12 Appendix L: Training Observation Tool

Appendix L – Training Observation Tool

AHRQ – Building Diagnostic Safety Capacity

TeamSTEPPS® Course Pilot Test Evaluation

Training Observation Tool

The training observation tool will be used to periodically assess the practices during their implementation of the TeamSTEPPS® modules. This assessment will be completed by a project team member and have minimal respondent burden. We aim to observe up to 2 module trainings during each practice’s adoption of the TeamSTEPPS® Course.

MedStar Health Research Institute (MHRI) will conduct direct observations of the TeamSTEPPS® training for up to 2 trainings per practice (n=40 trainings. Total time for the encounter burden was estimated at 1 hour per encounter.

Recruitment Criteria

Healthcare setting administrators who have been exposed to the TeamSTEPPS® Course within their setting will be eligible to participate in the interview. MHRI team members will work with the practice champions to identify administrators to participate in the interviews. We will aim to recruit administrators in the following manner:

• Administrators involved in the decision making around implementation of the TeamSTEPPS® Course or how have had experience using the TeamSTEPPS® Course

Interview Goals

The goals of the interviews will be to:

• Obtain feedback on the intervention Course materials

• Obtain feedback on the barriers and facilitators encountered during implementation

• Obtain feedback on satisfaction with instructions and materials

• Obtain feedback on receptivity and enhancements to the Course to improve adoption and implementation

Interview Materials

• Copies of the Course materials

• Informed consent documents

• Digital recorder

Location

Interviews will be conducted at a location within the practice or within the practice’s community. Interviews may also be conducted virtually via the telephone.

Participant Stipends

None.

Each observation will take no more than 60 minutes.

Informed Consent Procedures

Participants will complete the informed consent process at the time of arrival to the interview.

Form Approved
OMB No. xxxx-xxxx
Exp. Date xx/xx/20

AHRQ – Building Diagnostic Safety Capacity

TeamSTEPPS® Course Pilot Test Evaluation

Training Observation Tool

TeamSTEPPS® Course Component	Observed	Description
Module being Observed	☐	Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 Module 7
Observer Name	☐
Materials used during the training	☐	[Free Text]
Strategies Trained on During the Training		[Free Text]
– Questions posed by staff during the training	☐	[Free Text]
Questions posed by providers during the training		[Free text]
Observer’s Recommendations for Improvement of Materials		[Free Text]

This survey is authorized under 42 U.S.C. 299a. The confidentiality of your responses to this survey is protected by Sections 944(c) and 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)].  Information that could identify you will not be disclosed unless you have consented to that disclosure. Public reporting burden for this collection of information is estimated to average 20 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 5600 Fishers Lane, Room #07W42, Rockville, MD 20857.

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