***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To determine if high fidelity simulation based team training can improve clinical team performance when added to an existing didactic teamwork curriculum . Setting : Level 1 trauma center and academic emergency medicine training program . Participants : Emergency department ( ED ) staff including nurses , technicians , emergency medicine residents , and attending physicians . Intervention : : ED staff who had recently received didactic training in the Emergency Team Coordination Course ( ETCC ® )  also received an 8 hour intensive experience in an ED simulator in which three scenarios of graduated difficulty were encountered . A comparison group , also ETCC trained  , was assigned to work together in the ED for one 8 hour shift . Experimental and comparison teams were observed in the ED before and after the intervention . Design : Single , crossover , prospect i ve , blinded and controlled observational study . Teamwork ratings using previously vali date d behaviorally anchored rating scales ( BARS ) were completed by outside trained observers in the ED . Observers were blinded to the identification of the teams . Results : There were no significant differences between experimental and comparison groups at baseline . The experimental team showed a trend towards improvement in the quality of team behavior ( p = 0.07 ) ; the comparison group showed no change in team behavior during the two observation periods ( p = 0.55 ) . Members of the experimental team rated simulation based training as a useful educational method . Conclusion : High fidelity medical simulation appears to be a promising method for enhancing didactic teamwork training . This approach , using a number of patients , is more representative of clinical care and is therefore the proper paradigm in which to perform teamwork training . It is , however , unclear how much simulator based training must augment didactic teamwork training for clinical ly meaningful differences to become apparent OBJECTIVE To evaluate the effectiveness of training and institutionalizing teamwork behaviors , drawn from aviation crew re source management ( CRM ) programs , on emergency department ( ED ) staff organized into caregiver teams . STUDY SETTING Nine teaching and community hospital EDs . STUDY DESIGN A prospect i ve multicenter evaluation using a quasi-experimental , untreated control group design with one pretest and two posttests of the Emergency Team Coordination Course ( ETCC ) . The experimental group , comprised of 684 physicians , nurses , and technicians , received the ETCC and implemented formal teamwork structures and processes . Assessment s occurred prior to training , and at intervals of four and eight months after training . Three outcome constructs were evaluated : team behavior , ED performance , and attitudes and opinions . Trained observers rated ED staff team behaviors and made observations of clinical errors , a measure of ED performance . Staff and patients in the EDs completed surveys measuring attitudes and opinions . DATA COLLECTION Hospital EDs were the units of analysis for the seven outcome measures . Prior to aggregating data at the hospital level , scale properties of surveys and event-related observations were evaluated at the respondent or case level . PRINCIPAL FINDINGS A statistically significant improvement in quality of team behaviors was shown between the experimental and control groups following training ( p = .012 ) . Subjective workload was not affected by the intervention ( p = .668 ) . The clinical error rate significantly decreased from 30.9 percent to 4.4 percent in the experimental group ( p = .039 ) . In the experimental group , the ED staffs ' attitudes toward teamwork increased ( p = .047 ) and staff assessment s of institutional support showed a significant increase ( p = .040 ) . CONCLUSION Our findings point to the effectiveness of formal teamwork training for improving team behaviors , reducing errors , and improving staff attitudes among the ETCC-trained hospitals Objective To test an intervention to enhance collaborative communication among nurse and physician leaders ( eg , nurse manager , medical director , clinical nurse specialist ) in two diverse intensive care units ( ICUs ) . Background Collaborative communication is associated with positive patient , nurse , and physician outcomes . However , to date , intervention-focused research that seeks to improve collaborative communication is lacking . Methods A pretest – posttest repeated measures design incorporated baseline data collection , implementation of the intervention over 8 months , and immediate and 6-months-post data collection . Findings Communication skills of ICU nurse and physician leaders improved significantly . Leaders also reported increased satisfaction with their own communication and leadership skills . In addition , staff nurse and physician perceptions of nursing leadership and problem solving between groups increased . Staff nurses reported lower personal stress ( eg , more respect from co-workers , physicians , and managers ) , even though they perceived significantly more situational stress ( eg , less staffing and time ) . Conclusion Study findings provide evidence that nurse – physician collaborative communication can be improved Objective To determine the emergency department ( ED ) environmental factors associated with patient satisfaction . Methods A prospect i ve , observational study in a university-affiliated tertiary-referral ED and associated observation unit ( OU ) . The ED environment was evaluated with a structured question naire , scored using a 100-mm visual analogue scale . Patients who stayed in the ED over 8 h ( long-stay ED ; LSED ) were compared with those who stayed less than 4 h ( short-stay ED ; SSED )  and with a control group admitted to the OU .  Results A total of 233 patients was enrolled , overall satisfaction in SSED was 81 % ( 95 % CI 70.1 to 88.7 ) , 69 % in LSED ( 95 % CI 57.4 to 78.7 ) and 84 % in OU ( 95 % CI 73.6 to 91.0 ) . The most important environmental factors were cleanliness ( median importance 95 , interquartile range ( IQR ) 81–98 ) and communication with medical staff ( 94 , IQR 80–98 ) and family ( 92 , IQR 74–98 ) . The least important factors were access to nature ( 38 , IQR 19–65 ) , a natural light source ( 50 , IQR 24–74 ) and ability to sit out of bed ( 52 , IQR 26–75 ) . Factors rated high for importance but low for satisfaction were ED noise levels ( median difference 40 , IQR 3–70 ) , ED trolley comfort ( 19 , IQR 6–50 ) and food quality ( 12 , IQR −4–29 ) . Conclusion Patients who spend over 8 h in the ED are less satisfied with their environment than either those who spend less than 4 h or patients in an OU . Importantly , distinct , amenable factors can be identified . These should be addressed to improve patients ’ overall ED management and satisfaction 
    Output:
    
Environmental design , which involves nurses , support staff , and physicians , is one of the critical factors that promotes the efficiency of teamwork and collaborative communication .
Layout design , visibility , and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities