The effect of two cognitive aid designs on team functioning during intra‐operative anaphylaxis emergencies: a multi‐centre simulation study

This multi‐centre repeated measures study was undertaken to determine how contrasting designs of cognitive aids affect team performance during simulated intra‐operative anaphylaxis crises. A total of 24 teams consisting of a consultant anaesthetist, an anaesthetic trainee and anaesthetic assistant managed three simulated intra‐operative anaphylaxis emergencies. Each team was assigned at random to a counterbalanced order of: no cognitive aid; a linear cognitive aid; and a branched cognitive aid, and scored for team functioning. Scores were significantly higher with a linear compared with either a branched version of the cognitive aid or no cognitive aid for ‘Team Overall Behavioural Performance’, difference between study groups (F‐value) 5.8, p = 0.01. Aggregate scores were higher with the linear compared with the branched aid design (p = 0.03). Cognitive aids improve co‐ordination of the team's activities and support team members to verbalise their actions. A linear design of cognitive aid improves team functioning more than a branched design.