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Health Sciences students train on team communication


Date: June 18, 2012
Media Contact: Ashley Wiggin,, 206-221-2456

Student session 5.31.12Student session 5.31.12Six UW health sciences students stood around the crying baby, reading vital signs and injecting medications; listening to its heartbeat and tracking lung function. When they failed to feel a pulse, the team rushed to start chest compressions.  The group was relieved to hear the baby start crying again, followed by a voice on the speaker saying “good job, everyone.”

The voice on the speaker, belonging to Seattle Children’s ER doctor Kimberly Stone, MD, was almost the only thing that set this simulated patient scenario apart from a trip to the real emergency room.

In the simulated  acute care environments of the Institute for Simulation and Interprofessional Studies (ISIS) at UWMC and Harborview Medical Center, over 300 students from the Schools of Nursing, Pharmacy, Medicine and the MEDEX (Physician’s Assistant) training program came together in late may for an immersive education experience focusing on team communication at the bedside. In interprofessional groups, made up of nursing, pharmacy, PA, and medical students, learners had the opportunity to experience adult, pediatric, or OB/GYN simulated acute care scenarios, depending on their area of clinical interest.  Simulations allowed learners to react and communicate with fellow-team members in a realistic but controlled clinical setting. For many, this was the first opportunity in their training careers to learn in a collaborative environment with students from another specialty.  The life-like models, controlled by a team of simulation technicians, and clinical faculty from UW Health Sciences, UWMC, Harborview Medical Center, and Seattle Children’s Hospital, can perform functions seen in real patients, such as irregular heartbeats, pain in various body parts, and even cardiac arrest.

“This was a great experience for us,” said nursing student Kathryn Arlan. “We haven’t had a lot of opportunities to work side by side like this other disciplines.”

Overwhelmingly positive student responses have prompted Medicine, Nursing, Pharmacy, and MEDEX programs to continue to work collaboratively to provide additional opportunities for interprofessional training well into the future.

Dan Low, a Seattle Children’s Anesthesiologist and faculty member in the UW’s Department of Anesthesiology and Pain Medicine, led the pediatric acute care sessions with the students. Low also leads a monthly interprofessional crew resource management (CRM) training day which addresses a gap in current training programs.  It draws students from medicine, nursing and pharmacy and trains them in communication and teamwork strategies used successfully in aviation and other high risk industries.

The students learn fundamentals in science of human factors; specifically about leadership, situational awareness, communication, decision making and problem solving.

“It was a privilege to lead a team of instructors to train our next generation of graduating students entering pediatrics in these concepts,” said Low. “It’s always amazing to watch them grasp the concepts from the workshop and apply them in the simulator when immersed in scenarios designed to stress the teams.”

According to a report from the Institute of Medicine, healthcare errors cause up to 98,000 deaths each year. Data from JCAHO from 1995-2005 analyzing 3500 sentinel events indicates that the leading root cause of 2/3s of these cases is a breakdown in communication and teamwork (or human error).

Student comm session 5.31.12Student comm session 5.31.12“Other industries such as aviation have used proven techniques to transform their safety profiles with dramatic effect,” said Low. “Yet most medical, nursing and pharmacy curricula still fail to deliver this critical training in human factors.”

In 2008, the University of Washington received over $1 million of funding from the Josiah Macy Jr. Foundation and the Hearst Foundation to develop an interprofessional curriculum for healthcare professional students based on the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) model of effective communication. Led by the efforts of Brenda Zierler, Professor in the School of Nursing’s department of Biobehavioral Nursing and Health Systems, and Brian Ross, Professor in the Department of Anesthesiology and Pain Medicine, and additionally supported by faculty and staff from Harborview Medical Center, UWMC, UW Health Sciences Schools, and Seattle Children’s, the resulting experience combines both clinical practice and team skills in a simulated training environment.

Following each simulated patient scenario, the students completed an in-depth debriefing session to better understand how to improve team communication with each other (and ultimately improve patient care/safety) when dealing with these high-stress situations.

“They had measurable performance indicators in the simulations which would score them higher than ‘professional teams’ – this effect was directly due to how well they worked together, the excellent teamwork more than making up for their relative lack of clinical experience.,” said Low. “The student feedback is very encouraging, we are witnessing a new generation of healthcare professionals who want to create a safer culture for their patients.”


The University of Washington School of Nursing is consistently a top-rated nursing school, according to U.S. News & World Report. Ranked No. 3 in research funding from the National Institutes of Health, the UW School of Nursing is a national and international leader in improving the health and well-being of individuals, families and communities. The school addresses society’s most pressing challenges in health care through innovative teaching, award winning research and community service. For more information, visit