Abstract
BACKGROUND: Team performance is crucial in crisis situations. Although the Thai version of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been validated, challenges remain due to its subjective evaluation. To date, no studies have examined the relationship between electroencephalogram (EEG) activity and team performance, as assessed by TeamSTEPPS, during virtual simulation-based interprofessional education (SIMBIE), where face-to-face communication is absent. OBJECTIVE: This study aims to investigate the correlation between EEG-based brain-to-brain synchronization and TeamSTEPPS scores in multiprofessional teams participating in virtual SIMBIE sessions. METHODS: This single-center study involved 90 participants (15 groups of 6 simulated professionals: 1 medical doctor, 2 nurses, 1 pharmacist, 1 medical technologist, and 1 radiological technologist). Each group completed two 30-minute virtual SIMBIE sessions focusing on team training in a crisis situation involving COVID-19 pneumonia with a difficult airway, resulting in 30 sessions in total. The TeamSTEPPS scores of each participant across 5 domains were independently assessed by 2 trained raters based on screen recording, and their average values were used. The scores of participants in the same session were aggregated to generate a group TeamSTEPPS score, representing group-level performance. EEG data were recorded using wireless EEG acquisition devices and computed for total interdependence (TI), which represents brain-to-brain synchronization. The TI values of participants in the same session were aggregated to produce a group TI, representing group-level brain-to-brain synchronization. We investigated the Pearson correlations between the TI and the scores at both the group and individual levels. RESULTS: Interrater reliability for the TeamSTEPPS scores among 12 raters indicated good agreement on average (mean 0.73, SD 0.18; range 0.32-0.999). At the individual level, the Pearson correlations between the TI and the scores were weak and not statistically significant across all TeamSTEPPS domains (all adjusted P≥.05). However, strongly negative, statistically significant correlations between the group TI and the group TeamSTEPPS scores in the alpha frequency band (8-12 Hz) of the anterior brain area were found across all TeamSTEPPS domains after correcting for multiple comparisons (mean -0.87, SD 0.06; range -0.93 to -0.8). CONCLUSIONS: Strong negative correlations between the group TI and the group TeamSTEPPS scores were observed in the anterior alpha activity during online hexad virtual SIMBIE. These findings suggest that anterior alpha TI may serve as an objective metric for assessing TeamSTEPPS-based team performance.