Burtscher Michael J, Jordi Ritz Eva-Maria, Kolbe Michaela
Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Anaesthesiology, University Children's Hospital Basel, Basel, Switzerland.
BMJ Simul Technol Enhanc Learn. 2018 Oct 4;4(4):165-170. doi: 10.1136/bmjstel-2017-000268. eCollection 2018.
Team coordination represents an important factor for clinical performance. Research in this area suggests that not only behaviour frequencies but also patterns of team coordination constitute a central aspect of teamwork. However, little is known about potential differences in coordination patterns between novice teams (ie, teams of inexperienced members) and expert teams (ie, teams of experienced members). The current study addresses this gap by investigating the use of talking-to-the-room-an important implicit coordination behaviour-in novice teams versus expert teams.
To illustrate differences in coordination behaviour between novice and expert teams. This will provide important knowledge for simulation-based training.
The study was conducted in the context of two resuscitation training courses (introductory course and refresher course) for staff members at a children's hospital. Volunteers from both courses participated in the study. They were randomly assigned to 16 teams each consisting of one physician and two nurses. The study used a quasi-experimental design with two conditions (novice vs expert). Participants of the introductory course were assigned to the novice condition (eight teams), and participants of the refresher course were assigned to the expert condition (eight teams). All teams completed the same standardised paediatric resuscitation scenario. They were videotaped during the simulation, and team coordination behaviour was coded using Co-ACT.
Lag-sequential analysis of 1902 distinct coordination acts revealed that novice teams and expert teams differed significantly in their coordination behaviour. Expert teams were characterised by patterns in which implicit coordination behaviour (ie, talking to the room) was followed by further implicit coordination behaviour and not followed by explicit coordination behaviour (ie, instructions), whereas the reverse was found for novice teams.
The current study highlights role of coordination patterns for understanding teamwork in healthcare and provides important insights for team training.
团队协作是临床工作表现的一个重要因素。该领域的研究表明，不仅行为频率，而且团队协作模式也是团队合作的核心方面。然而，对于新手团队（即由经验不足的成员组成的团队）和专家团队（即由经验丰富的成员组成的团队）在协作模式上的潜在差异，我们知之甚少。本研究通过调查新手团队与专家团队中“对全体说话”（一种重要的隐性协作行为）的使用情况，来填补这一空白。
阐明新手团队与专家团队在协作行为上的差异。这将为基于模拟的培训提供重要知识。
该研究是在一家儿童医院为工作人员举办的两个复苏培训课程（入门课程和进修课程）的背景下进行的。两个课程的志愿者都参与了研究。他们被随机分成16个团队，每个团队由一名医生和两名护士组成。该研究采用了具有两种条件（新手组与专家组）的准实验设计。入门课程的参与者被分配到新手组（8个团队），进修课程的参与者被分配到专家组（8个团队）。所有团队都完成了相同的标准化儿科复苏模拟场景。在模拟过程中对他们进行录像，并使用Co-ACT对团队协作行为进行编码。
对1902种不同协作行为的滞后序列分析表明，新手团队和专家团队在协作行为上存在显著差异。专家团队的特点是，隐性协作行为（即对全体说话）之后会跟着进一步的隐性协作行为，而不是显性协作行为（即指令），而新手团队的情况则相反。
本研究强调了协作模式在理解医疗保健团队合作中的作用，并为团队培训提供了重要见解。
