Gardner Aimee K, Scott Daniel J, AbdelFattah Kareem R
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Surgery. 2017 May;161(5):1203-1208. doi: 10.1016/j.surg.2016.11.010. Epub 2017 Jan 4.
Team mental models represent the shared understanding of team members within their relevant environment. Thus, team mental models should have a substantial impact on a team's ability to engage in purposeful and coordinated action. We sought to examine the impact of shared team mental models on team performance and to investigate if team mental models increase over time as teams continue to work together.
New surgery interns were assigned randomly to 1 of 10 teams. Each team participated in one unique simulation every day for 5 days, each followed by video-based debriefing with a facilitator. Participants also completed independently a concept similarity tool validated previously in nonmedical team literature to assess team mental models. All performances were video recorded and evaluated with a scenario-specific team performance tool by a single, blinded junior surgeon under an institutional review board-approved protocol. Changes in performance and team mental models over time were assessed with paired samples t tests. Regression analysis was used to examine the extent to which team mental models predicted team performance.
Thirty interns (age 27; 77% men) participated in the training program. Percentage of items achieved (x¯ ± SD) on the performance evaluation was 39 ± 20, 51 ± 14, 22 ± 17, 63 ± 14, and 77 ± 25 for Days 1-5, respectively. Team mental models were 30 ± 5, 28 ± 6, 27 ± 8, 26 ± 7, and 25 ± 6 for Days 1-5 respectively, such that larger values corresponded to greater differences in team mental models. Paired sample t tests indicated that both average performance and team mental models similarity improved from the first to last day (P < .01, P < .05, respectively). Additionally, regression analyses indicated that team mental models predicted team performance on Days 2-5 (all P < .05) but not on the first day of simulations.
These results demonstrate that greater sharing of team mental models among the teams leads to better team performance. Additionally, the increase in team mental models over time suggests that engaging in team-based simulation may catalyze the process by which surgery teams are able to develop shared knowledge.
团队心智模型代表团队成员在其相关环境中的共同理解。因此，团队心智模型应该对团队进行有目的和协调行动的能力产生重大影响。我们试图研究共享团队心智模型对团队绩效的影响，并调查随着团队持续合作，团队心智模型是否会随着时间的推移而增加。
将新的外科实习医生随机分配到10个团队中的1个。每个团队每天参与一个独特的模拟，持续5天，每次模拟后由一名引导员进行基于视频的总结汇报。参与者还独立完成了一个先前在非医学团队文献中验证过的概念相似性工具，以评估团队心智模型。所有表现都进行了视频记录，并由一名独立的、不知情的初级外科医生根据机构审查委员会批准的方案，使用特定场景的团队绩效工具进行评估。使用配对样本t检验评估绩效和团队心智模型随时间的变化。回归分析用于检验团队心智模型预测团队绩效的程度。
30名实习生（年龄27岁；77%为男性）参加了培训项目。在绩效评估中，第1 - 5天完成项目的百分比（x¯ ± SD）分别为39 ± 20、51 ± 14、22 ± 17、63 ± 14和77 ± 25。第1 - 5天团队心智模型分别为30 ± 5、28 ± 6、27 ± 8、26 ± 7和25 ± 6，数值越大表示团队心智模型的差异越大。配对样本t检验表明，平均绩效和团队心智模型相似性从第一天到最后一天都有所提高（分别为P <.01，P <.05）。此外，回归分析表明，团队心智模型在第2 - 5天预测了团队绩效（所有P <.05），但在模拟的第一天没有。
这些结果表明，团队之间团队心智模型的更多共享会带来更好的团队绩效。此外，团队心智模型随时间的增加表明，参与基于团队的模拟可能会催化外科团队形成共享知识的过程。
