Dr Samantha Bendall1
1CareFlight, Northmead, Sydney, Australia, 2Royal Prince Alfred Hospital , Camperdown, Sydney, Australia
Next Generation CRM – Evolving for Performance
Aircrew have long had mandated annual CRM training and assessment in simulators using assessment tools such as NOTECHS. The core principles of CRM are now well embedded into critical care medicine and clinicians in pre-hospital and retrieval medicine (PHRM) learn and experience this at a higher level than many of their hospital-based colleagues.
PHRM teams are required to function at a very high level, with high cognitive loads, and in a way that the whole is greater than the sum of its parts. High levels of team performance can only be achieved by going past the basics and employing the next level of CRM skills – team intelligence, distributed cognition, implicit team coordination at times of high task and decision load and behaving as leaders at all levels.
CRM and team performance is such a cornerstone of excellence in PHRM practice and equally as important as the technical skills to master in order to be a safe and competent PHRM practitioner and crew member. Current CRM teaching is not focussed on bringing practitioners into the realm of the high performing team. Current assessment tools do not accurately reflect the dynamic nature of our team performance, making it difficult to measure and assess performance of this essential skill. Isn’t it time we remodelled CRM teaching for PHRM clinicians to equip our teams for the job they do, further the PHRM safety culture, and ensure they meet a standard that accurately reflects the complexity of the CRM and team performance required as a PHRM team. Time for next generation CRM.
Dr Sam Bendall is the Director of Education for CareFlight and an experienced retrieval physician. She is also a staff specialist in the Emergency Department at Royal Prince Alfred Hospital in Sydney. Her passion is human factors, teamwork and team performance and developing these through simulation. These all form the cornerstones of all education delivered by CareFlight to their clinicians and external training audiences.