2 Post-Training Survey

Attachment B: TeamSTEPPS Post-Training Survey (DRAFT)

Form Approved
OMB No. XXXX-XXXX
Exp. Date XX/XX/20XX

TeamSTEPPS^® Post-Training Survey

Introduction

Congratulations on completing the TeamSTEPPS training! The following questions will gauge your attitude toward TeamSTEPPS concepts and help us identify aspects of the training program that are useful or need improvement.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is [####-####]. This information collection is to examine the degree to which the updated TeamSTEPPS program improves the team effectiveness and streamlines team communication. The time required to complete this information collection is estimated to average less than 20 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, to review and complete the information collection. This information collection is voluntary, will remain confidential, and all data will be reported only in aggregate. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: [mailing address] or [email address], Attention: Information Collections Clearance Officer.

Should you have any questions or comments about this survey or the TeamSTEPPS evaluation effort, please contact [NAME], [TITLE], at [EMAIL]. Additional information about the TeamSTEPPS program can be found at https://www.ahrq.gov/teamstepps-program/index.html.

The public reporting burden for this collection of information is estimated to average 20 minutes per response, the estimated time required to complete the survey. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to

AHRQ Reports Clearance Officer

Attention: PRA, Paperwork Reduction Project (NUMBER and EXPIRATION DATE to BE PROVIDED)

AHRQ

540 Gaither Road, Room # 5036

Rockville, MD 20850

Enter the date of your training and your organization’s name.

Date: ___________

Organization: _________

Section A: TeamSTEPPS Teamwork Attitudes Questionnaire

Respond to the questions below by marking the box that corresponds to your level of agreement from Strongly Agree to Strongly Disagree. Select only one response for each question.

Team Structure	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
1. It is important to ask patients and their families for feedback regarding patient care.
2. Patients are a critical component of the care team.
3. This facility's administration influences the success of direct care teams.
4. A team's mission is of greater value than the goals of individual team members.
5. Effective team members can anticipate the needs of other team members.
6. High-performing teams in healthcare share common characteristics with high performing teams in other industries.
Leadership	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
7. It is important for leaders to share information with team members.
8. Leaders should create informal opportunities for team members to share information.
9. Effective leaders view honest mistakes as meaningful learning opportunities.
10. It is a leader's responsibility to model appropriate team behavior.
11. It is important for leaders to take time to discuss with their team members plans for each patient.
12. Team leaders should ensure that team members help each other out when necessary.

Situation Monitoring	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
13. Individuals can be taught how to scan the environment for important situational cues.
14. Monitoring patients provides an important contribution to effective team performance.
15. Even individuals who are not part of the direct care team should be encouraged to scan for and report changes in patient status.
16. It is important to monitor the emotional and physical status of other team members.
17. It is appropriate for one team member to offer assistance to another who may be too tired or stressed to perform a task.
18. Team members who monitor their emotional and physical status on the job are more effective.
Mutual Support	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
19. To be effective, team members should understand the work of their fellow team members.
20. Asking for assistance from a team member is a sign that an individual does not know how to do his/her job effectively.
21. Providing assistance to team members is a sign that an individual does not have enough work to do.
22. Offering to help a fellow team member with his/her individual work tasks is an effective tool for improving team performance.
23. It is appropriate to continue to assert a patient safety concern until you are certain that it has been heard.
24. Personal conflicts between team members do not affect patient safety.

Communication	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
25. Teams that do not communicate effectively significantly increase their risk of committing errors.
26. Poor communication is the most common cause of reported errors.
27. Adverse events may be reduced by maintaining an information exchange with patients and their families.
28. I prefer to work with team members who ask questions about information I provide.
29. It is important to have a standardized method for sharing information when handing off patients.
30. It is nearly impossible to train individuals how to be better communicators.

[PROGRAMMER NOTE: IF TeamSTEPPS for Diagnosis Improvement Trainee, SKIP TO Section C]

Section B: TeamSTEPPS 3.0 Module-Based Reaction Items

Next, we would like to hear about your experiences with each of the modules you completed.

Introduction

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Describe the TeamSTEPPS Trainer course.	1	2	3
2.b.	Describe the impact of errors and why they occur	1	2	3
2.c.	Describe the TeamSTEPPS framework	1	2	3
2.d.	State the outcomes of the TeamSTEPPS framework	1	2	3
3.	To what extent were the teaching methods and aids effective?	1	2	3
4.	Please provide any additional comments:

Module 1: Communication

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Describe how communication affects team processes and outcomes.	1	2	3
2.b.	Define effective communication.	1	2	3
2.c.	Identify communication challenges.	1	2	3
2.d.	Identify TeamSTEPPS tools and strategies that can improve a team’s communication.	1	2	3
3.	To what extent were the teaching methods and aids effective?	1	2	3
4.	Please provide any additional comments:

Module 2: Team Leadership

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Understand the benefits of team structure in teamwork.	1	2	3
2.b.	Define “team.”	1	2	3
2.c.	Identify the role of patients and their families as part of the care team.	1	2	3
2.d.	Describe the components and composition of a multi-team system.	1	2	3
2.e.	Describe how leadership affects team processes and outcomes.	1	2	3
2f.	Identify different types of team leaders.	1	2	3
2g.	Describe the activities involved in successfully leading teams.	1	2	3
2h.	Describe the tools for leading teams, including briefs, huddles, and debriefs.
4.	Please provide any additional comments:

Module 3: Situation Monitoring

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Understand how situation monitoring affects team processes and outcomes.	1	2	3
2.b.	Explain situation awareness and identify approaches to maximize it.	1	2	3
2.c.	Define a shared mental model and understand how it is cultivated within a team.	1	2	3
2.d.	List the components of STEP and other mnemonic tools.	1	2	3
3.	Please provide any additional comments:

Module 4: Mutual Support

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Describe how mutual support affects team processes and outcomes.	1	2	3
2.b.	Discuss specific strategies to foster mutual support (e.g., task assistance, feedback).	1	2	3
2.c.	Identify specific tools to facilitate mutual support.	1	2	3
2.d.	Describe conflict resolution strategies.	1	2	3
3.	Please provide any additional comments:

Implementation

Instructions: Please use the provided rating scale to select one response to each question. Rating Scale: 1 = Poor, inadequate, did not meet, ineffective 2 = Good, adequate, met, effective 3 = Excellent, more than adequate, exceeded, very effective
Instructor Name:
	Item	Poor	Good	Excellent
1.	To what extent was the instructor effective in their presentation?	1	2	3
	To what extent were the following session objectives achieved?
2.a.	Learn to assess your readiness for TeamSTEPPS.	1	2	3
2.b.	Explain measurement’s role in successful implementation.	1	2	3
2c.	Describe key principles of change management.	1	2	3
2d.	List key characteristics of successful coaching.	1	2	3
2e.	Practice creating an Implementation Plan.	1	2	3
3.	Please provide any additional comments:

[PROGRAMMER NOTE: SKIP TO SECTION D]

Section C: TeamSTEPPS for Diagnostic Improvement Module-Based Reaction Items

Next, we would like to hear about your experiences with each of the modules you completed.

Module 1: Introduction Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Define diagnostic error and its importance as a patient safety issue.	1	2	3
2.b. Explain the impact of provider communication breakdowns on diagnostic error.	1	2	3
2.c. Describe TeamSTEPPS and explain why it is an important and appropriate intervention to reduce diagnostic error.	1	2	3
2.d. Introduce course materials and explain how to use them.	1	2	3

Module 2: Diagnostic Team Structure Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Define the diagnostic team.	1	2	3
2.b. Discuss benefits of teamwork and structure.	1	2	3
2.c. Describe behaviors, structures, and processes that affect diagnosis.	1	2	3
2.d. Empower all diagnostic team members to be active participants in the patient’s diagnostic journey.	1	2	3
2.e. Discuss barriers to effective teamwork.	1	2	3

Module 3: Communication To Improve Diagnostic Improvement Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Indicate what makes communication effective for diagnosis.	1	2	3
2.b. Describe structured communication methods that can increase diagnostic safety.	1	2	3
2.c. Describe diagnostic uncertainty and strategies for communicating uncertainty.	1	2	3

Module 4: Leadership To Improve Diagnosis Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Define effective leadership for diagnostic teams.	1	2	3
2.b. Provide guidance to lead and facilitate the improvement of diagnosis-related provider communication.	1	2	3
2.c. Demonstrate the utility of four leadership tools: briefs, debriefs, huddles, and reflection.	1	2	3

Module 5: Situation Monitoring Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Define how situation monitoring may affect diagnostic outcomes.	1	2	3
2.b. Apply TeamSTEPPS reflective practice and communication tools to improve diagnosis.	1	2	3
2.c. Create a shared mental model for achieving a prompt, accurate, and effectively communicated diagnosis.	1	2	3

Module 6: Mutual Support To Improve Diagnosis Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Describe how mutual support affects team processes and outcomes.	1	2	3
2.b. Discuss specific strategies to foster mutual support, such as task assistance and feedback.	1	2	3
2.c. Identify specific tools to facilitate mutual support.	1	2	3
2.d. Describe conflict resolution strategies.	1	2	3

Module 7: Putting It All Together Instructor Name:	Poor	Good	Excellent
1. To what extent was the speaker effective in their presentation?	1	2	3
To what extent were the following session objectives achieved?
2.a. Summarize diagnostic error and its importance as a patient safety issue.	1	2	3
2.b. Describe the core principles, resources, and tools of TeamSTEPPS for Diagnosis Improvement.	1	2	3
2.c. List the positive outcomes that can be realized with the successful use of the TeamSTEPPS tools and strategies.	1	2	3

Section D: Overall Course Evaluation

Please rate the overall course by responding to the following questions and statements.

1. Overall, I am satisfied with the TeamSTEPPS training.

☐Agree ☐Somewhat agree ☐Neither agree nor disagree ☐ Disagree

2. I gained new knowledge and/or skills from this training.

☐Agree ☐Somewhat agree ☐Neither agree nor disagree ☐ Disagree

3. I will be able to apply the knowledge and/or skills gained from this training to improve my performance as a member of my health care team.

4. ☐Agree ☐Somewhat agree ☐Neither agree nor disagree ☐ Disagree

5. The content of this training was relevant to the needs of my health care team.

6. ☐Agree ☐Somewhat agree ☐Neither agree nor disagree ☐Disagree

7. The scope of this training was appropriate for my professional competency needs.

8. ☐Agree ☐Somewhat agree ☐Neither agree nor disagree ☐ Disagree

9. What changes will you make in your practice after attending this training?

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10. How can the educational aspects of this training be improved?

______________________________________________________________________

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11. What recommendations do you have for the TeamSTEPPS trainers?

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12. Additional comments:

______________________________________________________________________

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Thank you for taking the time to provide feedback about the [PROGRAMMER INSERT: TeamSTEPPS 3.0 Trainer Program OR TeamSTEPPS for Diagnosis Improvement Course].