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Are We on the Same Page? Shared Mental Models to Support Clinical Teamwork Among Health Professions Learners: A
Leslie Carstensen Floren1, DorAnne Donesky, Evans Whitaker
1L.C. Floren is associate professor, Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, and advanced fellow in health professions education evaluation and research, Department of Veterans Affairs, San Francisco, California. D. Donesky is codirector, Palliative Care Educational Program, School of Nursing, University of California, San Francisco, San Francisco, California. E. Whitaker is research librarian, Medical Library, University of California, San Francisco, San Francisco, California. D.M. Irby is professor, Department of Medicine, School of Medicine, and research faculty member, Center for Faculty Educators, University of California, San Francisco, San Francisco, California. O. ten Cate is professor, School of Medicine, Utrecht University, Utrecht, The Netherlands, and adjunct professor, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California. B.C. O'Brien is associate professor, Department of Medicine, and research faculty member, Center for Faculty Educators, School of Medicine, University of California, San Francisco, San Francisco, California.
Purpose:
To conduct a scoping review to explore the construct of shared mental models (SMMs) in the context of clinical teamwork among health professions learners.
Method:
The authors searched the PubMed, ERIC, CINAHL, Scopus, Web of Science, PsychINFO, and EMBASE databases for English-language articles published between 2000 and 2016. Eligible articles mentioned SMMs in relation to clinical teamwork and included health professions learners. Two reviewers screened studies for eligibility and extracted data to determine the depth and breadth of the literature on SMMs. The authors examined definitions of the SMM construct in the context of clinical teams, educational interventions using SMMs, and the measurement of SMMs.
Results:
Of the 1,273 articles retrieved, 23 met the inclusion criteria. SMMs were defined in less than two-fifths of the articles (9/23). All articles applied the construct to improvements in hospital-based patient safety, often in high-intensity settings (14/23). Most articles included graduate-level physicians (21/23) within clinical teams (18/23). Interventions designed to foster SMMs (6/23) included teamwork curricula/training and teamwork supportive tools. Measurements of SMMs (7/23) included a qualitative task analysis, quantitative analyses of speech, a concept mapping, and Likert-type surveys.
Conclusions:
In health professions education, the SMM construct lacks clear definition. Few studies described educational interventions aimed at SMM development, and few attempted to measure the construct. The authors propose an operational definition of SMMs in health care and illustrate how interventions intended to foster SMMs, such as team trainings or planning exercises and communication tools, could be developed, implemented, and assessed.