Journal of Surgical Simulation 2019; 6: 39 - 44

Published: 15 November 2019


Original article

Single-group analysis of simulation training improves the ability of anesthesiologist assistant students to use TeamSTEPPS during crisis management scenarios

Trine Vik, Ferenc Puskas and Erik Nelson
Corresponding author: Trine Vik, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 80045, USA. Email:


Background: Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was developed to increase patient safety through improved health care teamwork skills. The purpose of this investigation was to determine whether the teamwork skills of anesthesiologist assistant (AA) students improve after training with simulated crisis management scenarios.

Methods: This is a single-group pre-intervention and post-intervention study that included 12 students and four evaluators during crisis management simulations. Student self-assessment surveys and preceptor evaluation forms were administered before and after the intervention. The self-assessment survey evaluated their knowledge of and clinical utility of TeamSTEPPS strategies, and how well they applied specific TeamSTEPPS skills. The preceptors evaluated how the students performed the TeamSTEPPS skills along with their knowledge of principles and team structure. The survey and evaluation questions used a 5-point Likert scale. The intervention consisted of teaching the students the TeamSTEPPS Essentials course and giving feedback between the two crisis management scenarios. 

Results: Student self-evaluation scores on TeamSTEPPS knowledge (1.25–4.08, P < 0.001), utility (3.75–4.75, P = 0.03), leadership (2.08–3.17, P = 0.02), and mutual support (2.42–3.25, P = 0.03) showed improvement. Differences in student self-evaluation scores on communication (3.25–3.50, P = 0.55) were non-significant. Preceptor evaluation for TeamSTEPPS knowledge (1.52–3.85, P < 0.001), team structure (1.96–4.08, P <  0.001), leadership (2.33–3.52, P = 0.006), communication (2.54–3.61, P = 0.023), mutual support (2.08–3.27, P = 0.005), and situational awareness (2.40–3.69, P = 0.002) all showed significant improvement.

Conclusion: This innovative curriculum helps AA students to learn the principles of TeamSTEPPS and improves their performance during simulated crisis management scenarios.


simulation training; anesthesia assistants; graduate medical education; competency-based education; patient safety; health care crew resource management