Jayasuriya-Illesinghe Vathsala, Guruge Sepali, Gamage Bawantha, Espin Sherry
Daphne Cockwell School of Nursing, Ryerson University, 350 Victoria St, Toronto, ON, M5B 2K3, Canada.
Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka.
BMC Surg. 2016 Sep 5;16(1):61. doi: 10.1186/s12893-016-0177-7.
A growing body of research shows links between poor teamwork and preventable surgical errors. Similar work has received little attention in the Global South, and in South Asia, in particular. This paper describes surgeons' perception of teamwork, team members' roles, and the team processes in a teaching hospital in Sri Lanka to highlight the nature of interprofessional teamwork and the factors that influence teamwork in this setting.
Data gathered from interviews with 15 surgeons were analyzed using a conceptual framework for interprofessional teamwork.
Interprofessional teamwork was characterized by low levels of interdependency and integration of work. The demarcation of roles and responsibilities for surgeons, nurses, and anesthetists appeared to be a strong element of interprofessional teamwork in this setting. Various relational factors, such as, professional power, hierarchy, and socialization, as well as contextual factors, such as, patriarchy and gender norms influenced interprofessional collaboration, and created barriers to communication between surgeons and nurses. Junior surgeons derived their understanding of appropriate practices mainly from observing senior surgeons, and there was a lack of formal training opportunities and motivation to develop non-technical skills that could improve interprofessional teamwork in operating rooms.
A more nuanced view of interprofessional teamwork can highlight the different elements of such work suited for each specific setting. Understanding the relational and contextual factors related to and influencing interprofessional socialization and status hierarchies can help improve quality of teamwork, and the training and mentoring of junior members.
越来越多的研究表明，团队协作不佳与可预防的手术失误之间存在关联。在全球南方地区，尤其是南亚地区，类似的研究很少受到关注。本文描述了斯里兰卡一家教学医院的外科医生对团队协作、团队成员角色以及团队流程的看法，以突出跨专业团队协作的本质以及在此背景下影响团队协作的因素。
使用跨专业团队协作的概念框架，对采访15位外科医生收集的数据进行分析。
跨专业团队协作的特点是工作的相互依存度和整合度较低。在这种背景下，外科医生、护士和麻醉师的角色和职责划分似乎是跨专业团队协作的一个重要因素。各种关系因素，如专业权力、等级制度和社会化，以及背景因素，如父权制和性别规范，影响了跨专业协作，并对外科医生和护士之间的沟通造成了障碍。初级外科医生主要通过观察资深外科医生来理解适当的做法，并且缺乏正式的培训机会以及培养可改善手术室跨专业团队协作的非技术技能的动力。
对跨专业团队协作更细致入微的看法可以突出适合每种特定背景的此类工作的不同要素。了解与跨专业社会化和地位等级制度相关并影响其的关系和背景因素，有助于提高团队协作质量以及对初级成员的培训和指导。
