Board 537 - Technology Innovations Abstract Teamwork Training in the Virtual Environment (Submission #1374)

Introduction/Background Objectives: To improve multidisciplinary teamwork and communication through the use of TeamSTEPPS® principles in a simulated virtual learning environment. The null hypothesis is that teamwork and communication skills cannot be taught in a virtual environment. South Australia has a sparsely populated rural community with several geographically isolated townships. Providing face to face training for health care professionals in this environment is expensive and time consuming. We were interested in seeing if it was possible to provide quality training via the virtual environment, because this might circumvent some of the issues related to professional isolation. A partnership was established between Duke University (US) Human Simulation and Patient Safety Centre, Virtual Heroes (a US based software company) and the Safety and Quality Unit, Department for Health and Ageing in South Australia, to explore the feasibility of introducing a virtual environment to practice teamwork and communication skills while resolving a clinical scenario. This project was known as ‘ SimX’. SimX launched a virtual learning environment platform developed by Duke University and Virtual Heroes in 2013 to South Australian participants using gaming and avatars to two health unit teams in an obstetric setting at both a tertiary and country hospital and to undergraduate medical and midwifery students. The virtual environment was supported by two facilitators. Methods Participants received training in teamwork through the TeamSTEPPS program prior to entering the virtual environment. TeamSTEPPS is a teamwork and communication program developed by the Agency for Health Care Research and Quality and the Department of Defence (US) and has progressively been implemented across South Australian clinical health care teams and forms part of the curriculum for medical students. Participants then received an orientation to the virtual environment including how to navigate, communicate and operate their avatars in the delivery suite setting. Participants then entered the environment to address the clinical problem of a postpartum haemorrhage. Debriefing with facilitators occurred post scenario. Methodologies of debriefing in the virtual world were explored. Quantitative Methods were used to evaluate SimX including a pre and post assessment of teamwork attitudes (TAQ) and team skills questionnaire. Assessment of usability occurred through selected questions from the System Usability Scale (Bangor 2008) and the Virtual Reality Usability Scale (VRUSE) Kalawsky (1999) and additional questions were given to assess participant reaction to the training experience (Level 1 and 2 Kirkpatrick evidence). Qualitative method of evaluation occurred through the BARS scale to assess observable teamwork behaviours in both high and low performance (Level 3 Kirkpatrick evidence). Results: The outcomes of the project evaluation included a statistically significantly higher post training score in the following domains of teamwork as assessed by the Team Attitudes Questionnaire: team structure, situation monitoring, mutual support and communication. In relation to participant reaction to training, 74% of participants would use the system frequently and 76% agreed that the system was easy to use. Results: Conclusion Key learning’s from the SimX project included the importance and challenges of vision and innovation, liaison, international collaboration and developing a project team with the level of expertise required including ICT support and infrastructure, educational design, clinical skills and evaluation. We identified the importance of developing facilitator’s skills to lead the simulation and debriefing in the virtual learning environment. The emphasis placed on orientation of participants in the virtual environment and training in teamwork skills promoted immersion in the virtual learning environment. Finally the project team gained an insight into the opportunities that simulation in a virtual world has in educating our workforce and in providing the opportunity to practice in a safe environment with skilled facilitators and for participants to receive feedback on performance, while potentially staying in your own home town. Disclosures None.