Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing

Abstract Background Effective information sharing is crucial for emergency care teams to maintain an accurate shared mental model. This study describes the design, simulation-based testing and implementation of a team reflexivity aid to facilitate in-action information sharing during resuscitations....

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Main Authors: Lars Mommers, Dennie Wulterkens, Steven Winkel, Bas van den Bogaard, Walter J. Eppich, Walther N. K. A. van Mook
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Advances in Simulation
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Online Access:https://doi.org/10.1186/s41077-025-00340-8
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author Lars Mommers
Dennie Wulterkens
Steven Winkel
Bas van den Bogaard
Walter J. Eppich
Walther N. K. A. van Mook
author_facet Lars Mommers
Dennie Wulterkens
Steven Winkel
Bas van den Bogaard
Walter J. Eppich
Walther N. K. A. van Mook
author_sort Lars Mommers
collection DOAJ
description Abstract Background Effective information sharing is crucial for emergency care teams to maintain an accurate shared mental model. This study describes the design, simulation-based testing and implementation of a team reflexivity aid to facilitate in-action information sharing during resuscitations. Methods A five-phase team-centred iterative design process was employed. Phase 1 involved a literature review to identify in-action cognitive aids. Phase 2 focused on conceptual design, followed by simulation-based testing and modifications in phase 3. Implementation through simulation-based user training occurred in phase 4 at a large non-university teaching hospital. Phase 5 evaluated the aid among resuscitation team members in the emergency department after one year. Results The phase 1 literature review identified 58 cognitive aids, with only 10 designed as ‘team aid’. Studies using team information screens found increase team and task performance in simulation-based environments, with no evaluations in authentic workplaces. Phase 2 resulted in a three-section team reflexivity aid, iteratively modified in three rounds of simulation-based testing (N = 30 groups) phase 3 resulted in a team reflexivity aid containing five sections: resuscitation times and intervals, patient history, interventions on a longitudinal timeline, differential diagnosis and a quick review section. Phase 4 consisted of reflexivity aid user training with simulation-based education (N = 60 sessions) and the creation of a digital entry form to store data in the patient’s electronic medical record. Evaluation after one year in phase 5, (N = 84) showed perceived improvements in communication (3.82 ± 0.77), documentation (4.25 ± 0.66), cognitive load (3.94 ± 0.68), and team performance (3.80 ± 0.76) on a 5-point Likert scale. Thematic analysis of user feedback identified improvements in both teamwork and taskwork. Teamwork enhancements included better situation awareness, communication and team participation. Taskwork improvements were seen in drug administration and clinical reasoning. Conclusions This study demonstrated the successful development and implementation of a Team Reflexivity Aid for Cardiac arrests using simulation methodology. This task-focused team tool improved perceived team situation awareness, communication, and overall performance. The research highlights the interplay between task- and teamwork in healthcare settings, underscoring the potential for taskwork-oriented tools to benefit team dynamics. These findings warrant further investigation into team-supportive interventions and their impact on resuscitation outcomes.
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spelling doaj-art-d35dcaa3edd74ebf83e01c31ce48b5702025-08-20T02:49:26ZengBMCAdvances in Simulation2059-06282025-03-0110111810.1186/s41077-025-00340-8Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharingLars Mommers0Dennie Wulterkens1Steven Winkel2Bas van den Bogaard3Walter J. Eppich4Walther N. K. A. van Mook5Department of Simulation in Healthcare, MUMCMedical Quality Training InstituteDepartment of Intensive Care Medicine, OLVGDepartment of Intensive Care Medicine, OLVGFaculty of Medicine, Dentistry and Health Sciences, University of MelbourneSchool of Health Professions Education, Maastricht UniversityAbstract Background Effective information sharing is crucial for emergency care teams to maintain an accurate shared mental model. This study describes the design, simulation-based testing and implementation of a team reflexivity aid to facilitate in-action information sharing during resuscitations. Methods A five-phase team-centred iterative design process was employed. Phase 1 involved a literature review to identify in-action cognitive aids. Phase 2 focused on conceptual design, followed by simulation-based testing and modifications in phase 3. Implementation through simulation-based user training occurred in phase 4 at a large non-university teaching hospital. Phase 5 evaluated the aid among resuscitation team members in the emergency department after one year. Results The phase 1 literature review identified 58 cognitive aids, with only 10 designed as ‘team aid’. Studies using team information screens found increase team and task performance in simulation-based environments, with no evaluations in authentic workplaces. Phase 2 resulted in a three-section team reflexivity aid, iteratively modified in three rounds of simulation-based testing (N = 30 groups) phase 3 resulted in a team reflexivity aid containing five sections: resuscitation times and intervals, patient history, interventions on a longitudinal timeline, differential diagnosis and a quick review section. Phase 4 consisted of reflexivity aid user training with simulation-based education (N = 60 sessions) and the creation of a digital entry form to store data in the patient’s electronic medical record. Evaluation after one year in phase 5, (N = 84) showed perceived improvements in communication (3.82 ± 0.77), documentation (4.25 ± 0.66), cognitive load (3.94 ± 0.68), and team performance (3.80 ± 0.76) on a 5-point Likert scale. Thematic analysis of user feedback identified improvements in both teamwork and taskwork. Teamwork enhancements included better situation awareness, communication and team participation. Taskwork improvements were seen in drug administration and clinical reasoning. Conclusions This study demonstrated the successful development and implementation of a Team Reflexivity Aid for Cardiac arrests using simulation methodology. This task-focused team tool improved perceived team situation awareness, communication, and overall performance. The research highlights the interplay between task- and teamwork in healthcare settings, underscoring the potential for taskwork-oriented tools to benefit team dynamics. These findings warrant further investigation into team-supportive interventions and their impact on resuscitation outcomes.https://doi.org/10.1186/s41077-025-00340-8Team reflexivityTeam reflectionNon-technical skillsTeam performanceTeam mental modelShared mental model
spellingShingle Lars Mommers
Dennie Wulterkens
Steven Winkel
Bas van den Bogaard
Walter J. Eppich
Walther N. K. A. van Mook
Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
Advances in Simulation
Team reflexivity
Team reflection
Non-technical skills
Team performance
Team mental model
Shared mental model
title Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
title_full Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
title_fullStr Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
title_full_unstemmed Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
title_short Getting ON-TRAC, a team-centred design study of a reflexivity aid to support resuscitation teams’ information sharing
title_sort getting on trac a team centred design study of a reflexivity aid to support resuscitation teams information sharing
topic Team reflexivity
Team reflection
Non-technical skills
Team performance
Team mental model
Shared mental model
url https://doi.org/10.1186/s41077-025-00340-8
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