Upcoming September ‘TeamSTEPPS Trainer Essentials Plus’ Courses by Dr. Timothy Clapper at PA Global Institute for Sim Training


Word today is about an upcoming September 4th early-bird deadline to participate in Dr. Timothy Clapper’s Upcoming September/October TeamSTEPPS Trainer Essentials Plus courses. Dr. Clapper was the SimGHOSTS 2013 USA keynote speaker where he spoke on the ability for TeamSTEPPS to be utilized not only for healthcare to healthcare discussions, but also for healthcare to simulation staff conversations. It’s a communication tool set that enhances performance and patient safety.

Read our other simulation TeamSTEPPS articles by with Dr. Timothy Clapper:

Poor communication and teamwork can lead to under-performing clinical teams and errors that disrupt even the best patient safety initiatives. TeamSTEPPS can make a difference for organizations, but only if the organizations and clinicians understand, adopt, and apply the four competencies (Clapper & Ng, 2012).

Course Overview: This course trains teams in the essential skills needed to function as team members and leaders. This is the only master training course that includes the use of simulation and assists the learner with developing an implementation plan.

Course: “TeamSTEPPS Trainer Essentials Plus”
Course DatesSep. 21-23, 2015 or Sep. 30-Oct 2, 2015
Course Provided By: Global Institute for Simulation Training
Location: Simulation Training Center at Education Management Solutions, Exton, PA
Instructor: Timothy Clapper, PhD

Timothy Clapper, PhD

Dr. Clapper is one of four American College of Surgeons Advanced Trauma Life Support (ATLS) Educators in the world. As a TeamSTEPPS® Master Trainer, he has improved the teamwork skills and clinical practice of inter-professional teams at numerous healthcare facilities in the US and abroad. Using TeamSTEPPS® and his Saturation in Training theory (Clapper & Ng, 2012), he has improved the culture and practice of entire departments and reduced clinical errors.

Course Objectives:

  1. Use TeamSTEPPS communication tools to improve team communication and increase patient safety
  2. Use effective patient handoff techniques to enhance information exchange during transitions in care
  3. Identify barriers to teamwork and use strategies to overcome them
  4. Participants will receive an implementation guide – it is a core value to the course. They will not have to develop it. They will receive the implementation guide, and the course content will include training on how to tailor the plan for their own institute, including training cross-departmental teams.
  5. Participate in simulation to reinforce learning

Here’s what participants say:

“I had previously taken a TeamSTEPPS®workshop, but came back feeling like I had tools, but could not get “buy in” to use them. I was also unsure of how to fit it into our program. After attending this educational program, I am armed with both education, the means to carry it out, AND a plan! The plan will help us to move the process forward”

“I enjoyed the combination of information along with how to use it and implement it; the interaction among the group as led by [Dr. Clapper] and the various modes of education (lecture, video, sim) fully engaged me and kept my attention.”

Seating is limited to a maximum of 20 participants for each workshop.
Early registration rate is available until September 4.
Institutions are encouraged to send a team of three (physicians/nurses) from each department to facilitate effective implementation.

Click here for more information about the course.

Click here to register!

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Whitepaper from EMS: How to Strengthen Simulation Center Operational Efficiency.

ems whitepapers on medical simulation operations

Continuing our recent series of medical simulation ‘How To’ articles, today we are pointed in the direction of an EMS whitepaper entitled “How to Strengthen Simulation Center Operational Efficiency”. The article covers several major areas including:

  • Staffing Needs Identification
  • IT Department Communication
  • Simulation Staff Salaries

About the SimulationIQ WhitePaper:

Your institution has just opened a state-of-the-art simulation center complete with all the bells and whistles the industry has to offer. However, just as a car needs fuel and maintenance to run effectively, a simulation center requires investment beyond the initial technology purchase. A sim center does not operate and manage itself – people do. And these people should be hired long before the ribbon-cutting ceremony of your new center!

But what skills should you look for during the hiring process?

A sim center requires a similar type of operational knowledge as driving a car. One must first know how to drive a car in order to do so safely. This includes an understanding of the rules of the road and the actual physical movements required to operate the vehicle. Similarly, there are many administrative and educational tasks that need to be taken care of in order to have a smooth-running simulation center.

Get the FREE Whitepaper now from EMS!

TEDxTalk From PhD RN Elaine Meyer “On Being Present, Not Perfect” in Healthcare

tedtalk medical simulation

At IMSH 2015 I had the privilege of meeting Elaine C. Meyer, PhD, RN, in her capacity as Chair of the Affiliations committee for the Society of Simulation in Healthcare, and the Director of the Institute for Professionalism & Ethical Practice at Boston Children’s Hospital. Learning about her role as Associate Professor of Psychology at Harvard Medical School, Elaine and I started to talk about our shared mission to better the world by addressing the changes that need to come into healthcare communication. She informed me of her TEDxTalk on the very subject and I knew we had to share it on HealthySim! In her intimate talk, Dr. Meyer draws on both professional and personal experience to illustrate the profound gaps in healthcare communication and how to close them.

On Being Present, Not Perfect

The conversations that matter most in healthcare are often the most sensitive and challenging.  From conveying serious diagnoses to ethical quandaries surrounding end-of-life care, these conversations are the bedrock of the patient-provider relationship.  When they go well, patients’ health outcomes, trust, and satisfaction with care are enhanced.  In her highly regarded TEDTalk, “On Being Present, Not Perfect” Elaine C. Meyer, PhD, RN draws on both professional and personal experience to illustrate the profound gaps in healthcare communication and how to close them.  She unveils her vision to establish an emotional standard of care for patients and their families through honest, direct and genuine healthcare conversations.  She introduces the “one-room schoolhouse” educational approach and shares the Wizard of Oz metaphor blending Courage, Brains and Heart to guide healthcare conversations.  She also provides a helpful companion Facilitator’s Guide to deepen the learning potential of the Talk.

Elaine suggested to me at IMSH, that sometimes, change comes one conversation at a time. If this talk touches you, please share with your colleagues, friends and family. Together, we can help spread the word that these healthcare conversations matter deeply and that, indeed, we are called upon to be present, not perfect.

For more information, visit the Institute for Professionalism and Ethical Practice or email Elaine!

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New Japanese Humanoid Robot Demonstrates Communication Innovation


Toshiba has developed a lifelike communication android that can move its arms and hands smoothly and use Japanese sign language. The android is a prototype that the company will continue to develop towards achieving a service robot able to assist people in the fields of welfare and healthcare. The android will be showcased at CEATEC JAPAN 2014, which will be held from October 7 to 11.

Recently we have shared a number of stories highlighting increased advances in robotic technology, which we feel will have direct implications for the healthcare simulation industry.

Listen to the Full NPR story below:

Visit NPR.org for the complete Toshiba Customer Service Humanoid Story!

American Academy on Communication in Healthcare ENRICH Conference June 18-21

aach conference

Laura Cooley, PhD Director of Education at the American Academy on Communication in Healthcare wrote us to share about the upcoming AACH Enrich Conference which sounds very empowering for healthcare simulation educators looking to improve communication:

“Hello HealthySim – I would like to invite your readers to attend the AACH ENRICH Course “Meeting at the Crossroads of Communication and Professionalism”, June 18-21, 2015. ENRICH is a 4-day intensive and interactive course for clinicians and educators from a variety of healthcare perspectives.

Workshop topics include:

  • Relationship-centered Communication
  • Interprofessional Teams
  • Coaching and Remediation
  • Professionalism and Cultural Humility and
  • Promoting Professional Development in Healthcare Education

Keynote presentations include:

  • How Does Healthcare Reimbursement & Structure Affect Professionalism and Healthcare Communication?
  • Overview of Professionalism and Healthcare Communication
  • Compassion and Resilience.

ENRICH uses a learner-centered model and features educational activities designed to enhance knowledge, skills and attitudes needed to practice and teach relationship-centered communication.”

Learn more at the AACH Enrich Website!

Virtual TeamSTEPPS Online Program Enables Collaborative Training Opportunities

At IMSH HealthySim interviewed Rachel Umoren about her team’s Virtual TeamSTEPPS Simulation training system from the Institute for Digital Intermedia Arts at Ball State University. Watch the video below to learn all about it:

Dr. Rachel Umoren is a practicing neonatologist, a clinician educator and researcher in medical education. She is an Assistant Professor of Clinical Pediatrics at the Indiana University School of Medicine, a Faculty Fellow at the Ball State University Institute for Digital Intermedia Arts, and a visiting Scientist Scholar in Health Services Research at the Regenstrief Institute, Inc. in Indianapolis, Indiana. In these various capacities, she investigates the best practices and outcomes of educating health professional students through collaborative 3D virtual environments. Her particular interests are in interprofessional teamwork in both local and global health settings. In this capacity, she has developed simulations for teamwork, public health training, and traveler safety in global health settings.

Learn more about the project through this research report which utilized the Virtual TeamSTEPPS application.

‘Simulation Discomfiters’ – The Anti-Champions Who Frustrate Our Programs

healthcare egos

I looked up the definition of champion today. Words like “supporter”, “booster”, “friend”, “hero”, and “superstar” were among my favorites — and all words I feel when I think of the thousands of simulation champions I have met over the past many years. Below these great words I saw the antonyms of champion, which included words like “trivial”, “worst”, “least” and “discomfit”.

Discomfit was a word I had never heard before. It means “1. to make uneasy, confused, or embarrassed 2. to frustrate the plans or purpose of”. A discomfiter, therefore, is a person who makes things difficult, confusing, and embarrassing while frustrating the plans and purposes of a team.

On various occasions I have directly witnessed one individual’s ego take down an entire healthcare simulation program. As a community builder in our field of simulation, I have had countless phone calls with champions from around the world who share their grief and frustration over the constant roadblocking by another member of their team — a discomfiter who is usually set in their ways unable to truly adopt the change required for technical and learning innovation to occur. Whether its spreading rumors, continually demanding attention, discrediting and threatening others, or just ignoring contributions — these discomfiters do exist. Sadly, sometimes a discomfiter’s constant complaining and negative energy succeeds and they get their way which leads to the eviction of champions and the reduction of simulation.

Usually within three to six months after such a tragic event, I learn from the champion that the simulation program has suffered a great deal – with learning outcomes and operational efficiency diminishing sometimes down to nothing. Literally, a single personnel change and within six months a robust simulation program with huge learner impacts turns into wasted equipment, spaces, and time.

For some of us in smaller programs we are the entire simulation team. I’m sure you’ve wondered what would happen if you needed to find work elsewhere — but has your administration? How much knowledge and expertise walks out the door with you — especially when you do not have the opportunity to train your replacement.

Dr. Val Gokenbach, Professor for American Sentinel University in the DNP, MSN and BSN programs, wrote an article for NurseTogether.com called Lose the Ego Nurses, It’s Not About You“. In her article Dr. Gokenbach shares that “as an administrator for over 35 years in healthcare organizations, I have seen ego destroy individuals, ruin reputations, hinder personal growth and success”. (Nursing is just one example of where unchecked egos and unprofessional communication can cause problems, but such challenges exist throughout healthcare including patient vs doctor, nurse vs doctor, and even police officer vs. fire fighter engagements).

Dr. Gokenback explains the ego and the impact that ego can have on our lives and our programs when left unchecked: “Our ego is constantly threatened by the perception of others and is always in need of attention. Anything that threatens that security can become a basis for conflict, anger, and fear. The reality is that we all have egos. The successful nurse learns to realize the concept, protect themselves emotionally, and control their reaction.”

Ultimately in the workplace administrators have the responsibility to check egos and ensure that the program, simulation or otherwise, can continue to innovate and succeed. Tools that are available to help us with this delicate situation like signing up for the TeamSTEPPS Communication System Free Online Master Training or taking time to reflect on healthcare team communication with new books like Collaborative Caring by S. Gordon.

I faced such issues myself as the first director of the Clinical Simulation Center of Las Vegas. Primarily I quietly relied on one primary question to help me decipher if challengers where champions of discomfiters: does this person’s request benefit the simulation program, or benefit the person?

Dr. Gokenback’s advice to such discomfiters? “Get over yourself. Think of your importance to the greater good and not only your world, which is small in comparison.” Read her full article here.

Have you dealt with a “discomfiter” in your simulation career?
Share about your experience on the HealthySim LinkedIn Discussion Group!

TeamSTEPPS Online Master Trainer CE Course Now Available for FREE!

teamstepps free training

Thrilled to share that the AHRQ has enabled all of us to take their TeamSTEPPS team-based communication master trainer course for FREE!  TeamSTEPPS is the “healthcare version” of aviation’s CRM communication tool which has proven to dramatically reduce errors in the field. This is the best communication model available for practicing in your healthcare simulation programs!

Our good friend Dr. Timothy Clapper PhD has written numerous articles on how TeamSTEPPS can be utilized in simulation training, as well as presented on the topic as the SimGHOSTS 2013 Keynote Address.

Learn more & register for the next course at the AHRQ.gov website!

What is TeamSTEPPS specifically?

TeamSTEPPS is a teamwork system designed for health care professionals that is:

  • A powerful solution to improving patient safety within your organization. An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.
  • A source for ready-to-use materials and a training curriculum to successfully integrate teamwork principles into all areas of your health care system.
  • Scientifically rooted in more than 20 years of research and lessons from the application of teamwork principles.
  • Developed by Department of Defense’s Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.

TeamSTEPPS provides higher quality, safer patient care by:

  • Producing highly effective medical teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for patients.
  • Increasing team awareness and clarifying team roles and responsibilities.
  • Resolving conflicts and improving information sharing.
  • Eliminating barriers to quality and safety.

free master trainer communication course

More about the NEW Online Master Trainer Course

The TeamSTEPPS® 2.0 Online Master Trainer Course consists of 11 modules, 8 of which offer continuing education (CE) credits. Learners in a cohort or noncohort group completing the full course of all 11 modules and a coaching session with a TeamSTEPPS Master Trainer (also known as a teach-back session) not only receive CE credits, but can also receive certification as a Master Trainer. Learners can also choose to complete individual modules for CE credits only.

   For example:

  • Reynolds Army Community Hospital in Oklahoma decreased delays in surgery start times, and increased productivity just 6 months after implementing TeamSTEPPS.
  • Montgomery Community Hospital, a critical access hospital in North Carolina, improved efficiency and effectiveness in high-risk pediatric situations.
  • Madigan Army Medical Center in Washington State improved the time from decision to performance of an emergency Cesarean section, with no adverse outcomes for either the mother or the child.

We encourage potential master trainees to review the readiness assessment checklist to determine if this is the right time to begin implementation of the TeamSTEPPS initiative.

While multiple online classes will be made available throughout 2014-2015, the first course offerings include:

  • Self-Paced (Noncohort) 1: Class starts January 7, 2015, limited to 350 participants.
  • Group-Paced (Cohort) 2: Class starts January 12, 2015, limited to 100 participants.

The course timing and activities are:

Group-Paced (Cohort): Complete all 11 modules, view 3 Webinars, and teach a module to at least one Master Trainer in as few as 33 days but no longer than 120 days.

Self-Paced (Noncohort): Complete all 11 modules, and teach a module to at least one Master Trainer within 210 days.

While the course is offered at no cost to participants, AHRQ has committed significant resources to make the class available online. Professionals who want to be certified as Master Trainers will need to create a change team, submit a draft change plan and write a letter of commitment prior to enrolling in the course . Professionals wishing to obtain free continuing education credits but not complete the full course can still complete individual modules to develop mastery of teamwork concepts.


1: Introduction (No CE credits) – Provides an overview and examines the science of team performance, beginning in aviation and migrating to health care. Discusses why patient safety is so important and how teamwork can make a difference

2: Team Structure (.75 CE credit) – This is the first step in implementing a teamwork system. Delineates fundamentals, such as team size, membership, leadership, identification, and distribution.

3: Communication (1.0 CE credits) – The focus is on how to communicate effectively through standardized information exchange strategies, such as SBAR, check-back, callout, handoff, and checklists.

4: Leading Teams (1.25 CE credits) – Identifies key behaviors that leaders need to make sure teams perform effectively and attain desired outcomes. Introduces brief, huddle, and debrief skills.

bCE credits) – Discusses gaining or maintaining an accurate awareness and understanding of the situation in which the team is functioning. Results in situational awareness and, ultimately, a shared mental model among team members.

6: Mutual Support (2.0 CE credits) – Reviews backup behavior that allows teams to become self-correcting, distribute workload effectively, and regularly provide feedback. Introduces specific approaches to managing conflict; each team member becomes a part of the safety net.

7: Summary (No CE credits) – Provides an opportunity for participants to review and analyze a video case study.

8: Change Management (1.75 CE credits) – Realizing change is difficult, introduces John Kotter’s eight-step model for successful change efforts. Discussion of each step includes its implications for the change effort.

9: Coaching (2.0 CE credits) – Coaching describes a specific action, such as encouraging, reinforcing, giving feedback, and demonstrating. As coaches are important change agents and assist with implementing teamwork initiatives, the session will discuss aspects of coaching as key components in an organization’s change strategy and plan.

10: Measurement (1.50 CE credits) – Measurement helps determine if TeamSTEPPS® worked. Discusses the Kirkpatrick model of training evaluation and identifies measures that can be used to assess the impact of TeamSTEPPS®.

11: Implementation Planning (2.25 CE credits) – Based on the principle of improving health care quality and safety by improving clinical processes. Focuses on developing an actionable implementation plan for your organization.

Learn more & register for the next course at the AHRQ.gov website!

Supported Organization:

Timothy Clapper PhD Articles on TeamSTEPPS Communication Training Opportunities for Medical Simulation Programs

dr timothy clapper

Just received an email from my good friend Timothy Clapper, PhD regarding yet ANOTHER great article he has produced regarding TeamSTEPPS communication practices with regards to healthcare simulation. TeamSTEPPS was developed by the Agency for Healthcare Research and Quality utilizing CRM communication models from the space and aviation industry. Timothy’s work continues to innovate within our community, helping simulation champions better recognize and utilize simulation as a medium for revolutionary change within healthcare.

TeamSTEPPS is a teamwork system designed for health care professionals that is:

  • A powerful solution to improving patient safety within your organization. An evidence-based teamwork system to improve communication and teamwork skills among health care professionals.
  • A source for ready-to-use materials and a training curriculum to successfully integrate teamwork principles into all areas of your health care system.
  • Scientifically rooted in more than 20 years of research and lessons from the application of teamwork principles.
  • Developed by Department of Defense’s Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality.

TeamSTEPPS provides higher quality, safer patient care by:

  • Producing highly effective medical teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for patients.
  • Increasing team awareness and clarifying team roles and responsibilities.
  • Resolving conflicts and improving information sharing.
  • Eliminating barriers to quality and safety.

Timothy’s Letter and Article Links:

Dear Lance & HealtySimulation.com Readers,

Just an update on my latest article for TeamSTEPPS. You may recall that my first article described TeamSTEPPS and the need for this tool to improve patient safety. I am happy to share that this article is still at #25 on ScienceDirect’s top 25 articles!

This was followed by a second article that outlined some reasons why TeamSTEPPS programs fail and ways to work through those issues. My latest one, just released, focuses on next steps in TeamSTEPPS, including the observation that must be done to assess additional simulation training needs.

Clapper, T. C., & Kong, M. (2012). TeamSTEPPS: The patient safety tool that needs to be implemented. Clinical Simulation in Nursing, 8(8), e367-e373. doi:10.1016/j.ecns.2011.03.002

Clapper, T. C., & Ng, G. M. (2013). Why your TeamSTEPPS program may not be working. Clinical Simulation in Nursing,9(8), e287-e292. doi:10.1016/j.ecns.2012.03.007

Clapper, T. C. (2014, in press). Next steps in TeamSTEPPS®: Creating a just culture with observation and simulation. Simulation & Gaming. doi:10.1177/1046878114543638



Timothy C. Clapper, PhD

TeamSTEPPS Master Trainer and American College of Surgeons Advanced Trauma Life Support (ATLS) Educator
Editor, Healthcare Section, Simulation & Gaming (S&G): An International Journal of Theory, Practice and Research
Public Member, Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Anesthesiology
Adjunct Professor & Sr. Instructor, Graduate Instructional Technology Certificate Program University of Colorado at Colorado Springs, College of Education
Dissertation Chair Grand Canyon University, College of Doctoral Studies
Simulation and Education Consultant – TC Curriculum & Instructional Design, LLC

If you are interested in learning about TeamSTEPPS and how it can be used by not only your healthcare staff, but simulation team staff as well, check out the Laerdal sponsored SimGHOSTS 2013 Opening Keynote address provided by Dr. Timothy Clapper, which is permanently available for free on SimGHOSTS.org thanks to Laerdal!

Also, connect with Timothy through his website TC Curriculum & Instructional Design

Medical Student Speaks Up and Saves a Life — But Not Without Persistence

medical errors

Recently read this article on KevinMD.com about a 3rd year medical student risking his ego and speaking up for a patient he felt was in danger. While this story had a happy ending, you can see how much internal struggle Andrew goes through to request and then finally demand help. With an average of 1,000 patients dying a day due to medical error we have continue to ask why new medical and healthcare professionals are being trained into a system that has serious consequences for “wasting staff time” against saving patient’s lives.

Consider this story from 3rd Year Medical Student Andrew Ho:

As a third-year medical student, we are considered to be the bottom of the totem pole in the hospital. After spending the first two years studying for our Step 1 boards, the only clinical medicine we know comes from what we have read and heard about in books and lectures. Our questions are frequently met with laughter or are berated for lacking common sense. And in the fast paced world of the ED, nobody has time to answer stupid questions. “His nurse probably knew he had a head laceration,” I reasoned . “There’s no need to alert anybody. He’s not even my patient. The ED staff is more than capable of handling this.”

A minute passed. And then another. Nobody came by to see this patient, who continued to bleed. I hesitated against speaking up, since we were in the middle of a trauma. But I couldn’t wait any longer. I asked an ED nurse if he was her patient. “No,” she said before hurrying off. I told another nurse that a man was actively bleeding and he said, “Go get his nurse!” After a few more failed attempts, I had had enough and pulled aside my resident. “I think this man has been bleeding profusely for some time. What should we do?” His eyes widened as he saw the amount of blood that had soaked into the sheets. He reached for a pair of gloves and told me, “Get a suture kit, now!”

I hurried off to the supply closet and came back with a bunch of supplies. The patient was now writhing in pain as we dug around with our fingers inside his wound, trying to locate the bleeding vessel. We liberally injected lidocaine before exploring deeper with pickups and clamps. I tried to dab away the blood so that we could see into the laceration, but blood instantly filled the cavity. We couldn’t localize the source of the bleeding and our attempts to blindly clamp the vessel were met with frustration. Anytime we thought we stopped the bleeding, blood would spontaneously squirt out, like water spewing from a compressed hose. When the blood splashed up against our glasses, my resident and I looked at each other and knew we needed more help.

We wheeled the stretcher out of the back corner and into the trauma bay where we applied Yankauer suction into the wound. This helped us visualize the lacerated artery quickly. We clamped the vessel to stop the bleeding and tied it off with sutures. Given the amount of time he went unnoticed, we estimated that that patient’s estimated blood loss was anywhere from 500-1000 mL and gave him IV fluids to help replenish his intravascular volume. When the chaos had settled, a very surprised ED attending entered the bay. “He was playing on his cell phone just a few minutes ago!” she exclaimed. She thanked us for our work and my resident commended me with a quickly muttered, “Good job.”

A quickly muttered “good job” and no department follow-up or debrief? This was one time a medical student stood up but what about the next time his counter-part remains silent? Check out yesterday’s story on how “silence kills” in healthcare and learn about a book called “Beyond the Checklist” that shows us how we can fix this systemic problem.

Read the full story on KevinMD.com