The COVID-19 pandemic challenged schools of nursing to reimagine operations including course delivery, accreditation preparedness, curriculum review, meetings, and clinical placements. To successfully navigate these issues, faculty need strong relationships, clear communication, conflict mitigation skills, and situational awareness. Teamwork training promotes collaboration, improves communication, and reduces conflict.1 Pandemic constraints alter normal communication patterns while prohibiting face-to-face teamwork training; however, implementing established teamwork tools counteracts the barriers by fortifying structure and communication.2

Although descriptions of teamwork tools in the clinical setting abound, the literature lacks information demonstrating application in academic environments. A quality improvement (QI) intervention focused on improving teamwork and communication at a school of nursing indicated that faculty most often used the TeamSTEPPS tools of Situation-Background-Assessment-Recommendation/Request (SBAR), Brief, Huddle, and Debrief.3 This intervention included education and coaching in the TeamSTEPPS concepts and tools adapted for the academic environment and resulted in improvement in Team Structure, Leadership, and Communication.3 Although this QI project was not conducted during the pandemic, it provides insight into the TeamSTEPPS tools applicable to the academic environment.

In addition, in 2019, the authors conducted a survey of faculty in schools of nursing in 4 Midwest states to assess perceptions of teamwork as well as likelihood to use various TeamSTEPPS tools in the academic setting. The participants (n = 511) reported being most likely to use the TeamSTEPPS tools of Brief, Debrief, and Huddle.

These surveys and QI projects highlight that when schools adapt teamwork tools, communication and collaboration between faculty might be improved. This article informs nurse educators of TeamSTEPPS clinical communication tools and how they may be applied to the academic setting.

SBAR

The SBAR technique creates a framework for constructing a conversation that is focused, is concise, and can be used in verbal and written communication.1 Adapted for academia, the R often represents request rather than recommendation.

* Situation[forms light horizontal]What is happening at the present time?

* Background[forms light horizontal]What circumstances led up to this situation?

* Assessment[forms light horizontal]What is the problem?

* Recommendation/Request[forms light horizontal]What is the recommendation/request?

Example: Because of COVID-19, most departmental communication shifted to email, phone, and/or videoconferencing. Faculty and staff needed to establish parameters to increase clarity and prioritize the importance level. The SBAR technique provides an efficient format for focused communication. Imagine an email correspondence from a new faculty member to the prelicensure program director:

Situation: A student sends an email with an attached assignment on November 5, 2020, explaining that she forgot to submit an assignment due on October 28, 2020.

Background: The assignment due date was listed on course calendar and in weekly PowerPoint presentation. The syllabus states: "All written assignments are due on the date specified on course materials. Written assignments turned in after the due date will receive 5%/day deduction and will not be accepted if more than 3 days late."

Assessment: No technical issues prevented the student from turning in the assignment as 70 students were able to submit. Also, the student did not communicate any extenuating circumstances necessitating a late assignment.

Request: Because I am unfamiliar with standard practices of the School of Nursing for accepting late assignments, I am seeking guidance so that I am in alignment with other instructors. I am inclined to accept the assignment with the 5% per day deduction. If standard practice is to give a zero for the assignment, I can do that as well.

Brief

Briefs are held for planning purposes and are an effective strategy for sharing a plan, designating team roles and responsibilities, establishing goals, and engaging the team in short- and long-term planning.1 Briefs should occur at designated times such as the beginning of the semester and can be facilitated using a briefing checklist.

Examples: Faculty use a brief to discuss educational activities and issues among didactic and clinical faculty teaching the same cohort of students. The briefings are held at the beginning, middle, and end of each semester. At the beginning of the semester, the briefing is used to discuss the plan for the semester relative to the student learning objectives. Faculty discuss how classroom instruction/activities are applicable in the clinical setting and determine how to make the connection for students. For example, in the Leadership didactic course, students are required to complete a QI assignment. To make the connection to practice, the clinical instructors seek out examples of QI in the clinical setting. This has been beneficial in setting the stage for a successful course for the students and in fostering relationships among faculty.

Briefs also can be used at the start of an academic year for initial committee meetings to clarify committee duties, bylaws, and goals. Later, at each committee meeting, the brief can set the stage for critical agenda and action items to be accomplished by the team.

Huddle

Huddle is a tool for communicating adjustments to a plan that is already in place and allows team members to discuss critical issues and emerging events, anticipate outcomes and likely contingencies, assign resources, and express concerns.1 When a plan changes or aspects of the current plan are not working, a huddle can be convened by either the designated or situational leader.

Examples: A huddle can be called when a clinical practicum site is canceled, requiring an adjustment. The individual calling the huddle may be an administrator, a clinical instructor, a clinical placement coordinator, or another person designated as the leader. Huddle participants should include those with relevant knowledge or an interest in the outcome, for example, clinical instructors, clinical placement coordinator, academic advisor, simulation laboratory personnel, and administrator(s). Representatives from the clinical agency can be included if appropriate. The huddle is not intended to generate a long-term solution.

Another huddle opportunity arises when a task force or committee works on a complex situation, and team members find that sporadic electronic messaging leads to a lack of understanding or misunderstanding. Instead of perpetuating electronic communication, a team member may request a huddle to bring the team together either on the telephone or in a virtual meeting to gain situational awareness.

Debrief

Designed to improve processes and outcomes after meetings or events, a debrief functions as a concise, informal exchange summarizing lessons learned, successes, plans for improvement, and actionable goals.1 A debrief should last 3 to 5 minutes and can be facilitated using a checklist.

Example: At the end of faculty meetings, a debrief is conducted using the questions: what went well, what can be improved, what can be done differently, and what are the action items. Debriefs can also be used to account for assigned tasks and due dates to ensure that all participants are clear on the deliverables from the meeting.

CUS

"I'm Concerned, I'm Uncomfortable, there may be Safety issues" (CUS) acts as a mechanism to "stop the line" and alert team members to significant issues.1 In academia, the S may also represent success or satisfaction. Using CUS can alert the team or colleague that something critical must be addressed.

Example: A COVID-19 surge closes clinical practice sites: an instructor observes nursing students not demonstrating competency using only simulation experiences. The instructor uses CUS to alert the clinical coordinator of this critical issue: "I am concerned about the student's competency level and am uncomfortable with the situation. I believe there are patient care safety issues for our students as well as success issues for taking boards and professional practice."

Conclusion

In academia, the COVID-19 pandemic created unique communication and teamwork challenges. The volume of information being communicated, coupled with an unprecedented rate of change and the move to remote communication, called for clear, timely, and frequent communication. TeamSTEPPS tools have not been formally studied during the COVID-19 pandemic; however, evidence exists to recommend their use during this difficult time. Proven tools such as these compensate for barriers in communication and provide increased clarity and efficiency while minimizing misunderstanding.

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