• Robyn Clay-Williams, Catherine A McIntosh, Ross Kerridge, and Jeffrey Braithwaite.
• Faculty of Medicine, Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney NSW 2052, Australia. r.clay-williams@unsw.edu.au
• Int J Qual Health Care. 2013 Jul 1; 25 (3): 314-21.

ObjectiveTo test the hypotheses that classroom and simulation-based crew resource management (CRM) training interventions improve teamwork attitudes and behaviours of participants and that classroom training combined with simulation-based training provide synergistic improvements.DesignA randomized controlled trial.SettingArea Health Service in New South Wales, Australia.ParticipantsA total of 157 doctors, nurses and midwives randomized into one of four groups, consisting of three intervention groups and a control group.InterventionOne-day CRM-based classroom course; one-day CRM style simulation-based training or classroom training followed by simulation-based training.Main Outcome MeasuresPre- and post-test quantitative participant teamwork attitudes, and post-test quantitative trainee reactions, knowledge and behaviour.ResultsNinety-four doctors, nurses and midwives completed pre-intervention attitude questionnaires and 60 clinicians completed post-intervention assessments. No positive changes in teamwork attitudes were found associated with classroom or simulation training. Positive changes were found in knowledge (mean difference 1.50, 95% confidence interval (CI) 0.58-2.43, P = 0.002), self-assessed teamwork behaviour (mean difference 2.69, 95% CI 0.90-6.13, P = 0.009) and independently observed teamwork behaviour (mean difference 2.30, 95% CI 0.30-4.30, P = 0.027) when classroom-only trained group was compared with control; however, these changes were not found in the group that received classroom followed by simulation training.ConclusionsClassroom-based training alone resulted in improvements in participant knowledge and observed teamwork behaviour. The study found no additional impact of simulation training.

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