A Brain-Based Instruction Simulation Approach to Improve Code Team Response in an Internal Medicine Unit

AbstractBackground and Objectives. The code team course is a 3-hour, interactive course that follows a 4-phase brain-based lesson plan for simulation. Interprofessional teams receive instruction and practice in evidence-based teamwork, communication, and individual skills.Methods. This quantitative research included a pre-test and post-test design in an urban Department of Medicine. Sixteen groups n=109 participated in the course over a period of eight weeks. Classroom metrics included pre- and post-course High-Quality cardiopulmonary resuscitation CPR and code team didactic knowledge assessed by Wilcoxon rank-sum tests. In addition, four in-situ mock code simulations were conducted to provide the researchers with baseline and post-intervention data. Code team performance assessment scores were tallied and compared between baseline and post-intervention by Fisher's Exact Test.Results. The classroom metrics produced significant results. High-Quality CPR scores were higher post-training than pre-training median score 4 vs. 3, respectively; p=0.006. Didactic knowledge test scores were also significantly higher median score 90 vs. 70, respectively; p <0.001. In-situ team performance improved in several areas. There was a significant improvement in the area of cardiac code management in the day shift group. The percent ?done well? improved from 25% 5/20 to 100% 20/20 p= <0.001.Conclusion. The results of this pilot study suggest that code team training using the 4-phase BBL plan for simulation is associated with improvements in interprofessional team knowledge and performance during cardiac emergencies. It is equally important that the training is conducted over a short period in order to ensure that all team members are properly prepared.