Educating for teamwork--nursing students' coordination in simulated cardiac arrest situations.

AIM The overarching aim was to explore and describe the communicative modes students employ to coordinate the team in a simulation-based environment designed for resuscitation team training. BACKGROUND Verbal communication is often considered essential for effective coordination in resuscitation teams and enhancing patient safety. Although simulation is a promising method for improving coordination skills, previous studies have overlooked the necessity of addressing the multifaceted interplay between verbal and non-verbal forms of communication. METHOD Eighty-one nursing students participated in the study. The data were collected in February and March, 2008. Video recordings from 28 simulated cardiac arrest situations in a nursing programme were analysed. Firstly, all communicative actions were coded and quantified according to content analysis. Secondly, interaction analysis was performed to capture the significance of verbal and non-verbal communication, respectively, in the moment-to-moment coordination of the team. FINDINGS Three phases of coordination in the resuscitation team were identified: Stating unconsciousness, Preparing for resuscitation, Initiating resuscitation. Coordination of joint assessments and actions in these phases involved a broad range of verbal and non-verbal communication modes that were necessary for achieving mutual understandings of how to continue to the next step in the algorithm. This was accomplished through a complex interplay of taking position, pointing and through verbal statements and directives. CONCLUSION Simulation-based environments offer a promising solution in nursing education for training the coordination necessary in resuscitation teams as they give the opportunity to practice the complex interplay of verbal and non-verbal communication modes that would otherwise not be possible.