Welcome Guide for Trainers of Preprofessional Students

Welcome to the TeamSTEPPS^® curriculum.

TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety) addresses many users with various levels of TeamSTEPPS knowledge. This Welcome Guide calls attention to information of particular interest to people who will be training preprofessional students and who are familiar with TeamSTEPPS concepts and the needs and expectations of this audience. If you are also teaching frontline providers, you may also want to review the Welcome Guides for New Trainers or Experienced Trainers.

The TeamSTEPPS curriculum supports the needs of the 21st century healthcare workforce. This document highlights the key aspects of the TeamSTEPPS Course that trainers of preprofessional students should become familiar with.

What Is TeamSTEPPS?

TeamSTEPPS, an evidence-based program, is designed to optimize the performance of healthcare teams. Effective teamwork and communication are foundational to providing every patient with high-quality, safe care throughout the healthcare system. TeamSTEPPS has been developed in consultation with experts in teamwork and team training that included patients and family caregivers. It is guided by emerging research related to teams, team performance, communication, and adult learning, as well as input from frontline providers in care settings including hospitals, long-term care facilities, and outpatient practices.

Based on this guidance, five major emphases are reflected in the current version of the curriculum.

1. Patient Focus: How to involve patients and family caregivers in care processes and decision making is an important consideration for patient safety. Patients and family caregivers should be directly involved in care teams’ discussions. Examples, teaching approaches, and other resources in the curriculum are designed to reinforce this focus. The curriculum also considers additional communication and patient engagement methods, such as patient portals and telehealth tools and technology.

2. Integrated TeamSTEPPS Platform: TeamSTEPPS consolidates content from prior versions of the curriculum created for separate care settings and incorporates it into a single, integrated resource.

3. Modular Course Design: TeamSTEPPS can be taught in sessions of varying lengths. However, typically TeamSTEPPS training provided to preprofessional students is integrated into units on communication or teamwork and taught in relatively short segments with a focus on specific tools.
   
   The TeamSTEPPS curriculum is structured to enable preprofessional students to learn individual key concepts or tools without the need to cover all parts of the curriculum. Instructors are provided with guidance that will help them focus on the tools most relevant to the settings, challenges, and staff that your preprofessional students are likely to encounter.

4. Active Learning Strategies: The use of passive learning methods (e.g., listening to lectures) is less likely to produce sustainable changes in attitudes and behaviors of preprofessional students compared with active learning strategies, which today’s students expect. The curriculum is designed to provide a variety of options for helping you teach TeamSTEPPS using discussions, exercises, video-based simulations, and other approaches that your students can actively engage in.

5. Emerging Team Challenges and Opportunities: Technology changes such as high-speed internet, instant messaging, and telemedicine are accompanied by an evolution in the workforce, which is more diverse and multigenerational. TeamSTEPPS focuses on maximizing patient safety and makes connections between effective teamwork and the well-being, job satisfaction, and reduced burnout of frontline care providers. The curriculum calls attention to the ways a more diverse workforce can benefit team functioning.
   
   If you and your peers respect and support others whose backgrounds, politics, ethnicity, or other characteristics differ, the team will be able to better understand and address the needs of their increasingly diverse patient populations. The curriculum includes exercises and examples that incorporate newer communication technologies and can be tried out to directly experience how they affect communication with others. The team discussions include virtual teams and teams consisting of staff from multiple units or even multiple organizations that provide care to chronically ill or medically complex patients. Reinforcing the importance of these less visible but often critical teams can help your students function in them more successfully.

Why TeamSTEPPS Matters

As a teacher of preprofessional students, you have the opportunity to minimize the impact of poor communication and ineffective team leadership on patient safety, organizational efficiency, and staff morale, burnout, and turnover. Helping your students acquire and value TeamSTEPPS tools can enhance their ability to work better in teams to provide safe and quality care. Material in the Introduction reviews the connections between TeamSTEPPS and these outcomes and demonstrates the value TeamSTEPPS offers to the preprofessional students you will train.

• TeamSTEPPS tools help trainees to better cope with the stressors they face and to support their patients and peers.
• The expanded uses of communication technologies and electronic health records often pose challenges for some frontline providers you will teach. The curriculum provides relevant technical assistance to anyone who needs help in this general area.
• Public health emergencies have affected worker safety, family and other life routines, workplace protocols, and workloads and have contributed to tensions among staff with different life views. TeamSTEPPS tools and concepts can help you teach your students to better understand these risks and how to constructively cope with them.
• Changes in the job market linked to public health emergencies have expanded worker shortages, increased employee turnover, and undercut workplace stability. TeamSTEPPS can help your trainees more effectively manage challenges arising from rapid changes in teams.
• Levels of trust and mutual respect needed for effective team functioning can be threatened in teams with more diversity unless the differences are identified, directly acknowledged, and treated as an asset rather than an inconvenience.
• The expanded functionalities available in electronic health records risk an overdependence on technologies to facilitate care coordination at the expense of handoffs and other recommended practices for providing safe care to patients.
• Collectively, all these factors contribute to fatigue and burnout that create additional challenges for teams and risks for patients. TeamSTEPPS can assist in addressing these.

How To Approach the TeamSTEPPS Curriculum

Approaches to the TeamSTEPPS curriculum focus on acknowledging one’s own barriers to learning, embracing the positive aspects of incorporating new teamwork and communication strategies into practice, and recognizing the patient focus as the purpose of learning new skills.

• Acknowledge at the start that trainees may be stressed, distracted, and tired and that these factors can affect how well and quickly one can learn how to use TeamSTEPPS tools. Acquiring strategies to manage their stress and fatigue while in school can help equip them to cope with the challenging workforce they will join after they graduate. A 2020 survey of U.S. health workers found 38 percent reporting anxiety or depression, 43 percent reporting work overload, and 49 percent reporting burnout. Stress and fatigue make teaching preprofessional students even more challenging and effective teamwork even more important.
• While reflecting on patient harms that resulted from systemic and teamwork failures can have value, consider positive experiences that highlight the value of effective teamwork.
• It is easy to attend training sessions mechanically and "complete" them without much benefit. The use of active learning methods in the curriculum is designed to foster deeper engagement in the course.
• If patients or family caregivers are participating in the training, their stories of experiences with their care teams can remind your students of how effective teamwork has changed their lives for the better and of how important it is.

Evidence of TeamSTEPPS's Value

The TeamSTEPPS curriculum reflects published and gray literature reviewed as of December 2021. A summary of this literature is included in the Evidence Base section of the website, and key publications are reflected throughout the curriculum.

For updates on research related to teamwork and its components, use the AHRQ Patient Safety Network (PSNET) website, which highlights new literature on a range of safety topics, including teamwork, communication, and safety culture. Use PSNet to monitor emerging insights on these topics and incorporate them into your daily work of caring for patients.

How To Use the TeamSTEPPS Curriculum

• The curriculum includes examples, exercises, videos, and other resources directly relevant to specific clinical settings (long-term care, office practices, rapid response systems, etc.) and to diverse types of team participants (patients, support staff, administrators, etc.).
• Virtual trainings using an online platform or blended (hybrid) trainings with both virtual and in-person components are now common. Review the Virtual Training Guide, which provides tips and strategies to conduct virtual training.
• Several Welcome Guides are available, each focusing on a unique TeamSTEPPS audience. If you also teach frontline providers or work to implement TeamSTEPPS, other Welcome Guides may contain useful ideas.
• The Introduction includes foundational information on why patient safety can never be taken for granted, why safety culture and effective teamwork are essential, and how TeamSTEPPS enhances patient safety.
• The TeamSTEPPS curriculum is organized into four modules:
  • Module 1: Communication.
  • Module 2: Team Leadership.
  • Module 3: Situation Monitoring.
  • Module 4: Mutual Support.
• Each module has three sections:
  • Section 1: Overview of Key Concepts and Tools. Provides a quick overview. It can help identify information of particular interest or provide a quick review of available tools. The TeamSTEPPS Pocket Guide aligns with Section 1.
  • Section 2: Explanation of Key Concepts and Tools. Provides a deeper review of the concepts and tools included in the module. This section includes textual explanations as well as alternative ways to learn about these tools and concepts through videos, examples, case studies, etc. Resources for learning are drawn from multiple clinical settings and involve a variety of team members and both in-person and virtual teams. This approach is designed to help TeamSTEPPS users identify resources directly relevant to their situations.
  • Section 3: Teaching the Key Concepts and Tools. Includes instructor resources and rationales. The instructor resources provide both general guidance on approaches to teaching TeamSTEPPS effectively and specific strategies and approaches to teaching key concepts and tools in the module. They will also provide deeper insight into how tools can be used and why their use is critical.
• The Implementation Resources section includes resources that will be relevant to people responsible for implementing TeamSTEPPS (or parts of it) in a unit or organization. This section also includes teaching suggestions related to implementation topics. These suggestions may help expand your knowledge of key implementation processes and enable you to teach or guide their use within your organization.