TeamSTEPPS® toolkit: SBAR

The first time learners use Bodyswaps, an onboarding sequence familiarises them with the features of the app, takes them through an avatar selection and embodiment activity, and prepares them for the experience to come. 

In the onboarding, learners will: 

• Find out how this training is different from the rest
• Select their avatar
• Discover their virtual journal
• Learn how to navigate and use the tools and settings

The learner meets their virtual coaches, Nurse Sam and Nurse Carlos, in the tutor room of Summerview Hospital.

Sam and Carlos start by openly discussing the challenges of providing clear patient updates to other healthcare providers, sharing their personal stories along the way. This helps the learner feel connected to the coaches and psychologically safe. It also activates working memory by prompting them to think about their own experiences.

The coaches then reveal the solution to their communication challenges – the TeamSTEPPS® tool SBAR – which they’re going to help the learner explore and practice today.

Before the learner begins their first activity, they’re invited to complete a short, likert-style self-reflection survey, to indicate how confident they feel about the following key learning points:

• Identifying the four components of SBAR
• Applying the SBAR tool in practice yourself

These self-reflection questions are repeated in the debrief at the end, to assess how the learner’s confidence levels have changed.

In this activity, coaches Sam and Carlos firstly walk the learner through SBAR (situation, background, assessment, and recommendation) and discuss why it’s a winning formula. With SBAR, team members can share information with one another in a digestible, actionable way, helping everyone to progress their patients’ care.

The coaches show the learner how to best organize patient information and a nursing assessment into each section – providing practical examples as they go. Throughout the module, the learner can find summaries of the coaches’ advice and practical examples of SBAR in their journal.

Then, the learner has a go at stringing together four statements for themselves about a virtual patient, Jenna, in line with each part of SBAR.

Over four, three-option multiple choice questions, the learner’s goal is to choose the statement about Jenna that best fits S in the first MCQ exchange, B in the second, and so on. Throughout the activity, the learner can see Jenna’s chart on a TV screen.

Incorrect options prompt feedback from the coaches about why their selection wasn’t the best choice. The learner then tries again. When they select the right option, they receive positive reinforcement from the coaches before moving onto the next MCQ, meaning that by the end they will have formed an effective SBAR statement for progressing Jenna’s care.

Their complete SBAR update about Jenna goes into their journal as another example to refer to throughout the rest of the module. 

In this activity, the learner practices using SBAR in a freeform conversation. They move to the central nursing station, where one of the attending physicians at Summerview Hospital, Dr. Grace, awaits a patient update to help coordinate the next steps. The patient, Eli, is recovering from hip replacement surgery, but reports persistent surgical pain that isn’t responding to medication.

The learner’s goal is to give a clear, concise update about Eli using SBAR over four exchanges, this time in their own words. SBAR is delivered as one single statement in real life, but in this activity, the learner will give an ‘S’ statement in the first exchange, ‘B’ in the second, and so on, to help them get the hang of each section.

Throughout the activity, a computer monitor displays Eli’s chart, helping the learner identify what to share with Dr. Grace. The challenge for them is how they’ll organize the key details into S, B, A and R.

Additionally, a clipboard next to the computer monitor displays a checklist of SBAR. Each letter is ticked as the learner correctly uses each part, giving them visual feedback of their performance.

In each exchange, AI technology determines whether or not they successfully used the right part of SBAR to share the information and give a nursing judgment. They receive different responses from Dr Grace and text feedback from the coaches depending on what they said, which provides guidance on how well they did and how to get back on track, if needed.

The learner repeats each exchange until they succeed. If they end up struggling, they can move on to the debrief with the coaches at any time.

When they succeed in all four exchanges, Dr. Grace confirms that she’ll arrange a pain management consultation with Eli, now prepared with the information she needs to progress his care. The learner then proceeds to debrief with Sam and Carlos. 

The learner rejoins Sam and Carlos in the hospital tutor room. They receive one of two possible outcomes, depending on whether or not they successfully gave Dr. Grace an SBAR update about Eli.

If the learner was successful, Sam and Carlos congratulate them for using the technique to communicate Eli’s care needs to Dr. Grace and helping to progress his care.

If the learner struggled and had to move on from the activity, the coaches offer reassurance and encourage the learner to keep practicing. They explain that it can take time to get used to adapting your communication style to SBAR.

The coaches then offer some closing thoughts about the technique, encouraging the learner to continue applying it in their daily lives. Then, they ask them to complete the same confidence survey from the start.

Before the learner leaves the module, they are asked to complete a short survey about their experience.

This data helps us to assess the effectiveness of our product and identify any areas that need improvement. Clients also find it beneficial when assessing ROI.

They are asked to mark whether they agree or disagree with the following statements, on a 10 point scale: 

• I would recommend this experience to others. 
• The experience helped me identify how to improve my communication skills when giving patient information to other care providers.
• I now have a better understanding of how to use the TeamSTEPPS® tool SBAR to share patient information.