Six steps from head to hand: a simulator based transfer oriented psychological training to improve patient safety

Resuscitation. 2007 Apr;73(1):137-43. doi: 10.1016/j.resuscitation.2006.08.011. Epub 2007 Jan 22.


The incidence of human errors in the field of medicine is high. Two strategies to increase patient safety are simulator training and crew resource management (CRM) seminars, psychological courses on human performance and error management.

Aim: To establish a CRM course combining psychological training on human error with simulator training.

Methods: Evaluation of a new 1-day training approach targeting physicians, nurses, and paramedics. The course was divided into four modules focusing on situation awareness, task management, teamwork, and decision-making. Each of the modules was set up according to a new six-step approach. The course started with an introduction into good CRM behaviour and an instructor demonstration of a simulator scenario. The participants had to debrief the instructors regarding their human performance. Step 2 was a lecture about the psychological background, and the third step consisted of psychological exercises related to the topic of the module. A psychological exercise in a medical context (MiniSim) made up step 4, which involved a patient simulator. The last two steps were a simulator scenario and a debriefing, as in other simulator courses. A psychologist and a physician were the facilitators in all steps. Two pilot courses were evaluated.

Results: Seventeen evaluation questionnaires were received. All participants rated the course as good (10) and very good (7). The psychological exercises were highly valued (good, 5; very good, 11 participants). Thirteen participants agreed that the course content was related to their work.

Conclusion: We established the first course curriculum combining psychological teaching with simulator training for healthcare professionals in emergency medicine. Similar concepts using the six-step approach can be applied to other medical specialties.

MeSH terms

  • Curriculum
  • Decision Making
  • Emergency Medicine / education*
  • Germany
  • Humans
  • Inservice Training
  • Manikins
  • Medical Errors / prevention & control*
  • Medical Errors / psychology
  • Patient Care Team
  • Safety