Using Simulation-based Team Training to Improve Psychological Safety and Relational Coordination as Well as Conducting a Process Evaluation (InfecSIM)

Simulation-Based Team Training to Improve Psychological Safety and Relational Coordination in Clinical Teams

Simulation-based team training is increasingly used in hospitals to support teamwork and communication, particularly in situations that are complex or time-critical. While such training is known to improve observable team behaviours, less is known about how it is implemented in everyday clinical work and how it influences relational aspects of teamwork, such as psychological safety and relational coordination.

This study explores the implementation and perceived impact of a simulation-based training programme focused on infectious disease management in a hospital department. Psychological safety refers to whether staff feel safe to speak up, ask questions, and express concerns, while relational coordination concerns how well different professional groups communicate, share goals, and align their work.

Using a qualitative process and outcome evaluation, the study examines how the simulation activities were introduced, adapted, and experienced by different staff groups, and how participants perceived their influence on collaboration and professional behaviour. Data are collected through interviews with clinical staff and managers, questionnaires measuring psychological safety and relational coordination before and after the intervention, and systematic registration of simulation activities (including who participated, what was trained, and when and where simulations took place).

By combining process evaluation with an exploration of perceived outcomes, the study aims to provide insight into how simulation-based team training functions as a behavioural intervention in complex clinical settings, and how it may support psychologically safe and well-coordinated teamwork in everyday practice.

Study Overview

• Status: Active, not recruiting
• Conditions: Simulation Training; Medical Education, Simulation, Crisis Resource Management; Simulation Based Medical Education; Culture
• Intervention / Treatment: Behavioral: Simulation-based team training

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Aarhus, Denmark, 8200
    • Department of Infectious Diseases, Aarhus University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Employed in the included departments
• Profession as a doctor or nurse

Exclusion Criteria:

• If participants are employed in both intervention and control group during the project period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control
Experimental: Simulation intervention	Behavioral: Simulation-based team training; Staff participates in a simulation-based training initiative

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychological safety	Psychological safety will be assessed using the Team Psychological Safety scale (Edmondson). The scale consists of 7 items rated on a 1-7 Likert scale, with higher scores indicating greater psychological safety. The outcome will be reported as the mean questionnaire score. Qualitative interviews are not included in this outcome measure.	Baseline and immediately after the intervention period.
Relational coordination	Relational coordination will be assessed using the Relational Coordination Survey (Gittell). Items are rated on a 1-5 scale, with higher scores indicating stronger relational coordination. The outcome will be reported as the mean questionnaire score. Qualitative interviews are not included in this outcome measure.	Baseline and immediately after the intervention period.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Process evaluation	The process evaluation examines how the simulation-based team training was implemented, including organisation, adaptation, and contextual conditions shaping delivery and participation. Data are collected through qualitative interviews and systematic registration of simulation activities.	From intervention start until immediately after the intervention period.
Qualitative explanatory evaluation of intervention mechanisms	Qualitative interviews will explore how staff and managers describe changes in everyday work practices following the simulation-based team training and how these changes are understood within the local clinical context. Outcomes will be reported as qualitative themes.	Immediately after the intervention period.

Collaborators and Investigators

• Sponsor: University of Aarhus

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2025
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): January 1, 2028

Study Registration Dates

• First Submitted: January 15, 2026
• First Submitted That Met QC Criteria: January 23, 2026
• First Posted (Actual): February 2, 2026

Study Record Updates

• Last Update Posted (Actual): February 2, 2026
• Last Update Submitted That Met QC Criteria: January 23, 2026
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: Simulation-based team training; relational coordination; psychologically safety
• Other Study ID Numbers: InfecSIM

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No