Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2026.844812
Brazilian Journal of Anesthesiology
Original Investigation

Impact of named caps on anesthesia and intensive care team performance: a randomized simulation study

Impacto de toucas com identificação no desempenho da equipe de anestesia e terapia intensiva: um estudo de simulação randomizado

Sylvain Garnier, Laurent Mattatia, Nicolas Boulet, Gregoire Bosselut, Chris Serrand, Sylvain Benenati, Philippe Cuvillon, Laurent Muller, Lionel Brunel, Claire Roger

http://dx.doi.org/10.1016/j.bjane.2026.844812 Braz J Anesthesiol, vol.76, n5, 844812, 2026
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Abstract

Background

Effective communication and team non-technical skills are key points for patient safety in anesthesia and intensive care. Named caps have been proposed as a strategy to enhance team efficiency. However, evidence regarding their impact on objectively assessed team performance remains limited.

Methods

We conducted a prospective, single center, randomized, and experimental study in a high-fidelity simulation setting (SimHU, Nîmes). Anesthesia and intensive care residents, young doctors, and paramedics participated in simulated critical scenarios, alternating between sessions with and without named caps. The primary objective was to compare team performance, assessed by observers using the TEAM score. The secondary objectives were self-reported measures of entitativity, team cohesion and inclusion of self in the group.

Results

A total of 112 participants across 32 simulation sessions were included, which were assessed by 19 instructors. TEAM scores were significantly higher in the named cap group compared to the control group: the 44 points TEAM score (37 ± 7 vs. 33 ± 7; p = 0.026) and the total score (45 ± 8 vs. 40 ± 9; p = 0.020). Subjective perceptions of entitativity and team cohesion did not differ significantly.

Conclusions

Named caps were associated with higher team performance in a simulated environment. Their impact on perceived team cohesion and entitativity was not statistically significant under simulation conditions. Further research in clinical settings is needed to determine whether named caps improve teamwork and patient safety.

Keywords

Anesthesiology; Clinical Competence; Communication; Patient care team; Patient safety; Simulation training

Resumo

Introdução

Uma comunicação eficaz e habilidades não técnicas da equipe são pontos-chave para a segurança do paciente em anestesia e terapia intensiva. O uso de toucas com identificação (contendo nome e função) tem sido proposto como uma estratégia para aumentar a eficiência da equipe. No entanto, as evidências sobre seu impacto no desempenho da equipe avaliado de forma objetiva permanecem limitadas.

Métodos

Conduziu-se um estudo experimental, prospectivo, randomizado e de centro único em um ambiente de simulação de alta fidelidade (SimHU, Nîmes). Residentes de anestesiologia e terapia intensiva, médicos recém-formados e paramédicos participaram de cenários clínicos críticos simulados, alternando entre sessões com e sem o uso de toucas com identificação. O objetivo primário foi comparar o desempenho da equipe, avaliado por observadores por meio do escore TEAM. Os objetivos secundários foram as medidas autorrelatadas de entitatividade, coesão da equipe e inclusão do eu no grupo.

Resultados

Um total de 112 participantes em 32 sessões de simulação foram incluídos, os quais foram avaliados por 19 instrutores. As pontuações do escore TEAM foram significativamente maiores no grupo com toucas identificadas em comparação ao grupo controle: tanto no escore de 44 pontos do TEAM (37 ± 7 vs. 33 ± 7; p = 0,026) quanto na pontuação total (45 ± 8 vs. 40 ± 9; p = 0,020). As percepções subjetivas de entitatividade e coesão da equipe não diferiram significativamente.

Conclusão

O uso de toucas com identificação foi associado a um melhor desempenho da equipe em ambiente simulado. Seu impacto na coesão percebida da equipe e na entitatividade não foi estatisticamente significativo sob condições de simulação. Pesquisas adicionais em cenários clínicos são necessárias para determinar se as toucas com identificação melhoram o trabalho em equipe e a segurança do paciente.

Palavras-chave

Anestesiologia; Competência clínica; Comunicação; Equipe de assistência ao paciente; Segurança do paciente; Treinamento por simulação

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Submitted date:
09/21/2025

Accepted date:
07/26/2026

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