Enhancing Team Strategies and Tools to Enhance Performance and Patient Safety Performance Through Medical Movies, Massive Open Online Courses, and 3D Virtual Simulation-Based Interprofessional Education: Mixed Methods Double-Blind Quasi-Experimental Study.

Background: The interprofessional educational curriculum for patient and personnel safety is of critical importance, especially in the context of the COVID-19 pandemic, to prepare junior multiprofessional teams for emergency settings.

Objective: This study aimed to evaluate the effectiveness of an innovative interprofessional educational curriculum that integrated medical movies, massive open online courses (MOOCs), and 3D computer-based or virtual reality (VR) simulation-based interprofessional education (SimBIE) with team co-debriefing to enhance interprofessional collaboration and team performance using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). This study addressed 3 key questions. First, it aimed to examine the impact of 3D computer-based and VR SimBIE with co-debriefing following medical movies and MOOCs on improving TeamSTEPPS competencies compared to 3D computer-based SimBIE without preparation or debriefing. Second, it explored learners' perceptions of TeamSTEPPS effectiveness using the New World Kirkpatrick model. Third, it assessed differences in Simulator Sickness Questionnaire scores between the 3D and VR SimBIE formats.

Methods: This mixed methods, prospective, double-blinded (raters and statistician) quasi-experimental study was conducted at a university hospital from August 2022 to September 2023 and involved 87 clinical undergraduate students from various disciplines, including medicine, nursing, pharmacy, radiology, and medical technology. Students were divided into 3 arms: arm A (control) received 3D computer-based SimBIE without debriefing; arm B received a medical movie, MOOCs, 3D computer-based SimBIE, and co-debriefing; and arm C received the same as arm B but with VR-based SimBIE. The validated Modified TeamSTEPPS Team Performance Observation Tool was used to measure team performance. A 60- to 90-minute focus group discussion with semistructured interview questions, based on the New World Kirkpatrick model and aligned with the TeamSTEPPS framework, was conducted with subsequent thematic analysis.

Results: In total, 87 participants were enrolled in this study. TeamSTEPPS' performance was significantly higher (P<.001) in arms B and C, which received comprehensive training with medical videos, MOOCs, and 3D computer-based or VR-based SimBIE with co-debriefing, compared to the control group. Additionally, the analysis of focus group discussions based on Kirkpatrick's model levels 1 to 3 indicated positive effects on satisfaction, engagement, knowledge, skills, attitude, and confidence, enriched by game practice and debriefing sessions. Simulator Sickness Questionnaire scores increased significantly in arm C (VR; Δ=21.0; P=.001) but not in arm B (computer; Δ=5.3; P=.44).

Conclusions: Integrating TeamSTEPPS with medical movies, MOOCs, 3D computer-based or VR-based SimBIE training, and co-debriefing effectively improved interprofessional collaboration and team performance in emergency medicine. We recommend adopting these novel instructional designs as standard preparation of undergraduate health care professionals for better clinical practice to improve patient and personnel safety and patient outcomes.