Faculty Bibliography

Background: Pediatric emergency medicine (PEM) fellows must acquire necessary knowledge and skills to lead a multidisci- plinary team under crisis conditions. Without consistent training in teamwork, however, many PEM fellows rely on mock codes or rare resuscitation events for experiential learning. In order to introduce and practice teamwork behaviors and skills, we organized a 2-day multi-institutional, multidisciplinary program, BASE Camp 2010: Basic Training for Pediatric Emergency Medicine. Objectives: To determine the skills PEM fellows identified as essential for effective teamwork, and to characterize potential barriers to integrating these principles in practice. Methods: Using qualitative methods, we conducted two focus group interviews (n = 16). Fellows described their teamwork experiences at BASE Camp, how they would integrate team principles into future practice, and prior resuscitation experiences. Responses to open-ended questions were recorded, transcribed, and analyzed by a constant comparative method in Atlas.ti (qualitative data analysis program). Data were cross-coded to ensure agreement. Themes were identified by content analysis. The study was IRB-approved, and all subjects consented. Results: Seventeen PEM fellows (12 first and 5 second year) from 10 fellowships in NY, CT, and RI participated in BASE Camp (Oct 23-24, 2010). Twenty-nine percent were male. Five themes reflecting five core teamwork principles were identified; in order of response frequency: role clarity (37%), communication (26%), leadership (17%), situational monitoring (13%), and mutual support (7%). A sixth theme emerged from an inductive interpretation of coded data segments. Barriers to integrating the five core principles are categorized by: Hierarchy (n = 16): discomfort asserting teamwork principles with more experienced multidisciplinary practitioners. Inexperience (n = 15): challenges to integrating teamwork principles when resuscitation events are rare. Communication (n = 8): difficulty implementing communication strategies with colleagues untrained in teamwork principles. Conclusion: Fellows acquired basic teamwork principles during BASE Camp training and are eager to incorporate these behaviors and skills into future practice despite the barriers identified. BASE Camp may be useful to overcome these challenges, and our results will help inform future iterations of our educational intervention