Are we on the same page Shared mental

Are we on the same page? Shared mental models to support clinical teamwork among health professions learners: A scoping review Leslie Carstensen Floren, Pharm. D, MA Doranne Donesky, RN, Ph. D, ANP Evans Whitaker, MD David Irby, Ph. D Olle ten Cate, Ph. D Bridget C. O’Brien, Ph. D 10/9/17

Session Learning Objectives By the end of the session, participants will be able to: • Define a “shared mental model” (SMM) • Describe qualitative and quantitative approaches to measuring SMMs • Discuss how we may apply the SMM construct to the design of educational interventions to support teamwork 2

Shared Mental Models & Teamwork Photo 1 § Team-based healthcare delivery • Struggle to “get on the same page” § Common understanding of tasks, roles = SMM • Organized Knowledge Shared X Team § SMMs support • Members’ ability to: predict, adjust, coordinate 3

Why Focus on SMMs in Health Professions Education? SMMs IMPROVE TEAMS INTERVENTIONS WORK • Processes • Performance • Facilitate SMM development Recognize, adapt, align MMs SMM of patient care Improved healthcare delivery 4

Study Purpose § To conduct a scoping review to: • Explore construct of SMMs in context of clinical teamwork among health professions learners • Identify gaps in current literature • Disseminate findings § Questions • How defined/applied? • Types of interventions? • Approaches to measurement? Photo 2 5

Methodological Framework 1. Identify Research Questions 2. Identify Relevant Studies Arksey & O’Malley, 2005; Levac et al. 2010 6 3. Study Selection 4. Chart Data 5. Collate, Summarize, Report Data

Results 1, 273 Records retrieved 7

Results: § SMM definitions ‒ SMM variably, infrequently defined (9/23) § Characterized as cognitive construct § Knowledge shared across members § Applications ‒ Hospital-based care (23/23) § High-intensity settings (14/23) ‒ Grad level MDs (21/23) 8 Image 1

Results: § Interventions ‒ Few interventions to foster SMM development (6/23) § Curricula, Team training, Tools • e. g. , checklist to develop SMM of Family-Centered Rounds § Measurement ‒ SMMs infrequently measured (7/23) • All included quantitative approaches • e. g. , surveys, concept maps, card sorting • One qualitative analysis 9

Discussion Recommendations/Actions • DEFINE: SMM to promote consistent usage • “An individually held, organized, cognitive representation of taskrelated knowledge and/or team-related knowledge held in common among health care professionals who must interact as a team in pursuit of common objectives for patient care. ” • DESIGN: use SMM construct to design team interventions • MEASURE: SMMs Directly or…. Indirectly 10

Acknowledgements Leslie Floren is funded by the Veterans Administration though the VA Advanced Fellowship Program in Health Professions Education Evaluation and Research

Image & Photo Credits • Photo 1 (Slide 2) ‒ https: //www. flickr. com/photos/dfid/16768375614/ [CC 2. 0] • Photo 2 (Slide 4) ‒ https: //upload. wikimedia. org/wikipedia/commons/1/13/US_Navy_071116 -N 1251 W 005_Hospital_corpsmen_assigned_to_the_Special_Medical_Operations_Respons e_Team_at_U. S. _Naval_Hospital_%28 USNH%29_Yokosuka%2 C_treat_a_simulate d_victim_during_a_bilateral_earthquake_response_drill. jpg; By U. S. Navy photo by Mass Communication Specialist 3 rd Class Matthew R. White [Public domain, via Wikimedia Commons] • Image 1 (Slide 8) ‒ https: //openclipart. org/pdf/169413/teamwork. pdf [Openclipart. org] 12

Background

How are SMMs characterized? • CONTENT DOMAINS • Taskwork • Goals & performance requirements related to team’s task What is a SMM? • Organized understanding / mental representation, shared across team members • CONTENT • Knowledge • Teamwork • Interpersonal interactions; team member K/S/A • PROPERTIES • Similarity • Accuracy • STRUCTURE • Organization of knowledge SMM 14 How are SMMs measured? • CONTENT • Survey instruments • Questionnaires • CONTENT + STRUCTURE • Paired comparisons • Card sorting • Concept mapping • Qualitative methods

Approach to Knowledge Synthesis • Scoping vs. Systematic Review ‒ Goal: comprehensive and inclusive exploration of SMM construct related to clinical teamwork in HPE context § Scoping methodology • Supports less restrictive inclusion criteria • Allows inclusion of information from many sources ‒ Few empirical studies of SMMs in HP trainees during initial exploration of construct Levac et al. , 2010; Colquhoun et al. , 2014 15

Discussion Attempted Application. . • Address GAPS: SMMs in learners in non-acute settings • Learner teams developing SMMS of care in Skilled Nursing Facility patients • Interviews focused on SMM of: • Falls Assessment (Task) • Professional roles (Team) • Did not reveal anything unexpected • Together for 2 weeks, saw one another’s roles “in action” • Perhaps less important in low acuity, synchronous care 16