Team Decision Making Practice Questions

55 multiple-choice questions on Team decision making for paramedic and EMT students, from Chapter 12 (Critical Thinking and Clinical Decision Making). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

55 practice questions

1. Crew resource management refers to:

   1. A. Maintaining the fleet on a set service schedule
   2. B. Tracking equipment and supply inventory on each unit
   3. C. Scheduling staff to cover peak call volumes
   4. D. Using all team resources with clear communication
   Show answer

   Answer: D. Using all team resources with clear communication

   It came from aviation and translates directly to EMS. CRM means using all available people and information effectively with shared awareness.

2. A junior crew member who notices a problem with the plan should:

   1. A. Speak up directly, since safety outranks hierarchy
   2. B. Stay silent out of respect for the senior provider
   3. C. Report it to a supervisor at the end of shift
   4. D. Wait until after the call to raise the concern
   Show answer

   Answer: A. Speak up directly, since safety outranks hierarchy

   Systems that welcome that voice catch more errors.

3. Closed-loop communication means:

   1. A. Speaking to only one team member at a time
   2. B. Restricting information to the team leader only
   3. C. Giving all orders in writing rather than verbally
   4. D. The receiver repeats the order back for confirmation
   Show answer

   Answer: D. The receiver repeats the order back for confirmation

   It is standard for medication orders and resuscitation tasks.

4. During a resuscitation, a clear team leader improves outcomes by:

   1. A. Personally performing most critical tasks
   2. B. Keeping an overview and assigning roles
   3. C. Speaking loudest to keep control of the room
   4. D. Handling documentation while others work
   Show answer

   Answer: B. Keeping an overview and assigning roles

   The leader should keep their hands free when the team is large enough. The leader also keeps the team on the plan.

5. Situational awareness means:

   1. A. Tracking elapsed scene and transport times
   2. B. Knowing what's happening and what comes next
   3. C. Knowing the relevant protocol word for word
   4. D. Keeping constant watch on the cardiac monitor
   Show answer

   Answer: B. Knowing what's happening and what comes next

   Losing it is a common factor in serious errors.

6. Conflicting opinions between crew members are best resolved by:

   1. A. The senior provider deciding without discussion
   2. B. A brief, respectful exchange of reasoning
   3. C. Deferring the choice to the patient
   4. D. Avoiding the issue to keep the peace
   Show answer

   Answer: B. A brief, respectful exchange of reasoning

   The disagreement itself often reveals a missed finding. Do it away from the patient when possible and involve medical control if needed.

7. Assigning specific tasks by name during a critical call:

   1. A. Is unnecessary on a well-trained crew
   2. B. Prevents duplicated and missed tasks
   3. C. Slows the team during critical moments
   4. D. Undermines a sense of shared teamwork
   Show answer

   Answer: B. Prevents duplicated and missed tasks

   "Mike, get the IV" beats "someone get access." A task given to no one is done by no one.

8. A brief plan stated aloud before a critical procedure helps by:

   1. A. Locking the team into a single plan
   2. B. Letting the leader skip role assignments
   3. C. Sharing expectations and a backup plan
   4. D. Satisfying medicolegal documentation needs
   Show answer

   Answer: C. Sharing expectations and a backup plan

   Ten seconds of planning prevents most improvisation. A stated plan includes a backup, so it does not lock the team into one approach, and it makes roles clearer rather than replacing role assignment.

9. Including first responders, family, and the patient in the information flow:

   1. A. Slows care by adding extra discussion
   2. B. Often adds information that improves care
   3. C. Confuses the scene with too many voices
   4. D. Usually violates the patient's privacy protections
   Show answer

   Answer: B. Often adds information that improves care

   The person who knows the patient's baseline is frequently standing behind you.

10. Hand-off to the hospital is a decision point because:

    1. A. It is a required step under agency policy
    2. B. It ends EMS responsibility for the patient
    3. C. It is mainly a documentation exercise
    4. D. Information lost there can undo good care
    Show answer

    Answer: D. Information lost there can undo good care

    Structure the report so nothing critical is left unsaid.

11. Effective team decision making in EMS depends on:

    1. A. One provider handling every task alone
    2. B. Clear leadership and open communication
    3. C. Equal decision authority for everyone
    4. D. Quiet work with minimal talking between members
    Show answer

    Answer: B. Clear leadership and open communication

    Teams perform best with a defined leader and free flow of information. A shared understanding of the situation is also essential.

12. Crew resource management (CRM) principles were adapted from:

    1. A. Aviation
    2. B. Hospital nursing
    3. C. Law enforcement
    4. D. Fire service command
    Show answer

    Answer: A. Aviation

    CRM originated in aviation to reduce errors from poor communication and hierarchy. Nursing, law enforcement, and fire service command later adopted CRM ideas but did not originate them.

13. What does a MIST handoff report for a trauma patient include?

    1. A. Medications, insurance, social history, and time
    2. B. Mental status, intake, stool, and temperature
    3. C. Medical history, IV size, sedation, and trip
    4. D. Mechanism, injuries, signs, and treatment given
    Show answer

    Answer: D. Mechanism, injuries, signs, and treatment given

    MIST is a structured trauma handoff: Mechanism of injury, Injuries found or suspected, Signs (vital signs and trends), and Treatment given. A structured format reduces lost information. The other lists are not the MIST elements.

14. 'Shared mental model' means:

    1. A. A teaching model used only in training
    2. B. Everyone thinks identically and never disagrees
    3. C. One person does the thinking for the team
    4. D. Everyone understands the situation, plan, and roles
    Show answer

    Answer: D. Everyone understands the situation, plan, and roles

    Shared models keep the team coordinated and able to anticipate.

15. Two paramedics arrive at a cardiac arrest at the same time. What is the best way to organize leadership?

    1. A. Both lead, splitting the decisions equally
    2. B. Whoever arrived first leads without saying so
    3. C. Agree on one leader and state it aloud
    4. D. The patient's family decides who will lead
    Show answer

    Answer: C. Agree on one leader and state it aloud

    A resuscitation needs one clearly identified leader so that orders do not conflict and tasks are not duplicated. Saying it aloud lets everyone know whom to report to. Shared or unstated leadership causes confusion, and the family should not be asked to decide.

16. During your verbal handoff, ED staff are moving the patient and talking among themselves. What is best?

    1. A. Leave the written report and go back in service
    2. B. Give the report anyway while they keep working
    3. C. Shout the report over the noise as fast as possible
    4. D. Ask for a brief pause for a focused handoff
    Show answer

    Answer: D. Ask for a brief pause for a focused handoff

    Handoffs given during patient transfers lose information. A brief 'hands-off' pause, where the team listens to a structured report, improves retention. A written report alone delays key information, and shouting over the noise does not get it heard.

17. During CPR, why should compressors switch about every 2 minutes?

    1. A. Protocols require each person to do equal work
    2. B. It lets the team skip rhythm analysis at each switch
    3. C. Compressors must also give the ventilations
    4. D. Fatigue reduces compression quality, often unnoticed
    Show answer

    Answer: D. Fatigue reduces compression quality, often unnoticed

    Compression depth and rate decline within 1 to 2 minutes as the compressor tires, often before the person notices, so the AHA recommends switching about every 2 minutes, at the rhythm check, to keep CPR effective. The switch coincides with rhythm analysis rather than replacing it, and fairness and ventilations are not the reason.

18. The 'two-challenge rule' means:

    1. A. Raise a concern twice, then defer to the leader
    2. B. Question the patient twice to confirm the history
    3. C. Require two people to confirm each drug dose
    4. D. If ignored twice, escalate or stop the unsafe act
    Show answer

    Answer: D. If ignored twice, escalate or stop the unsafe act

    The two-challenge rule empowers team members to halt errors. Deferring after two ignored challenges defeats the purpose of the rule, and a two-person dose check is a separate safety practice.

19. Debriefing after a call supports team decision making by:

    1. A. Assigning blame for the errors made on the call
    2. B. Identifying what worked and what to improve
    3. C. Replacing the need for written documentation
    4. D. Providing a purely social break for the crew
    Show answer

    Answer: B. Identifying what worked and what to improve

    Non-punitive debriefing is the main vehicle for team learning.

20. Authority gradient refers to:

    1. A. Perceived power differences that silence juniors
    2. B. A hospital's ranking among trauma centers
    3. C. Differences in pay grade between crew members
    4. D. The formal chain of command as written on paper
    Show answer

    Answer: A. Perceived power differences that silence juniors

    Steep authority gradients suppress safety-critical input.

21. A paramedic notices the SpO2 falling, realizes the tube may be dislodged, and prepares for a possible arrest. Which part reflects the 'projection' level of situational awareness?

    1. A. Noticing that the SpO2 is falling
    2. B. Preparing for a possible arrest
    3. C. Realizing the tube may be out
    4. D. Documenting each of the SpO2 readings
    Show answer

    Answer: B. Preparing for a possible arrest

    Endsley's model has three levels: perception (noticing the falling SpO2), comprehension (realizing the tube may be dislodged), and projection (anticipating what will happen next and preparing for it). Documentation is not a level of situational awareness.

22. Which best describes 'graded assertiveness'?

    1. A. Escalating from a hint to a direct statement
    2. B. Letting only the leader voice concerns
    3. C. Never speaking up unless certain of an error
    4. D. Waiting to speak until asked by the leader
    Show answer

    Answer: A. Escalating from a hint to a direct statement

    Graded assertiveness provides a respectful path to being heard.

23. A paramedic working with a new EMT partner should:

    1. A. Let the EMT decide roles independently
    2. B. Assume the EMT already knows every expectation
    3. C. Perform all care alone to avoid confusion
    4. D. Clarify roles early and communicate clearly
    Show answer

    Answer: D. Clarify roles early and communicate clearly

    Explicit role assignment prevents gaps and duplication.

24. Team decision making improves outcomes mostly because:

    1. A. Teams bring more equipment to the scene
    2. B. Teams don't need to follow protocols
    3. C. Multiple perspectives catch errors
    4. D. Teams always work faster than individuals
    Show answer

    Answer: C. Multiple perspectives catch errors

    Redundancy of attention is the error-catching mechanism.

25. During a cardiac arrest, the team leader should stand where?

    1. A. Where they can see the whole scene, hands-free
    2. B. Outside the room to reduce crowding
    3. C. At the head, managing the airway personally
    4. D. In the ambulance preparing for transport
    Show answer

    Answer: A. Where they can see the whole scene, hands-free

    The leader's job is oversight; being task-saturated loses the big picture. Typically this is at the foot or side, without a hands-on task if staffing allows.

26. A 'pre-brief' before a high-risk procedure (e.g., RSI) includes:

    1. A. Roles, plan, expected problems, and backups
    2. B. Only the equipment needed and where it is placed
    3. C. Nothing; it is best to simply begin
    4. D. Only the drug doses and when to give them
    Show answer

    Answer: A. Roles, plan, expected problems, and backups

    Pre-briefing aligns the team before high-stakes actions.

27. Interprofessional handoff to the ED is a team decision-making event because:

    1. A. It ends EMS responsibility for the patient
    2. B. It is a purely clerical transfer of paperwork
    3. C. It passes on information the next team needs
    4. D. It requires no clinical reasoning
    Show answer

    Answer: C. It passes on information the next team needs

    Quality handoff carries the reasoning forward.

28. Which behavior most undermines team decision making?

    1. A. Verbalizing safety concerns aloud
    2. B. A leader who dismisses or punishes input
    3. C. Using closed-loop communication
    4. D. Team members asking clarifying questions
    Show answer

    Answer: B. A leader who dismisses or punishes input

    Punishing input silences the team and hides errors.

29. Mutual support (backing each other up) in a team means:

    1. A. Taking over the other person's assigned job
    2. B. Covering for each other's mistakes in the report
    3. C. Watching each other's workload and offering help
    4. D. Staying out of each other's work entirely
    Show answer

    Answer: C. Watching each other's workload and offering help

    Mutual support is a core TeamSTEPPS competency.

30. When a physician on scene gives an order, the paramedic should:

    1. A. Follow the physician's orders without question
    2. B. Hand over all care to the physician immediately
    3. C. Verify credentials and consult medical control
    4. D. Ignore the physician and follow protocol only
    Show answer

    Answer: C. Verify credentials and consult medical control

    On-scene physicians require verification and must generally agree to accompany the patient to assume care. Clearly harmful orders should be refused.

31. During a cardiac arrest, the team leader says, 'Give 1 mg epinephrine IV.' The paramedic drawing it up should respond:

    1. A. Say 'okay' and draw up the medication
    2. B. Repeat the order back, then confirm when given
    3. C. Nod to acknowledge, then give it silently
    4. D. Give the medication without saying anything
    Show answer

    Answer: B. Repeat the order back, then confirm when given

    Closed-loop communication repeats the order back and confirms completion, reducing errors. For example: 'Giving 1 mg epinephrine IV now,' then announce when it is given.

32. An EMT notices that the paramedic is about to give a medication to a patient with a documented allergy to it. Using graded assertiveness, the EMT's first statement should be:

    1. A. Grab the syringe before it can be given
    2. B. Stay silent to avoid conflict with the paramedic
    3. C. Report the paramedic to a supervisor after the call
    4. D. 'I'm concerned—her chart lists an allergy to that drug.'
    Show answer

    Answer: D. 'I'm concerned—her chart lists an allergy to that drug.'

    Stating a concern clearly and specifically is the first step in graded assertiveness.

33. A paramedic on a fire scene is directed by the incident commander to stage the ambulance away from the patient. The paramedic believes the patient needs immediate care. The best response is to:

    1. A. Stop communicating with command until cleared
    2. B. Voice concerns to command and follow direction
    3. C. Leave the scene since you cannot reach the patient
    4. D. Ignore the order and enter the hot zone
    Show answer

    Answer: B. Voice concerns to command and follow direction

    Incident command structures protect safety; concerns should be expressed through proper channels.

34. Which best demonstrates a shared mental model during a trauma call?

    1. A. Only the driver knows the destination
    2. B. The leader states the impression and plan aloud
    3. C. Each member works from their own impression
    4. D. The plan is decided after hospital arrival
    Show answer

    Answer: B. The leader states the impression and plan aloud

    A shared mental model aligns the team's understanding of the patient and the plan.

35. A first responder hands off a patient by saying, 'He was fine, just some chest pain.' What is the best way to improve this handoff?

    1. A. Ignore the first responder's report
    2. B. Ask focused questions about vitals and changes
    3. C. Accept the summary and proceed with care
    4. D. Wait until hospital arrival to ask questions
    Show answer

    Answer: B. Ask focused questions about vitals and changes

    Structured, focused questions ensure critical information is not lost at handoff. Ask about interventions as well.

36. Which structured format is widely used for handoff communication?

    1. A. SBAR
    2. B. OPQRST
    3. C. AVPU
    4. D. DCAP-BTLS
    Show answer

    Answer: A. SBAR

    SBAR organizes handoff information in a concise, predictable way. SBAR stands for Situation, Background, Assessment, Recommendation.

37. The team leader during a resuscitation is focused on intubating. Which problem is most likely?

    1. A. Fewer pauses in chest compressions overall
    2. B. Stronger leadership through example
    3. C. Clearer communication with the team
    4. D. Loss of overall situational awareness
    Show answer

    Answer: D. Loss of overall situational awareness

    Leaders who become task-focused lose the big picture; leaders should delegate hands-on tasks when possible. Intubation by the leader tends to add compression pauses, and a leader busy with a task communicates less, not more clearly.

38. During a resuscitation, a team member states, 'We've been 2 minutes; it's time for a rhythm check.' This behavior reflects:

    1. A. Undermining the leader's authority
    2. B. An unnecessary interruption of the leader
    3. C. Mutual monitoring that supports the leader
    4. D. A sign the member lacks role training
    Show answer

    Answer: C. Mutual monitoring that supports the leader

    Team members tracking time and tasks help the leader maintain situational awareness.

39. A paramedic student is hesitant to point out an error to a senior paramedic. What concept describes this barrier?

    1. A. A steep authority gradient
    2. B. Crew resource management
    3. C. Shared mental model
    4. D. Closed-loop communication
    Show answer

    Answer: A. A steep authority gradient

    A steep authority gradient discourages junior members from speaking up about safety concerns.

40. A team leader can flatten the authority gradient by:

    1. A. Skipping team briefings to save time
    2. B. Discouraging questions during critical moments
    3. C. Inviting input, such as 'What am I missing?'
    4. D. Making all decisions silently and quickly
    Show answer

    Answer: C. Inviting input, such as 'What am I missing?'

    Explicitly inviting input encourages all team members to share concerns.

41. At a busy scene, two people give you conflicting orders. The best action is to:

    1. A. Clarify who is in charge and confirm with them
    2. B. Choose the order you personally prefer
    3. C. Ignore both orders until things settle
    4. D. Follow whichever order is given more loudly
    Show answer

    Answer: A. Clarify who is in charge and confirm with them

    Clarifying the chain of command prevents confusion and conflicting care.

42. Which statement about debriefing a difficult call is most accurate?

    1. A. Debriefing should be nonpunitive and system-focused
    2. B. Debriefing should assign blame to individuals
    3. C. Debriefing should be skipped to save time
    4. D. Debriefing is needed only after an error
    Show answer

    Answer: A. Debriefing should be nonpunitive and system-focused

    Nonpunitive debriefing encourages honest discussion and learning.

43. During transport, your EMT partner says the patient's breathing sounds different. You are busy documenting. The best response is to:

    1. A. Note the comment and recheck at arrival
    2. B. Stop and reassess the breathing now
    3. C. Finish the documentation first
    4. D. Ask the partner to keep an eye on it
    Show answer

    Answer: B. Stop and reassess the breathing now

    Team member observations can identify deterioration early and should be acted on promptly.

44. Which behavior shows effective followership on a team?

    1. A. Changing the plan independently when needed
    2. B. Performing tasks without informing the leader
    3. C. Doing assigned tasks and reporting progress
    4. D. Waiting silently for the next instruction
    Show answer

    Answer: C. Doing assigned tasks and reporting progress

    Good followers complete tasks, communicate status, and speak up about concerns. Good followers also voice concerns.

45. When a fire captain on scene is responsible for operations and you are responsible for patient care, decision making is most effective when:

    1. A. Each communicates and respects the other's role
    2. B. The fire captain makes all medical decisions
    3. C. The paramedic directs all fire operations
    4. D. Each agency works without communicating
    Show answer

    Answer: A. Each communicates and respects the other's role

    Clear roles and mutual respect among agencies improve coordination.

46. Which technique best ensures that a nurse at the receiving hospital understood a critical piece of information, such as a medication given?

    1. A. Record it on the patient care report only
    2. B. Assume the nurse heard and understood
    3. C. Ask the nurse to repeat it back
    4. D. Mention it once during the verbal report
    Show answer

    Answer: C. Ask the nurse to repeat it back

    Read-back confirms understanding and reduces communication errors.

47. During a pediatric resuscitation, a team member states, 'I think the dose is wrong, let's double-check with the tape.' The team leader should:

    1. A. Remove the member from the team
    2. B. Reprimand the team member later
    3. C. Ignore the comment and proceed
    4. D. Pause and verify the dose
    Show answer

    Answer: D. Pause and verify the dose

    Stopping to verify a potential error when a concern is raised is a core CRM principle.

48. The 'CUS' tool for speaking up stands for:

    1. A. Concerned, Uncomfortable, Safety issue
    2. B. Confirm, Update, Support the leader
    3. C. Caution, Urgent, Stop the procedure
    4. D. Check, Understand, Stop everything
    Show answer

    Answer: A. Concerned, Uncomfortable, Safety issue

    CUS gives team members escalating phrases: 'I'm concerned... I'm uncomfortable... This is a safety issue.'

49. Why is it important to include the patient in decision making when possible?

    1. A. It shortens transport and on-scene times
    2. B. It eliminates the need for formal consent
    3. C. It is required only to limit legal liability
    4. D. It respects autonomy and gains useful information
    Show answer

    Answer: D. It respects autonomy and gains useful information

    Shared decision making respects autonomy and improves information gathering. Patients have the right to participate and often provide valuable information.

50. A team leader assigns tasks by saying, 'Someone get the monitor.' What is the problem?

    1. A. The task may be missed or duplicated
    2. B. The order is too specific for the team to follow
    3. C. There is no problem with this approach
    4. D. It slows the call by requiring discussion
    Show answer

    Answer: A. The task may be missed or duplicated

    Directed communication to a named person ensures accountability.

51. After a successful resuscitation, a team member mentions that compressions were interrupted frequently. The best response is to:

    1. A. Dismiss it because the patient survived
    2. B. Avoid discussing the call to protect morale
    3. C. Discuss it as a team to improve
    4. D. Blame the person who did compressions
    Show answer

    Answer: C. Discuss it as a team to improve

    Successful outcomes can still involve process problems worth improving.

52. Which situation best reflects 'situation monitoring' by team members?

    1. A. An EMT reports that the IV has infiltrated
    2. B. A paramedic silences monitor alarms to reduce noise
    3. C. An EMT stays focused only on driving
    4. D. A team member leaves to restock the unit
    Show answer

    Answer: A. An EMT reports that the IV has infiltrated

    Team members continuously watch the patient, equipment, and environment and report changes.

53. A paramedic disagrees with medical control's order but believes it is not harmful. The best approach is to:

    1. A. Do what you prefer and document it later
    2. B. Hang up the radio and act on your own
    3. C. Refuse the order and document the disagreement
    4. D. Voice the concern, then follow the order
    Show answer

    Answer: D. Voice the concern, then follow the order

    Professional disagreement is voiced respectfully; nonharmful orders are generally followed after discussion. Discuss respectfully, then follow the order if it remains appropriate.

54. Which statement best describes the role of the driver/EMT during transport of a critical patient?

    1. A. Someone with no role in patient care decisions
    2. B. The person who decides the destination alone
    3. C. A team member supporting decisions and safety
    4. D. Responsible only for operating the vehicle
    Show answer

    Answer: C. A team member supporting decisions and safety

    Drivers contribute to the team by maintaining safety, communicating, and helping with logistics.

55. A team uses the phrase 'stop the line' when anyone sees a dangerous error about to occur. This practice:

    1. A. Wastes time during critical procedures
    2. B. Is appropriate only in hospital settings
    3. C. Empowers anyone to pause care to prevent harm
    4. D. Undermines the leader and slows critical care
    Show answer

    Answer: C. Empowers anyone to pause care to prevent harm

    Empowering all team members to stop dangerous actions is a core safety principle.