JMIR Publications

ABSTRACT

Background:

Team performance is crucial in crises. Recently, we validated the Thai version of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). Despite the validated assessment is provided in native language, challenges remain in accurately and consistently evaluating the assessment due to its subjective nature. To our knowledge, there has been no study about the relationship between students' electroencephalograms (EEG) and team performance assessed by TeamSTEPPS.

Objective:

This study aims to investigate the correlation between EEG brain-to-brain synchrony and TeamSTEPPS scores in groups of 6 multiprofessional students participating in online, virtual simulation-based interprofessional education (SIMBIE) sessions.

Methods:

A single-center university hospital study conducted from July 2022 to September 2023 involved 15 teams (90 participants), with each team consisting of 6 clinical students: 1 medical student, 2 nurses, 1 pharmacist, 1 medical technologist, and 1 radiological technologist. Teams used 3D virtual simulation for approximately 30 minutes for 2 sessions: The content focused on crisis training involving COVID pneumonia with difficult airway scenarios. In total, we conducted 30 experiment sessions. The students' screens were recorded to capture their activities during the simulations for further analyses. Of 15 teams, 5 teams conducted the experiments with VR headsets. The TeamSTEPPS scores of each student were assessed by 2 blinded matched-professional raters using corresponding recorded screen footages; in total, 12 multiprofessional trained raters were required to rate the 180 recorded screen footages. During the 3D virtual simulation, students' brain activity was recorded with an affordable wireless EEG acquisition device. EEG data were cleaned with independent component analysis, and used for computing total interdependence (TI), an EEG measure of brain-to-brain synchronization, between pairs of students during verbal communications. We then analyzed the Pearson correlation between TI and TeamSTEPPS scores.

Results:

Ninety students were informed consents and recruited. Of 90 students, 5 were excluded from our analyses due to exclusion criteria, resulting in 170 recorded screen footages remaining. Of these, 24 footages were excluded due to EEG excessive artifacts. Interrater reliability for the TeamSTEPPS scores among 12 raters indicated good agreement on average (mean 0.73, SD 0.18; range 0.32-0.999). Pearson correlations between each student's TIs and the respective TeamSTEPPS scores for all participants were weak and not statistically significant (all adjusted P values≥.05). However, strongly negative, statistically significant correlations between group TIs and group TeamSTEPPS scores in the alpha frequency band (8-12 Hz) of the anterior brain area were found after correcting for multiple comparisons (mean −0.87, SD 0.06; range −0.93-−0.8).

Conclusions:

Strong negative correlations were observed between the anterior alpha activity, measured by the group TI, and the group TeamSTEPPS scores during online hexad virtual SIMBIE. Anterior alpha TI shows potential as an objective indicator for evaluating TeamSTEPPS performance. Clinical Trial: None