 20. | The measure assessing change between three time points in medical team's resuscitation medical management. The pre-test (Baseline), immediate post-test after intervention (Time 2), and three months later after intervention (Time 3), respectively. | 
| The healthcare professionals' learning cognitive load after intervention | The healthcare professionals' learning cognitive load was assessed by Chinese Version of Learning Cognitive Load questionnaires (Hwang & Yangru, 2013) which consisted of 8 items. The learning cognitive load questionnaires comprised of 2 main aspects including mental Load and mental efforts. The scale was from 1 (Very disagree) to 6 (strongly agree), and the total score was 48. | The immediate post-test after intervention. | 
| Course survey | Two questions for course satisfaction after board game-based learning. First question, how do you feel about your board game-based learning experience? (For example: any difficult or interesting, etc...). Second, are there any suggestions you can provide to help improve this course? | The immediate post-test after intervention. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Teamwork, Resuscitation, Team training