The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students : a randomised controlled trial

Aims and objectives: The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes. Background: Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear. Design: Randomised controlled trial in a convenience sample (n=116) in Belgium. Data were collected between February 2015-April 2015. Methods: Participants in the intervention group (n=60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n=56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted. Results: The intervention group increased on self-efficacy (2.13%, p=.02) and team efficacy (9.92%, p<.001); the control group only increased significantly on team efficacy (4.5%, p=.001). The intervention group scored significantly higher on team efficacy (8.49%, p<.001) compared to the control group. Conclusion: Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects. Relevance to clinical practice: By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety