Table 1. Overview of included studies.

First Author, Year, Data Collection, Country	Study Design	Population Characteristics	Instruments Y if validated	Frame-work	Intervention	Results
Barzallo Salazar, 2014 [42] 2011 to 2012 United States	RCT	Setting: OR Population: Medical students beginning their obstetric rotation Gender (male; female) I: 12/28; 16/28 C: 12/27; 15/27 Age (years) Mean: I: 26; C: 25	Personality tests General Decision Making Scale: Y Self-Construal Scale: Y	N	Simulated surgeries with training in basic surgical techniques and speaking up with trainees who witnessed a surgical error. The simulation was spread over two days and not more than one week between the surgical training session. A senior surgeon took a few minutes to create an environment for trainees to encourage/ discourage speaking-up using a scripted scenario	The trainees in the encouraged group were more likely to speak-up about the surgical error (p <0.001). The surgeon’s attitude influenced trainees’ willingness to speak up after controlling for personality traits (p <0.001).
Beck, 2019 [57] February to December 2017 Germany	RCT	Setting: simulated in-hospital cardiac arrest during mandatory BLS training at a University Medical Center Population: Physicians, nurses, scientist, administrative staff Gender Female % (n): I: 68 (160/235) C: 67 (116/174) Age (years) % (n) 16–2: 24 (57/241) C: 17 (30/178) 30–39: I: 34 (83/241) C: 33 (59/178) 40–49: I: 18 (44/241) C: 21 (38/178) 50–59: I: 20 (49/241) C: 24 (42/178) 60+: I: 3 (8/241) C: 5 (9/178)	German version of Team Assessment Scale (TAS): Y Internal consistency Cronbach’s α 0.67–0.81 [59]	Y Salas framework and shared mental models	Intervention included a 90-minute training session with a lecture on outcome relevant actions, group work to establish priorities in case of arrest, 4 min video of in-hospital BLS and practical training in AED use in teams with feedback. Participants received hands-on training in a two-rescuer BLS scenario on a high-fidelity manikin and feedback using learning conversation and a performance checklist.	TAS was high in all dimensions. Overall score for BLS performance was not significantly different between the groups p = 0.49. No significant difference between groups: Team Adjustment Behavior (TAB) p = 0.82
						Cooperation and information exchange (CIE) p = 0.43 Team coordination (TC) p = 0.88 Hands-off time lower in the intervention group (5.4% vs. 8.9, p = 0.029). All dimensions of the TAS correlated negatively with the hands-off time (TC: CC = 0.23; p = 0.010, CIE: CC = 0.28, p = 0.001, TAB: CC = 0.28; p = 0.001).
Chang, 2019 [53] October 2015 to January 2016 Taiwan	Pre/post test	Setting: Large teaching hospital. Population: newly registered postgraduate trainees (residents, nurses, respiratory therapists)	The technical skills: Y Non-technical skills (ANTS): Y Cronbach alpha (α) values from 0.79–0.83 [81].	N	Simulated transport of patient in sceptic shock with equipment difficulties and physiologic instabilities. The intervention included a two-hour training session spread over three months and included monthly in-situ scenarios, video-based feedback and focus group discussions to enhance re-evaluation, communication, prioritization of interventions, and equipment recovery. Tasks and competencies were outlined for each professional group.	Teams exhibited higher levels of non-technical skills (i.e., task management, teamwork, situational awareness, and decision-making) before and after transport (p values between 0.006 to 0.032), and participation in problem-solving (p values between 0.005 to 0.011). Only the results for the respiratory therapist group were not significant for participation in problem solving (p = 0.06). No corrections were applied for multiple comparisons in this study.
		Gender: Not reported
		Age: Not reported
Coppens et al., 2018 [55] February to April 2015 Belgium	RCT	Setting: High-fidelity simulation training in a Simulation Training Centre. Population: Nursing undergraduates N = 116 in 30 groups (3-5/ group): I: 15 groups (n = 60) C: 15 groups (n = 56) Gender Women %(n): I: 82 (49) C: 73 (41) Men: I: 18 (11) C: 27 (15) Age (years) % (n) I: 20–21 55 (33) >21: 45 (27) C: 20–21: 57 (32) >21: 43 (24)	Teamwork (CTS): (Kappa .78; interclass correlation .98) [82]: Y Team efficacy (TE): Construct validity: (Cronbach’s a > .8) and internal consistency (r = .57, p < .0001) [83]: Y General Self-Efficacy Scale (SE): Cronbach’s Alpha: .76–.90; [84]: Y Technical skills (TECH): N	Y	The 90-minute intervention included a 30-minute course on crisis resource management (CRM) principles with 45 minutes facilitated debriefing. Simulation mirrored a patient’s room. Two scenarios lasting 15 minutes were completed. Debriefing using Steinwachs’ approach included examining impressions following simulation, reconstructing the scenario, reflections on successes, challenges and ways to improve.	The intervention group had significantly higher scores on Teamwork (p = .011), CTS (p = .011), TE (p < .001) and TECH (p = .014), and a significant increase in all variables (SE (p = .02), CTS (p < .001), TE (p < .001)) except for TECH (p = .607). The experience from both interventions led to a significant increase in only CTS (p < .001) and TE (p = .001) for the control group.
Evain et al. 2019**[56] November 2015 to June 2016 France **Unclear if outcomes included 17 or 21 teams in the intervention group.	RCT	Setting: Scenarios in the emergency room; operating theatre; delivery suite; intensive care unit; and intra-hospital patient transport. Population: Year 1–5 trainees in anaesthetia and intensive care. Gender: n (%) In pairs FF/FM/MM I: 4(19)/ 11(52)/6 (29) C: 6 (29)/ 11 (52)/4 (19) Age Median [range] I: 27 [24–37] C:27 [24–30]	1) Twelve scenario checklists: N 2) Ottawa global rating scale [85]: Y 3) Visual analogue scale (VAS): N 4) Cognitive appraisal ratio: N	N	The intervention included a 4-minute period for a team planning discussion. The discussion initiated by two standardized questions, namely ‘Given the informationprovided, what can be expected?’ and ‘How will you organise yourselves?’. Facilitator prohibited from answering questions or leading the discussion. Oral briefing given before initiating the scenario. Following each simulation, two instructors led a structured debriefing. No details provided.	Clinical performance scores were higher in the intervention group (p = 0.039). After controlling for the scenario, the intervention associated with a 5-point (11%) increase in clinicalperformance score (95%CI (0.6–9.6), p = 0.029). No significant difference noted in crisis resource management scores following planning discussion (p = 0.065). Authors report similar perceived stress levels between the groups at three measurement times.
Fernandez, 2013 [52] August 2010 to March 2010 United States	RCT	Setting: Patient crisis resuscitation scenario Population: Code team. 4th-year medical students and 1st-, 2nd-, 3rd year residents in emergency medicine Gender n (%): Male I: 74(63) C: 67 (60) Age: Mean(SD) I: 27.7 (3.16) C: 27.2 (2.94)	Checklists measures using evidence-based guidelines. N	Y	Two-hour computer-based teamwork training that included audio-narrated slide presentation viewed at individual workstations, video-recorded validated high-fidelity simulations for resuscitation scenarios of a cardiac arrest or hemorrhagic shock, and debriefing.	The intervention significantly increased teamwork behaviours and patient care behaviours in teams receiving the computer-based teamwork training intervention (F (1, 42) = 4.66, p reported as less than 0.05) after controlling for experience using a low-intensity simulation platform. Team size did not significantly affect teamwork or patient care behaviours. No details provided for the debriefing.
Fernandez, 2020* [54] April 2016 to December 2017 United States*Some inconsistencies noted between the abstract and main text. Data extracted from main text.	Single- blind RCT	Setting: Actual trauma resuscitation at a regional, university-affiliated level 1 trauma center. Population: 2nd- and 3rd- year emergency medicine and general surgery residents acting as trauma team leaders as part of their training. Gender n (%): Male C: 21/30 (70) I: 19/30 (63) Age (years): Mean (SD) C: 29 (2) I: 30 (3) Residency year: n (%) Postgraduate Y2 C: 14/30 (37) I: 19/30 (63) Postgraduate Y3 C: 16/30 (53) I: 11/30 (37) Specialty: n (%) Emergency medicine C: 19/30 (63) I: 26/30 (87) General surgery C: 11/30 (37) I: 4/30 (13)	Team leadership measure: N Patient care measure checklist: N. Injury Severity Score [ISS] [26]. Y	N	Intervention included a single, 4-hour session with facilitated discussion of trauma leadership skills (30–45 min), a didactic session on leadership behaviors in trauma care (30 min. lecture), simulations, and debriefing sessions. Simulations could be adapted to facilitate learning and meet core training requirements. During the simulation, one participant functioned as the team leader, while the second participant observed using a leadership checklist. Debriefing immediately followed each simulation. Three self-identified areas for improvement and instructor observations informed subsequent simulations. A plan was created for each participant to apply learning in practice.	Simulation-based leadershipintervention resulted in a 56% improvement in leadership behavior after controlling for subject and patient factors (p<0.001). Intervention improved 5 out of the 7 leadership behaviors: Explicitly assuming leadership (p = 0.002); Performing pre-briefs (p < 0.001); Performing an arrival brief (p = 0.004); Performing huddles (p = 0.001); Seeking input (p = 0.030); Planning (p = 0.257); and Role assignment (p = 0.084). No significant differences in patient care between groups (p = 0.99)**. Leadership behaviors predicted patient care (p < 0.001) after controlling for experimental condition, year in residency, days since/until training, and ISS. Leadership behaviors appear to mediate the effect of training on patient care with a significant indirect effect.
Jankouskas, 2011 [43] Dates Not reported 10-month study period United States	Pre/post test	Setting: Intensive care unit transport team Population: 4-member teams of senior-year nursing students + third-year medical student. Gender: Male6% of the nursing student sample; 52% of the medical student sample Age: Not reported	University of the West of England Inter-professional Question naire Anesthetists’ Non-Technical Skills (ANTS) : Y	Y	Three-hour training session with two video-recorded scenarios, a high-fidelity simulator and didactic material for crew resource management (CRM) training related to task management, teamwork, situational awareness, a review of basic life support, and facilitated debriefing of patient crisis management using a non blaming technique. Four-member teams included senior-year nursing students and third year medical students.	Significant differences were noted for task management (p = 0.05), teamworking (p = 0.02), and situation awareness (p = 0.01). No differences were noted in error rates, response time for oxygen placement, response time for bag-mask-valve ventilation (BMV), and response time for chest compressions. Correlations between CRM training and team effectiveness measured using error rate and response time were not significant. Team process and team effectiveness improved in all groups from pretest to posttest as an effect of team practice (p < .001). No details provided of participant views of facilitated debriefing.
Kalisch, 2015 [44] Dates Not reported United States	Pre/post test	Setting: medical–surgical patient virtual patient care unit in an academic health center Population: Nursing staff who provide direct care to patients (RNs and nursing assistants). Gender: 81% female (n = 35) Age: Not reported	Nursing teamwork survey (NTS): Y Teamwork Knowledge Survey: Y Concurrent, convergent, and contrast validity is strong [60].	Y	One hour and 40 minute intervention included a 30-minute podcast of teamwork followed by a one-hour virtual simulation using a multi-user virtual environment. A 10-minute debriefing with an experienced trainer was conducted to highlight teamwork behaviours, provide feedback on the scenarios, and examine what would be done differently in the future. Three scenarios highlighted ways to resolve team conflicts between nurses and nursing assistants for common nursing problems using eight teamwork behaviours consistent with the Salas TeamSTEPPS model. The modules for the virtual environment were purchased from a software developer. The intervention required extensive preparation to develop the virtual unit, conference room, and semi-private rooms for patients.	Scores for teamwork overall (p = 0.12), trust (p = 0.042), team orientation (p = .004), and backup (p = .045) improved significantly. Scores for shared mental model, team leadership and teamwork knowledge did not reach significance. Computer proficiency pre- and post-intervention did not influence scores. No details provided of the results of the debriefing exercise.
			Adapted TeamSTEPPS Questionnaire [86]: Y Computer and virtual experience: questionnaire: N
Liaw, 2019 [58] Data collection dates not reported. Singapore	Three-arm RCT	Setting: Healthcare course involving three universities. Interprofessional bedside rounds involving a simulated patient with physical and psychosocial issues at a university simulation center. Students logged in to a virtual platform. Population: Healthcare students from medicine, nursing, pharmacy, physiotherapy, occupational therapy, and social work as part of their course work. Gender: Female: 65% Age: Not reported	Team performance rating scale: N Attitudes Towards Interprofessional Health Care Teams (ATIHCT). Cronbach α: 0.82. Y. Interprofessional Socialization and Valuing Scale (ISVS). Cronbach α: 0.95. Y.	N	Intervention 1 lasted 30 minutes and included asynchronous delivery of didactic training on cognitive tools to use in interprofessional rounds. Online video covered a modified ISBAR communication tool on team member roles, sequence and nature of communication with patients, families and healthcare team members, and the biopsychosocial model of health to facilitate the development of an actionable plan of care. Intervention 2 included a 2-hour virtual team training simulation where students embodied avatars of their health profession for real-time, virtual interprofessional rounds in two different scenarios. Debriefing after each scenario but no details provided. Scenario 1 was a bedside round of an elderly patient following surgery. Scenario 2 was a discussion with the patient’s family regarding discharge.	Only the full team training intervention significantly improved mean team performance scores (p<0.05). Both intervention groups significantly improved mean interprofessional attitude scores (ATIHCT: p<0.05; ISVS: p<0.001). No differences between intervention groups on mean team performance (p = 0.96) and interprofessional attitude (ATIHCT: p = 1.00; ISVS: p = 0.77) scores.
Mahramus, 2016 [45] Dates not reported. United States	Pre/post test	Setting: medical simulation laboratory at a large teaching hospital Population: Hospital code teams: physicians, nurses and respiratory therapists Gender: Female: 70% m Age: Not reported	Team tool: Y Program evaluation: N	N	Two-hour training session included two video-recorded cardiac resuscitation scenarios on airway and cardiac arrythmia management with a high-fidelity mannequin and a 45-minute educational session covering teamwork behaviours related to leadership, communication, role and responsibility designation, and mutual respect for physicians, nurses, and respiratory therapists on code teams. A 10-minute debriefing session led by the trained simulation leader followed the intervention. The intervention focussed on teamwork during cardiac arrest. Debriefing after each scenario.	Mean scores for teamwork and the overall rating of teamwork increased after the didactic training between the simulation 1 and 2 (p < .001). No differences were noted between professional groups for the overall rating of teamwork. Respiratory therapists rated teamwork higher than physician residents in the second simulation for items related to global perspective and prioritizing tasks (p = .05). Respiratory therapists scored higher than nurses and physician residents on team morale and following standards and guidelines (p = .05). Participants identified that the debriefing sessions were helpful to reinforce learning and provide an opportunity to step back from fast-paced events for an overview of critical events.
Marshall, 2009 [39] Dates Not reported Australia	RCT	Setting: Not reported Population: final-year medical students Gender: Not reported Age: Not reported	Patient satisfaction questionnaire with attending rounds: N	N	Forty-minute small-group training session related to the Identification, Situation, Background, Assessment, Recommendation (ISBAR) communication tool and a simulated scenario using a patient simulator into a 2- to 4- hour didactic lecture for final year medical students. Students needed to ask a senior clinician for assistance over the telephone during a crisis situation. The 40-minute small group teaching session focussed on the importance of effective communication during telephone referrals, critique of videos exemplifying poor communication including the lack of explicit declaration of identity and location, presentation of the ISBAR tool and role plays. Students were allocated to groups of 10 to 12 participants and reporting was done by one student to represent the group.	The content and clarity of the telephone communication was rated higher (p <0.001).
Monash, 2017 [46] September to November 2013 United States	Cluster-RCT	Setting: internal medicine teaching service Population: team of physician, senior resident (2nd or 3rd year of residency training), 2 interns, and a 3rd and/or 4th-year medical student. AND their patients admitted to the medicine service. Gender: Providers: Not reported Patients (Women) n (%):I: 301 (51); C: 337 (56) Age mean (SD): Providers: Not reported Patients: I : 59.5 (18.9); C : 60.1 (18.7)	Patient and provider questionnaires adapted from the literature: No details provided: N	N	Standardized bedside rounds to present and discuss patients’ plans of care. Rounds were conducted by teams of physicians, senior residents, two interns and third- and fourth-year medical students and the patients they followed who were admitted to a medicine service. The training session lasted 1.5 hours and focussed on a bundled set of five key attending rounds recommendations that included 1) pre-round huddle to establish round schedule and priorities, 2) conduct of round, 3) inclusion of bedside nurses in rounds, 4) real-time order entry, and 5) updated patient care plan on a whiteboard. Monthly training sessions were conducted with physicians and physician residents in the intervention arm. Patient views were measured to determine their level of involvement in decision-making, quality of communication between the patient and the medical team, and perception that the medical team cared for them.	Significant differences were noted for pre-round huddle (p < .001), conduct of rounds (p < .001), inclusion of nurses (p < .001), real-time order entry (p < .001), use of whiteboard (p < .001). Patient satisfaction significantly different with rounds (p = 0.011) and perception that team cares for them (p = 0.031). The time spent per patient increased by four minutes on average (p < .001). Several differences were noted in trainee and MD satisfaction scores. Although the intervention decreased the time needed for rounding by an average of 8 minutes (p = 0.52), trainees perceived that attending rounds lasted longer (p < .001).
O’Leary, 2010 [47] August-February 2008 United States	RCT	Setting : nursing station of a tertiary-care teaching hospital Population : physician residents, nurses Gender Women n (%):Physician Resident: C: 25(61), I: 23(49) Nurses : C: 22(88), I: 31(91) Age Mean (SD) Physician Resident: C: 27(1.7) I: 27.6 (2.1) Nurses: C: 33.6 (8.3) I: 30.8 (8.0)	Safety Attitudes Questionnaire: Y Scale reliability was 0.9 using Raykov's ρ coefficient, indicating strong reliability [87].	N	Structured daily inter-disciplinary rounds (SIDR) that included a structured communication tool to address the needs of newly admitted patients, patient safety and develop a plan of care. The tool was used in conjunction with regular interdisciplinary rounds co-led by the nurse manager and unit medical director. A work group met weekly over 12 weeks prior to implementation to determine content areas and develop the communication tool.	The intervention lasted an average 33.5 minutes (standard deviation: 5.7 minutes) and included a structured communication tool to discuss the needs of patients admitted within the last 24 hours. Differences noted in teamwork climate (p = .01) with higher perceptions of teamwork climate by nurses (p = .005), nurses’ rating of the quality of communication and collaboration and perceptions of SIDR (p = .02). No differences noted in physician resident ratings of the quality of communication and collaboration and perceptions of SIDR. Physicians and nurses agreed that SIDR improved efficiency of the workday, collaboration and patient care. No differences were noted for safety climate, length of stay or costs.
Oner, 2018 [48] April-July 2016. United States	RCT	Setting: labor and delivery and postpartum units Population: nurses Gender n(%): Female I: 34 (100) C: 36 (100) Age mean (SD): I: 42.4 (12.3) C: 43.4 (11.3)	Modified Pian-Smith grading scale: Y	N	Three-hour simulation-based educational intervention on assertiveness and advocacy training for nurses. The intervention included a review of information about the Maternal Abnormal Vital Signs (MAViS), training in the Assertiveness/ Advocacy/CUS/two-challenge rule (AACT) for nurses in labour and delivery and postpartum care to encourage speaking up, and debriefing using a two-on-one advocacy-inquiry non judgemental technique. Training included Power Point slides and pre-scripted role-playing scenarios, simulations and debriefing. Ten to 15 minute debriefing sessions performed immediately to demonstrate assertiveness, recognize emergency situations and reflect on performance and provide guidance to change internal dialogue and encourage nurses’ willingness to speak up. Each simulation lasted 5–10 minutes followed by 10–15 minute debriefing.	No significant differences in speaking up were found between the control group and intervention. Differences were found within groups where nurses in labour and delivery spoke up more than nurses in post partum (2.29 ± 0.89 vs. 1.25 ± 0.43, P < 0.006). These differences remained significant after controlling for baseline differences.
Thomas, 2010 [49] AND Katakam, 2012 [50] June 2007 to June 2008 United States	RCT	Setting: Surgical and Clinical Skills Center. Cardiac arrest simulation theaters.m Population: incoming interns (1st year) for pediatrics with no previous completed NRP certification Gender: Not reported Age: Not reported	Neonatal Resuscitation Program Megacode Assessment Form: N	N	Two-hour training session for first-year incoming interns in pediatrics about teamwork, resuscitation using high-fidelity and low fidelity mannequins to standard neonatal resuscitation program (NRP) and debriefing after each scenario. The intervention provided by two trained instructors included information about human error, communication behaviours (information sharing, assertion, inquiry, vigilance, leadership), standard terminology, SBAR (Situation, background, assessment and recommendation) communication, customized video-clips and role playing to illustrate teamwork, and debriefing after each scenario.	Interns who received a brief teamwork curriculum with NRP training used more frequent teamwork behaviors (p = 0.001). Each additional assertion behaviour per minute (e.g., voicing an opinion, change of phase in resuscitation) resulted in a 41 second decrease in resuscitation duration (p = 0.009). Teams who received team training took less time to complete the resuscitation scenarios (p = 0.009) and resuscitation workload was better managed (p<0.001). The effect of the intervention on team behaviors persisted for at least six months (9 = 0.030). There was no clear affect on team vigilance as all teams maintained their vigilance for at least 95% of the scenario. High or low fidelity did not influence NRP performance of resuscitation duration. No information provided about debriefing.
Weaver, 2010 [51] February to July 2008 United States	Quasi-experimental mixed-model design	Setting: OR service line with a control location. C and I groups located at separate campuses Population : surgeons, certified registered nurse anesthetist, nurse, surgical technician anasthesiologist, physician assistant Gender: not reported Age: mean 36–55.5 years	Trainee reactions to training session: N Medical Performance Assessment tool: N Hospital Survey on Patient Safety Culture (HSOPS): Y HSOPS subscales between 0.40–0.83 [88] Operating Room Management, Attitudes Questionnaire (ORMAQ): Y	Y	Four-hour training session using interactive role playing for three interdisciplinary teams from the operating theater to improve teamwork and highlight impact of the TeamSTEPPS program. Didactic sessions included TeamSTEPPS competencies related to structured communication (e.g., SBAR, Call-Out, Check-Back), leadership, mutual support, and situation monitoring. Behaviours in the OR were measured using an observation tool to capture precase briefing and debriefing.	Differences were noted in communication (p < .05), precase briefing (p < .001), mutual support (p < .05), and situation monitoring (p < .01). No differences were noted in leadership, debriefing, dimensions of the Hospital Survey on Patient Safety and the Operating Room Management Attitudes questionnaire.
Weller, 2014 [41] Dates Not reported New Zealand	Pre/post test	Setting : post-anaesthesia care unit (PACU) simulated crisis of two major teaching hospitals Population : anaesthetists, anaesthetic technicians, and PACU nurses Gender: not reported Age: not reported	TeamSTEPPS Survey: Y HSOPS questionnaires: Y Reliability estimates Cronbach alpha from 0.88–0.96 reported elsewhere [86, 89].	N	Video-recorded teaching simulation based on the Stop; Notify; Assessment; Plan; Priorities; Invite ideas (SNAPPI) structured communication tool, and a 10-minute debriefing session for anesthetists. Anesthesia technicians and post-anesthesia care unit nurses received relevant information probes about the surgical case that were not provided to the anesthetists. The intervention lasted 45 minutes and included a 15-minute baseline video-recorded simulation to explain SNAPPI and a demonstration of a simulated patient crisis. A 10-minute educational debriefing session highlighted crisis management principles. A follow-up simulation was completed an average of 37 days apart (range 24–91 days).	Anesthetists learned all the probes in 27% of simulations (range: 10–49%). Significant differences were noted for the SNAPPI scores (p < .001), verbalize diagnoses (p = .043). No differences were noted for team information sharing and medical management. The debriefing sessions highlighted that anesthetists believed that it was common for operating room personnel to have different information about a surgical case.
Zausig, 2009 [40] 2003 Germany	RCT	Setting: Two university hospitals and 5 community hospitals. Setting of scenarios: not reported Population: Anaesthesiologist (more than 6 months experience) Gender n male/female I: 10/10; C: 12/10 Age (years): I: 33 (30–37); C: 31 (29–35)	ANTS: Y	N	Intervention for anesthesiologists with at least six months work experience that lasted 3.5 hours and incorporated two scripted simulation scenarios and a single in-depth debriefing session to compare the medical management and non-technical skills in a simulated anesthesia crisis. Each group had a distinct debriefing strategy with an emphasis on reflecting on one’s performance. The intervention included a single training session and a 30-minute video-based debriefing where medical management was addressed in both groups (10 minutes) and non-technical skills were addressed in the intervention group. The first scenario included actors and interactive lectures on topics related to crisis management and non-technical skills (i.e., resource management, planning, leadership, communication).	The overall quantity of the non-technical skills were different between the groups (p = 0.02). The medical management activities and the quality of the non-technical skills were highly correlated (r = 0.59, p < .001). However, the overall quality of the non-technical skills was not significantly different between the groups. A single debriefing session did not improve non-technical skill performance.