Twelve tips for integrating team reflexivity into your simulation-based team training

Abstract

Due to increasing complexity in healthcare, clinicians must often make decisions under uncertain conditions in which teams must be flexible and process emerging information “on the fly” in order to adapt to changing circumstances. A crucial strategy that helps teams to adapt, learn, and develop is team reflexivity (TR) – a team’s ability to collectively reflect on group objectives, strategies, processes, and outcomes of past and current performance and to adapt accordingly. We provide 12 evidence-based tips on incorporating TR into simulation-based team training (SBTT). The first three points elaborate on basic principles of TR, when TR can take place and why it matters. The following nine tips are then organized according to three phases in which teams are able to engage in TR: pre-action, in-action, and post-action. SBTT represents an ideal venue to train various TR behaviors that foster team learning and improve patient care.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Jan B. Schmutz

Jan B. Schmutz, PhD, is researcher and lecturer at the Department of Management, Technology and Economics of the ETH Zurich, Zurich, Switzerland. As a psychologist and healthcare simulation educator, his interests include teamwork and in particular team reflexivity in medical teams but also in teams from other industries where teams have to deal with challenging and extreme environments.

Michaela Kolbe

Michaela Kolbe, PhD, is director of the Simulation Centre of the University Hospital Zurich, Zurich, Switzerland. Her interests include debriefing and the social dynamics of “speaking up” across the authority gradient and across disciplines in healthcare.

Walter J. Eppich

Walter J. Eppich, MD, MEd, is associate professor of pediatrics emergency medicine and medical education at Northwestern University Feinberg School of Medicine, Chicago, Illinois. His interests include healthcare debriefing and team reflexivity. He studies the intersections between workplace- and simulation-based learning, focusing on the role of talk as a medium for individual and team learning.