Tools for structured team communication in pre-registration health professions education: a Best Evidence Medical Education (BEME) review: BEME Guide No. 41

Abstract

Introduction: Calls for the inclusion of standardized protocols for information exchange into pre-registration health professions curricula have accompanied their introduction into clinical practice. In order to help clinical educators respond to these calls, we have reviewed educational interventions for pre-registration students that incorporate one or more of these ?tools for structured communication?.

Methods: Searches of 10 databases (1990?2014) were supplemented by hand searches and by citation searches (to January 2015). Studies evaluating an intervention for pre-registration students of any clinical profession and incorporating at least one tool were included. Quality of included studies was assessed using a checklist of 11 indicators and a narrative synthesis of findings undertaken.

Results: Fifty studies met our inclusion criteria. Of these, 21 evaluated the specific effect of a tool on educational outcomes, and 27 met seven or more quality indicators.

Conclusions: Pre-registration students, particularly those in the US, are learning to use tools for structured communication either in specific sessions or integrated into more extensive courses or programmes; mostly ‘Situation Background Assessment Recommendation’ and its variants. There is some evidence that learning to use a tool can improve the clarity and comprehensiveness of student communication, their perceived self-confidence and their sense of preparedness for clinical practice. There is, as yet, little evidence for the transfer of these skills to the clinical setting or for any influence of teaching approach on learning outcomes. Educators will need to consider the positioning of such learning with other skills such as clinical reasoning and decision-making.

Acknowledgements

We would like to thank Frances Arnull, Adrian Buckley, Alessandro Lazdins, Jens Murphy and Flemming Jakobsen for assistance with translation; Lisa Hill for assistance with retrieval of articles; and Kathryn Buckley for clerical support. We would also like to thank Rhona Patey, Stuart Marshall and Marilyn Hammick for their advice during the preparation of our review protocol.

Disclosure statement

Jonathan Stewart is a Master TeamSTEPPS^® instructor. No conflicts of interest are known to the authors.

Funding

This study was funded in part by a National Teaching Fellowship awarded to Sharon Buckley by the Higher Education Academy, UK.

Notes on Contributors

Sharon Buckley MSc PhD PGCE DipSciComm FHEA, is Senior Lecturer in Medical Education at the University of Birmingham. Her interests centre on the development of professional skills such as teamwork and communication. She is co-founder of the BEME International Collaborating Centre ?CUB2E2?, has completed a previous BEME systematic review and is a National Teaching Fellow (2010).

Lucy Ambrose MD, is a General Practitioner and former Senior Lecturer and Director of Clinical Skills at Keele University, UK. Her research interests include patient safety, human factors and error in skills performance.

Elizabeth Anderson BSc (Hons) PhD SRN, SCM, HV PGCHE, is Professor of Interprofessional Education at the University of Leicester and a National Teaching Fellow (2007). She is Lead for Patient Safety at Leicester Medical School and has published widely in the areas of interprofessional education and patient safety.

Jamie J. Coleman MA (Med Ed), MD, FRCP (UK), FBPhS, is Professor of Clinical Pharmacology and Medical Education at the University of Birmingham. He is Deputy Programme Director of the Birmingham MBChB programme and has completed a previous BEME systematic review.

Marianne Hensman MSc, is a Chartered Physiotherapist and Teaching Associate in the School of Sport, Exercise and Rehabilitation at the University of Birmingham. Her research interests include the evaluation of new educational initiatives, particularly in the area of interprofessional education.

Christine Hirsch MSc, PhD, is a registered pharmacist, Senior Lecturer in Clinical Pharmacy and Director of Clinical Pharmacy Education for the MPharm pharmacy programme at the University of Birmingham. Her research interests include end of life care and pharmacy education with a particular interest in interprofessional education.

James Hodson BSc, is a statistician at Queen Elizabeth Hospital Birmingham. He provides statistical consultancy to clinical and educational projects both at the hospital and at the University of Birmingham.

David Morley MA (currently undertaking an EdD), is an education development specialist at the University of Birmingham with a particular interest and expertise in curriculum development. He has completed a previous BEME systematic review.

Sarah Pittaway PhD, is Academic Services Team Leader at the University of Worcester (formerly subject librarian in the College of Medical and Dental Sciences, University of Birmingham). Sarah has extensive expertise in literature searching and retrieval.

Jonathan Stewart MBChB MD PGCE (MedEd) FRCS (Ed) FRCS (Eng), is a retired consultant surgeon, formerly at the Heart of England NHS Foundation Trust, UK. His interests include human factors and patient safety. He is a Master Team STEPPS? instructor, advises health organisations in team training and is a specialist advisor to the UK Care quality Commission.