Enhancing nurse and physician collaboration in clinical decision making through high-fidelity interdisciplinary simulation training

Mayo Clin Proc. 2011 Jan;86(1):31-6. doi: 10.4065/mcp.2010.0282.


Objective: To determine whether interdisciplinary simulation team training can positively affect registered nurse and/or physician perceptions of collaboration in clinical decision making.

Participants and methods: Between March 1 and April 21, 2009, a convenience sample of volunteer nurses and physicians was recruited to undergo simulation training consisting of a team response to 3 clinical scenarios. Participants completed the Collaboration and Satisfaction About Care Decisions (CSACD) survey before training and at 2 weeks and 2 months after training. Differences in CSACD summary scores between the time points were assessed with paired t tests.

Results: Twenty-eight health care professionals (19 nurses, 9 physicians) underwent simulation training. Nurses were of similar age to physicians (27.3 vs 34.5 years; p = .82), were more likely to be women (95.0% vs 12.5%; p < .001), and were less likely to have undergone prior simulation training (0% vs 37.5%; p = .02). The pretest showed that physicians were more likely to perceive that open communication exists between nurses and physicians (p = .04) and that both medical and nursing concerns influence the decision-making process (p = .02). Pretest CSACD analysis revealed that most participants were dissatisfied with the decision-making process. The CSACD summary score showed significant improvement from baseline to 2 weeks (4.2 to 5.1; p < .002), a trend that persisted at 2 months (p < .002).

Conclusion: Team training using high-fidelity simulation scenarios promoted collaboration between nurses and physicians and enhanced the patient care decision-making process.

MeSH terms

  • Adult
  • Cooperative Behavior*
  • Decision Making*
  • Female
  • Humans
  • Inservice Training*
  • Male
  • Patient Care Team / organization & administration*
  • Physician-Nurse Relations*
  • Statistics, Nonparametric
  • Surveys and Questionnaires