Hyperkalemic Arrest: Developing Team Cognition

INTRODUCTION: Critical events are frequently managed by individuals with different skill sets, funds of knowledge, and experiences who form ad hoc teams on a daily basis without any previous practice together. Such groups' spontaneity of formation puts a premium on individuals' ability to understand team cognition and work together. Team cognition can be thought of as an analogue of individual cognition and is revealed during functional interactions of team members working interdependently on a shared goal. This simulation helps trainees develop and practice team-training skills in order to better form ad hoc teams and manage critical events. METHODS: This simulation can be applied to senior medical students and residents and focuses on the management of an accidental administration of potassium leading to hyperkalemic arrest. The simulation takes 10 minutes to complete and, when coupled with a debriefing session, can be accomplished in under 45 minutes. RESULTS: Twenty-two trainees, consisting of five teams of four to five residents, participated in this simulation. Each team showed varying levels of team cognition, and most successfully managed the hyperkalemic arrest; both of these points were reviewed at length during the debriefing. The trainees gave the simulation high ratings in terms of its effectiveness for team training, with a score of 6.7 on a scale of 1–7. DISCUSSION: Medical simulations have been very productive in providing learners with opportunities to manage critical events. With the exploding practice of interdisciplinary medicine, we believe simulation-based training should be implemented to develop team cognition and practice team training.