Purpose for the program:   To provide a safe learning environment for staff to build on their prior knowledge, improve understanding of roles during high risk/high stress scenarios, and increase communication between members of the Women’s Care staff and the staff from other units at Saint Joseph East.  

Proposed change:   The staff based education committee sought new and innovative methods to perform competency validation for annual training that included a realistic clinical setting in which staff could build on their own knowledge, relate the scenario to real life, and develop their skills in a safe learning environment that did not compromise patient safety. Improvement in communication and teamwork both from intra and interdepartmental perspectives was also part of the proposed change.  

Implementation, outcomes and evaluation:  Key staff members and leaders were identified and asked to participate in the collaborative multidisciplinary scenario team.  A standardized scoring rubric was developed to assess learning and success outcomes.  Quarterly scenario based drills with scores of 90 or above on the standardized rubric were one part of the desired outcome.  Program effectivesness was also determined from reports from staff that they felt decreased anxiety, improved critical thinking skills, and improved communication and teamwork among staff during scenario based training and in real life situations.  This program is ongoing and the outcomes and evaluation are still being monitored. 

Implications for nursing practice: Perhaps the first lesson from this program that has impacted nursing practice at the Women’s Care Hospital is that practice really does make perfect—the once a year checklist is not always enough to prepare a staff member for real life high risk scenarios.  Nurses also now feel like they have a voice and have the opportunity for open dialogue with staff and physicians from their areas and other departments.  This program's most valuable implication is that staff members have discovered that communication is key, that each person and department is critical in a high risk scenario, and that it takes teamwork to promote good patient outcomes.    

Keywords: scenario based training, teamwork, communication, competencies