NetworkZ is a simulation-based team training programme for operating room staff. Types of training include scenarios followed by debriefs, and facilitated discussions and training on key communication tools.
The NetworkZ process has been carefully designed to integrate three forms of learning.
Team participation in challenging cases.
Facilitated debrief exploring the experience.
Complementary training in communication and teamwork strategies.
The scenarios are created from clinical cases and reviewed and validated by content experts. The participants will engage in simulated realistic procedures on a 'patient' - this may be an actor or or simulator.
The simulator can be programmed to realistically depict a range of clinical situations in healthcare. Teams will need to work collaboratively to manage each situation. The training is complemented with training on specific communication tools and techniques.
What makes NetworkZ effective?
NetworkZ was piloted at the University of Auckland Simulation Centre for Patient Safety (SCPS) between October 2012 and July 2013. We delivered 20 courses to 120 general surgical staff (surgeons, anaesthetists, nurses and anaesthetic technicians) from Auckland and Counties-Manukau DHBs. Evaluation data from participant questionnaires, interviews and analysis of course performance showed a positive effect. OR teams (200 pre, 200 post NetworkZ) showed a significant improvement in scores for teamwork and communication, which previous research suggests will reduce the risk of patient morbidity and mortality by 14%.1
1 Weller JM CD, Civil I, Torrie J, Merry A et al. Multidisciplinary Operating Room simulation-based team training to reduce treatment errors: a feasibility study in New Zealand hospitals. N Z Med J 2015;in press.
What is unique about NetworkZ training?
Health professionals often participate in discipline-specific training but operating room teams rarely train and reflect as a team.
NetworkZ is an innovative programme because its specific aim is to train teams that normally work together: surgeons, anaesthetists, nurses, anaesthetic technicians, and other members of the OR team.
What does the NetworkZ training look like?
The NetworkZ training is approximately 8 hours of face to face training for operating theatre teams. The teams will be made up of the normal staffing model for your DHB but should include a surgeon, anaesthetist, anaesthetic technician, 2-3 nurses. The team can also include registrars or additional healthcare staff in your OR model. We recommend a team of 6 - 10 people per session.
The training is modular in design to create flexibility in the delivery.
1 hour sessions on key communication tools: speaking up, closed loop communication and sharing the mental model
Half day of scenario-based learning with up to 3 scenarios and debriefs.
Full day of scenario-based learning with 5-6 immersive scenarios, debriefs and discussions.
The intention is that all OR staff take part in a minimum of one full NetworkZ course in a 4 year period.
What is simulation-based training?
Simulation-based learning (SBL) is a technique that uses a situation or environment created to allow persons to experience a representation of a real event for the purpose of practice, learning, evaluation, testing, or to gain understanding of systems or human actions.
When can my DHB expect to be involved with NetworkZ?
The programme will be rolled out in stages to all DHBs in NZ with training being rolled out sequentially each 12 months from February 2017.
Capital & Coast
Bay of Plenty
What is the timeline for the NetworkZ training at DHBs?
All DHBs in New Zealand will be offered the NetworkZ programme in a staged roll out. Five DHBs will be recruited to start at 12 month intervals thus covering the 20 DHBs in four cohorts.
The NetworkZ programme involves training local champions to run NetworkZ to an accredited standard at each DHB. The Instructor Training Programme will offer instructors initial training and ongoing multi-modal support to deliver NetworkZ training specifically to meet their DHB needs.
Over a five year timeframe we aim to establish NetworkZ nationwide.
What do I need to know about being a participant?
Participants are those who receive the training.
Who is the training for?
The NetworkZ course is for operating room teams – surgeons, anaesthetists, nurses, anaesthetic technicians, and support staff. Because the learning is team based it is vital that all members of operating room teams attend the training together.
What does the training involve?
The training includes 8-10 hours of face-to-face time, which can be broken into 2 or 3 modules. During this time participants will take part in a simulated training scenario in their normal role, debrief as a team the the help of experienced facilitators, and receive instruction to provide them with a toolkit of tried and proven communication strategies.
When will the training be provided?
In accordance with our logistical capabilities, the roll out will be a stepped process in which training is provided to cohorts of DHBs, one cohort at a time (see NetworkZ timeline).
What is involved in becoming a NetworkZ Instructor?
Locally-led and centrally supported
The local instructors will be nominated by their DHB - expressing an interest, having simulation experience and enthusiasm are all a good start. Your group should represent a range of disciplines. The group from each DHB will take part in a two-day instructor course (the first one being held in Auckland) that will introduce them to NetworkZ, human factors and debriefing. The NetworkZ faculty will then come to each DHB at least three times to run NetworkZ with the local staff. Instructors will be trained and mentored by NetworkZ faculty with ongoing trainng and support.
Accredited Instructor Training Programme
Accreditation as NetworkZ instructors will be achiecved at the completion of additional online learning modules and simulation delivery.
Advanced Training Course
This will be offered after simulation activities have been established within DHBs.
Ongoing support for trainers
All local NetworkZ instructors will have access to a suite of resources in the form of an e-Learning package with course material, practical exercises, discussion boards, assignments, and portfolio recommendations. Answers to queries and techical issues will be provided by email and telephone.
What simulation equipment is used?
Laerdal SimMan 3G
The main piece of simulation equipment that supports the NetworkZ training is the Laerdal SimMan 3G. This is a full body life size manikin with computerised functions. Training and support will be provided for operating the manikin.
The scenarios are augmented with additional surgical models that will be part of the scenarios and provided as part of the programme. Smaller models will be part of scenario packages and become DHB property while larger more sophisticated models will be shared across regional DHBs.
Is NetworkZ linked to PROMPT Maternity training?
NetworkZ is not linked to the the PROMPT training but would compliment this and other existing mulit-professional training in DHBs. Similar principles are employed but unlike PROMPT which is situated in the delivery suite, NetworkZ is in the OR. The scenarios would be surgically focused.
At this stage obstetrics and gynacology specialtes are not included in the NetworkZ roll out - because PROMPT training is already mandated by the College. Also Laerdal SimMan 3G does not have the capacity to have a fetus like specifically designed maternity manikins.
This does not stop DHBs from creating specific obstetric and gynecology scenarios and utilising the surgical models to manage massive haemorrhage, failed intubations, and many other critical events.
What progress have we made to date?
NetworkZ is now embedded in all 20 DHBs across New Zealand. The program is well established in 15 DHBs. The last five DHBs came on board in early 2020. T