Impact of Team Composition on Learning Outcomes Following Simulation-Based Training of Teamwork Competencies: A Systematic Review

INTRODUCTION: This systematic review aims to investigate the impact of team composition on learning outcomes following simulation-based training of teamwork competencies for healthcare professionals and healthcare students.

METHODS: We searched Ovid Embase, CINAHL, and OVID Medline from 2011 to July 3, 2023, and included randomized trials and observational studies with a control group. Risk of bias was assessed using the revised Cochrane Risk-of-Bias tool and the Risk of Bias in Non-Randomized Studies tool. We did not conduct a meta-analysis because of heterogeneity. We evaluated certainty of evidence using GRADE methodology.

RESULTS: We screened 14,309 abstracts and included 11 studies. We found 6 studies investigating uniprofessional (UP) versus multiprofessional (MP) teams, 3 studies investigating team size, 1 study investigating dynamic versus stable teams, and 1 study investigating the effect of gender composition. Studies overall found that team composition may affect team performance. Studies on UP versus MP teams investigated skill acquisition, knowledge acquisition, and self-efficacy, showing no difference between groups or a small benefit of MP team training. The certainty of evidence was very low.

DISCUSSION: We identified very low certainty evidence, suggesting that team composition affects team performance and MP team training should be considered as opposed to UP team training when providers are expected to work together across professions in clinical practice. Further research is needed to identify the optimal team composition for training of teamwork competencies.