Targeted Simulation-based Leadership Training for Trauma Team Leaders

OBJECTIVES/SPECIFIC AIMS: The objective of this research was to assess the clinical impact of simulation-based team leadership training on team leadership effectiveness and patient care during actual trauma resuscitations. This translational work addresses an important gap in simulation research and medical education research. METHODS/STUDY POPULATION: Eligible trauma team leaders were randomized to the intervention (4-hour simulation-based leadership training) or control (standard training) condition. Subject-led actual trauma patient resuscitations were video recorded and coded for leadership behaviors (primary outcome) and patient care (secondary outcome) using novel leadership and trauma patient care metrics. Patient outcomes for trauma resuscitations were obtained through the Harborview Medical Center Trauma Registry and analyzed descriptively. A one-way ANCOVA analysis was conducted to test the effectiveness of our training intervention versus a control group for each outcome (leadership effectiveness and patient care) while accounting for pre-training performance, injury severity score, postgraduate training year, and days since training occurred. Association between leadership effectiveness and patient care was evaluated using random coefficient modeling. RESULTS/ANTICIPATED RESULTS: Sixty team leaders, 30 in each condition, completed the study. There was a significant difference in post-training leadership effectiveness [F(1,54)=30.19, p<.001, η2=.36] between the experimental and control conditions. There was no direct impact of training on patient care [F(1,54)=1.0, p=0.33, η2=.02]; however, leadership effectiveness mediated an indirect effect of training on patient care. Across all trauma resuscitations team leader effectiveness correlated with patient care (p<0.05) as predicted by team leadership conceptual models. DISCUSSION/SIGNIFICANCE OF IMPACT: This work represents a critical step in advancing translational simulation-based research (TSR). While there are several examples of high quality translational research programs, they primarily focus on procedural tasks and do not evaluate highly complex skills such as leadership. Complex skills present significant measurement challenges because individuals and processes are interrelated, with multiple components and emergent nature of tasks and related behaviors. We provide evidence that simulation-based training of a complex skill (team leadership behavior) transfers to a complex clinical setting (emergency department) with highly variable clinical tasks (trauma resuscitations). Our novel team leadership training significantly improved overall leadership performance and partially mediated the positive effect between leadership and patient care. This represents the first rigorous, randomized, controlled trial of a leadership or teamwork-focused training that systematically evaluates the impact on process (leadership) and performance (patient care).

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Using cervical spine clearance guidelines in a pediatric population: a survey of physician practices and opinions

CJEM ◽

10.2310/8000.2011.100220 ◽

2011 ◽

Vol 13 (01) ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Emma C. Burns ◽

Natalie L. Yanchar

Keyword(s):

Cervical Spine ◽

Design Method ◽

Pediatric Population ◽

Trauma Team ◽

Pediatric Emergency ◽

Team Leaders ◽

Physician Practices ◽

Clinical Criteria ◽

Radiologic Imaging ◽

National Emergency

ABSTRACT Background: Unlike in adults, there are currently no standardized, validated guidelines to aid practitioners in clearing the pediatric cervical spine (C-spine). Many pediatric centres in Canada have locally produced, adult-modified guidelines, but the extent to which these or other guidelines are used is unknown. Objective: The purpose of this study was to determine if Canadian physicians are using either locally produced or adult C-spine guidelines to clear the C- spines of patients < 16 years of age. The study also characterized the common methods used by physicians to clear pediatric C-spine injuries in terms of clinical examination and radiologic imaging. Methods: A 20-question survey was distributed to 240 Canadian pediatric emergency physicians and trauma team leaders using the Dillman Total Design Method. Results: The response rate was 68%. The results showed that 61% of physicians currently use guidelines to assist in the clearance of pediatric C-spines. Of those physicians not using guidelines, 85% stated that they would use them if they were available. The clinical criteria most often used to clear pediatric C-spines were a normal neurologic examination (97%) and the absence of C-spine tenderness (95%), intoxication (94%), and distracting injuries (87%). Conclusions: Guidelines are commonly used by Canadian physicians when clearing the pediatric C-spine, yet few are validated in children. Those most commonly used are locally developed guidelines, the Canadian C-spine guidelines, or National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria.

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Experienced trauma team leaders save the lives of multiple-trauma patients with severe head injuries

Surgery Today ◽

10.1007/s00595-018-1723-y ◽

2018 ◽

Vol 49 (3) ◽

pp. 261-267

Author(s):

Zhi-Jie Hong ◽

Cheng-Jueng Chen ◽

De-Chuan Chan ◽

Teng-Wei Chen ◽

Jyh-Cherng Yu ◽

...

Keyword(s):

Multiple Trauma ◽

Head Injuries ◽

Trauma Team ◽

Trauma Patients ◽

Team Leaders ◽

Multiple Trauma Patients

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Leadership training and delivery prospects of team leaders in Communication Network Support Services Limited, Ilorin

Africa’s Public Service Delivery and Performance Review ◽

10.4102/apsdpr.v5i1.139 ◽

2017 ◽

Vol 5 (1) ◽

Author(s):

Abdulahi G. Olatunji ◽

Ademola Ojelabi ◽

Abdulwaheed A. Isiaq ◽

Issah Moshood ◽

Amali S. Ewaoda

Keyword(s):

Leadership Training ◽

Survey Design ◽

Industrial Relations ◽

Sampling Technique ◽

Simple Random Sampling ◽

Work Organisation ◽

Team Leaders ◽

Chi Square ◽

Statistical Tool ◽

Network Support

Training and development of staff has been one of the key focuses of every human resources department of any formal work organisation. This is as a result of the realisation that training is an important determinant of people’s behaviour as well as their general delivery ability at work. In realisation of this, intellectuals and researchers in industrial relations generally have put vested interest in the phenomena of training and work delivery ability. However, despite the enormous volume of literatures available in this regard, very few among them have specifically examined the importance of leadership training as a possible determinant of work delivery. Thus, this study is an attempt to cover this gap. In order to achieve this objective, survey design was used as the research design for the study. A questionnaire was used to elicit information from the respondents, while simple random sampling technique was used to select the study sample. Frequency distribution and percentage were used as descriptive tools, while chi-square was used as an inferential statistical tool in the study. The study found out that leadership training has a significant relationship with the identified work delivery elements measured in the study. The study concluded that leadership training has a significant effect on delivery ability of team leaders and thus recommended that leadership training should be given utmost priority in work organisations so that work delivery prospects of the employees could be realised.

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Clinical handover from emergency medical services to the trauma team: A gap analysis

CJEM ◽

10.1017/cem.2019.438 ◽

2020 ◽

Vol 22 (S2) ◽

pp. S21-S29

Author(s):

Arshia P. Javidan ◽

Avery B. Nathens ◽

Homer Tien ◽

Luis T. da Luz

Keyword(s):

Emergency Medical Services ◽

Gap Analysis ◽

Trauma Team ◽

Trauma Centre ◽

Medical Services ◽

Active Listening ◽

Team Leaders ◽

Process Measures ◽

Team Members ◽

Emergency Medical

ABSTRACTObjectivesThere has been limited evaluation of handover from emergency medical services (EMS) to the trauma team. We sought to characterize these handover practices to identify areas of improvement and determine if handover standardization might be beneficial for trauma team performance.MethodsData were prospectively collected over a nine-week period by a trained observer at a Canadian level one trauma centre. A randomized scheduled was used to capture a representative breadth of handovers. Data collected included outcome measures such as duration of handover, structure of the handover, and information shared, process measures such as questions and interruptions from the trauma team, and perceptions of the handover from nurses, trauma team leaders and EMS according to a bidirectional Likert scale.Results79 formal verbal handovers were observed. Information was often missing regarding airway (present 22%), breathing (54%), medications (59%), and allergies (54%). Handover structure lacked consistency beyond the order of identification and mechanism of injury. Of all questions asked, 35% were questioning previously given information. The majority of handovers (61%) involved parallel conversations between team members while EMS was speaking. There was a statistically significant disparity between the self-evaluation of EMS handovers and the perceived quality determined by nurses and trauma team leaders.ConclusionsWe have identified the need to standardize handover due to poor information content, a lack of structure and active listening, information repetition, and discordant expectations between team members. These data will guide the development of a co-constructed framework integrating the perspectives of all team members.

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