LEARNING TEAMWORK IS NOT AN EVENT; IT’S A JOURNEY: IMPLEMENTING THE TEAMSTEPPS® TEAM TRAINING PROGRAM IN BACHELOR OF NURSING EDUCATION TO ENHANCE PATIENT SAFETY

Aim: The overall aim of the thesis was to implement a longitudinal team training intervention in bachelor of nursing education and describe students’ reactions to team training, explore changes in their attitudes toward teamwork, and describe how they experienced teamwork skills in practice. Methods: This thesis is based on three studies, using quantitative and qualitative methods. Study Ⅰ investigated the validity and reliability of the Norwegian version of the Teamwork Attitudes Questionnaire (T-TAQ) when used in a sample of nursing students (n = 509). Data were analyzed via confirmatory factor analysis (CFA) (Ⅰ). In study Ⅱ and Ⅲ a team training intervention was conducted in a cohort of nursing students over 26 months. In Study Ⅱ, attitudes to teamwork were measured using the TTAQ at baseline (T0) and after the passage of 10 months (T1) and 24 months (T2) in the intervention and control groups. A total of 295 students participated. Data were analyzed using inferential and descriptive statistics (Ⅱ). In Study Ⅲ, students’ team training experiences and their use of teamwork skills in practice were examined via focus group interviews (n = 22). Data were analyzed via inductive content analysis (Ⅲ). Main results: The Norwegian version of the T-TAQ has some potential to display reliable and valid answers when used in a sample of nursing students (Ⅰ). Nursing students who participated in the team training showed significantly positive attitudinal changes with regard to teamwork (Ⅱ). Students initially experienced team training as complex and theoretical, but team training gradually increased their awareness that the practical application of teamwork skills facilitates the sense of being a team member, while also enhancing learning and patient safety in clinical practice (Ⅲ). Conclusion: It is recommended that the Norwegian version of the T-TAQ be considered unidimensional when used in a sample of nursing students. Team training positively affects students’ attitudes toward teamwork. However, grasping the principles of teamwork and the relevance of team training requires repeated training. The use of teamwork skills enhances students’ experiences of belonging to a team, enhance learning and patient safety in clinical placements. Team training should be an integrated part of the bachelor of nursing program to enhance patient safety