Team FIRST: an innovative educational strategy for teaching teamwork competencies to medical students

Effective teamwork is paramount for the delivery of safe and reliable patient care. For high-level performance, team members must develop core teamwork competencies early in their careers. Although training approaches exist for professionals working in a clinical setting, a consensus on how best to deliver competency-based teamwork education to medical students beginning their healthcare careers is lacking. The Team FIRST curriculum consists of a series of five modules designed to inform, demonstrate, allow practice, and provide feedback to learners participating in role-playing and guided discovery experiences. The modules are designed to build confidence and competence in ten foundational teamwork competencies needed for clinical work and to prime learners for on-the-job teamwork training throughout their careers. Collectively, these modules provide up to ten hours of learning activities using medical scenarios, experiential learning, interprofessional activities, and practice giving and receiving patient handovers. Internally developed instruments assess participant reactions and self-efficacy beliefs (i.e., confidence) for all modules, as well as teamwork competencies needed for safe patient handovers in Modules 2 and 5. The curriculum and related learning activities are based on an iterative, user-centered, mixed-methods approach consistent with adult learning theory. The Team FIRST curriculum was delivered to five cohorts of medical students (n = 1,162) by 230 instructors between July 2023 and June 2024. Students reported significant improvement in self-efficacy from pre- to post-surveys in all modules. Competency-based teamwork skills were assessed in Module 2 (low-complexity handover) and Module 5 (moderate-complexity handover). Students appear to give and receive handovers more effectively in Module 5 (post-clerkship) despite the higher complexity. Our findings show the learning activities were well received, improved learner confidence in using teamwork skills, and established proficiency in entrustable professional activities (EPAs), like giving and receiving patient handovers (EPA 8). The Team FIRST education and implementation strategies improve student learning outcomes and produce a competency-based assessment for safe patient handovers. Institutional capacity for transferring teamwork skills to the clinical learning environment is enhanced by developing an experienced cadre of faculty from every department using an iterative, participatory design approach for curriculum development and implementation.