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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2010

Open Access 01-12-2010 | Original research

Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design

Authors: Heidi Kristina Westli, Bjørn Helge Johnsen, Jarle Eid, Ingvil Rasten, Guttorm Brattebø

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2010

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Abstract

Background

Non-technical skills are seen as an important contributor to reducing adverse events and improving medical management in healthcare teams. Previous research on the effectiveness of teams has suggested that shared mental models facilitate coordination and team performance. The purpose of the study was to investigate whether demonstrated teamwork skills and behaviour indicating shared mental models would be associated with observed improved medical management in trauma team simulations.

Methods

Revised versions of the 'Anesthetists' Non-Technical Skills Behavioural marker system' and 'Anti-Air Teamwork Observation Measure' were field tested in moment-to-moment observation of 27 trauma team simulations in Norwegian hospitals. Independent subject matter experts rated medical management in the teams. An independent group design was used to explore differences in teamwork skills between higher-performing and lower-performing teams.

Results

Specific teamwork skills and behavioural markers were associated with indicators of good team performance. Higher and lower-performing teams differed in information exchange, supporting behaviour and communication, with higher performing teams showing more effective information exchange and communication, and less supporting behaviours. Behavioural markers of shared mental models predicted effective medical management better than teamwork skills.

Conclusions

The present study replicates and extends previous research by providing new empirical evidence of the significance of specific teamwork skills and a shared mental model for the effective medical management of trauma teams. In addition, the study underlines the generic nature of teamwork skills by demonstrating their transferability from different clinical simulations like the anaesthesia environment to trauma care, as well as the potential usefulness of behavioural frequency analysis in future research on non-technical skills.
Literature
1.
go back to reference Wisborg T, Rønning TH, Beck VB, Brattebø G: Preparing teams for low-frequency emergencies in Norwegian hospitals. Acta Anaesthesiol Scand. 2003, 47: 1248-50. 10.1046/j.1399-6576.2003.00249.x.CrossRefPubMed Wisborg T, Rønning TH, Beck VB, Brattebø G: Preparing teams for low-frequency emergencies in Norwegian hospitals. Acta Anaesthesiol Scand. 2003, 47: 1248-50. 10.1046/j.1399-6576.2003.00249.x.CrossRefPubMed
2.
go back to reference Sexton JB, Thomas EJ, Helmreich R: Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ. 2000, 320: 745-49. 10.1136/bmj.320.7237.745.PubMedCentralCrossRefPubMed Sexton JB, Thomas EJ, Helmreich R: Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ. 2000, 320: 745-49. 10.1136/bmj.320.7237.745.PubMedCentralCrossRefPubMed
3.
go back to reference Gaba DM, Howard SK, Flanagan B, Smith BE, Fish KJ, Botney R: Assessment of clinical performance during simulated crises using both technical and behavioural ratings. Anaesthesiology. 1988, 89: 8-18. 10.1097/00000542-199807000-00005.CrossRef Gaba DM, Howard SK, Flanagan B, Smith BE, Fish KJ, Botney R: Assessment of clinical performance during simulated crises using both technical and behavioural ratings. Anaesthesiology. 1988, 89: 8-18. 10.1097/00000542-199807000-00005.CrossRef
4.
go back to reference Fletcher G, Flin R, McGeorge P, Galvin R, Maran N, Patey R: Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. British Journal of Anaesthesia. 2003, 90: 580-588. 10.1093/bja/aeg112.CrossRefPubMed Fletcher G, Flin R, McGeorge P, Galvin R, Maran N, Patey R: Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. British Journal of Anaesthesia. 2003, 90: 580-588. 10.1093/bja/aeg112.CrossRefPubMed
5.
go back to reference Wisborg T, Brattebø G, Brinchmann-Hansen Å, Uggen PE, Hansen KS: Effects of nationwide training of multiprofessional trauma teams in Norwegian hospitals. J Trauma. 2008, 64: 1613-18. 10.1097/TA.0b013e31812eed68.CrossRefPubMed Wisborg T, Brattebø G, Brinchmann-Hansen Å, Uggen PE, Hansen KS: Effects of nationwide training of multiprofessional trauma teams in Norwegian hospitals. J Trauma. 2008, 64: 1613-18. 10.1097/TA.0b013e31812eed68.CrossRefPubMed
6.
go back to reference Fletcher G, Flin R, McGeorge P, Glavin R, Maran NJ, Patey R: Rating non-technical skills: developing a behavioural marker system for use in anaesthesia. Cogn Tech Work. 2004, 6: 165-171. 10.1007/s10111-004-0158-y.CrossRef Fletcher G, Flin R, McGeorge P, Glavin R, Maran NJ, Patey R: Rating non-technical skills: developing a behavioural marker system for use in anaesthesia. Cogn Tech Work. 2004, 6: 165-171. 10.1007/s10111-004-0158-y.CrossRef
7.
go back to reference Flin R, Maran N: Identifying and training non-technical skills for teams in acute medicine. Qual Saf Health Care. 2004, 13: 80-84. 10.1136/qshc.2004.009993.CrossRef Flin R, Maran N: Identifying and training non-technical skills for teams in acute medicine. Qual Saf Health Care. 2004, 13: 80-84. 10.1136/qshc.2004.009993.CrossRef
8.
go back to reference Reader T, Flin R, Lauche K, Cuthbertson BH: Non-technical skills in the intensive care unit. Br J Anaesth. 2006, 96: 551-59. 10.1093/bja/ael067.CrossRefPubMed Reader T, Flin R, Lauche K, Cuthbertson BH: Non-technical skills in the intensive care unit. Br J Anaesth. 2006, 96: 551-59. 10.1093/bja/ael067.CrossRefPubMed
9.
go back to reference Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D: Development of a rating system for surgeons' non-technical skills. Med Educ. 2006, 40: 1098-1104. 10.1111/j.1365-2929.2006.02610.x.CrossRefPubMed Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D: Development of a rating system for surgeons' non-technical skills. Med Educ. 2006, 40: 1098-1104. 10.1111/j.1365-2929.2006.02610.x.CrossRefPubMed
10.
go back to reference Cannon-Bowers JA, Salas E, Converse SA: Shared mental models in expert team decision making. Individual and group decision making. Edited by: Castellan JNJ. 1993, New Jersey: Lawrence Erlbaum Associates Cannon-Bowers JA, Salas E, Converse SA: Shared mental models in expert team decision making. Individual and group decision making. Edited by: Castellan JNJ. 1993, New Jersey: Lawrence Erlbaum Associates
11.
go back to reference Mohammed S, Klimoski RJ, Rentsch JR: The measurement of team mental models: We have no shared schema. Org Res Meth. 2000, 3: 123-65. 10.1177/109442810032001.CrossRef Mohammed S, Klimoski RJ, Rentsch JR: The measurement of team mental models: We have no shared schema. Org Res Meth. 2000, 3: 123-65. 10.1177/109442810032001.CrossRef
12.
go back to reference Orasanu JM, Salas E: Team decision making in complex environments. Decision making in action: models and methods. Edited by: Klein G, Orasanu JM, Calderwood R, Zsambok C. 1993, Nj: Ablex, 327-45. Orasanu JM, Salas E: Team decision making in complex environments. Decision making in action: models and methods. Edited by: Klein G, Orasanu JM, Calderwood R, Zsambok C. 1993, Nj: Ablex, 327-45.
13.
go back to reference Langan-Fox J, Code SL, Langfield-Smith K: Team mental models: techniques, methods and analytic approaches. Hum Factors. 2000, 42: 242-271. 10.1518/001872000779656534.CrossRefPubMed Langan-Fox J, Code SL, Langfield-Smith K: Team mental models: techniques, methods and analytic approaches. Hum Factors. 2000, 42: 242-271. 10.1518/001872000779656534.CrossRefPubMed
14.
go back to reference Undre S, Sevdalis N, Healey AN, Darzi A, Vincent CA: Teamwork in the operating theatre: cohesion or confusion?. J Eval Clin Pract. 2006, 12: 182-89. 10.1111/j.1365-2753.2006.00614.x.CrossRefPubMed Undre S, Sevdalis N, Healey AN, Darzi A, Vincent CA: Teamwork in the operating theatre: cohesion or confusion?. J Eval Clin Pract. 2006, 12: 182-89. 10.1111/j.1365-2753.2006.00614.x.CrossRefPubMed
15.
go back to reference Smith-Jentsch K, Johnston JH, Payne S: Measuring team-related expertise in complex environments. Making decisions under stress. Edited by: Cannon-Bowers J, Salas E. 1998, Washington DC: American Psychological Association, 61-87. full_text. Smith-Jentsch K, Johnston JH, Payne S: Measuring team-related expertise in complex environments. Making decisions under stress. Edited by: Cannon-Bowers J, Salas E. 1998, Washington DC: American Psychological Association, 61-87. full_text.
16.
go back to reference Noldus LPJJ, Trienes RJH, Hendriksen AHM, Jansen H, Jansen RG: The observer video-pro: new software for the collection, management, and presentation of time-structured data from videotapes and digital media files. Beh Res Met, Instr Comp. 2000, 32: 197-206.CrossRef Noldus LPJJ, Trienes RJH, Hendriksen AHM, Jansen H, Jansen RG: The observer video-pro: new software for the collection, management, and presentation of time-structured data from videotapes and digital media files. Beh Res Met, Instr Comp. 2000, 32: 197-206.CrossRef
17.
go back to reference Advanced trauma life support student manual. 2004, American College of Surgeons, Chicago, 7 Advanced trauma life support student manual. 2004, American College of Surgeons, Chicago, 7
18.
go back to reference Bernardin HJ, Beatty RW: Performance appraisal: Assessing human behaviour at work. 1984, Boston: Kent Bernardin HJ, Beatty RW: Performance appraisal: Assessing human behaviour at work. 1984, Boston: Kent
19.
go back to reference Espevik R: Felles Mentale Modeller: en studie i av betydningen av systemkunnskap vs. personkunnskap i krisesituasjoner. 2001, Bergen: Sjøkrigsskolen Espevik R: Felles Mentale Modeller: en studie i av betydningen av systemkunnskap vs. personkunnskap i krisesituasjoner. 2001, Bergen: Sjøkrigsskolen
20.
go back to reference Dickinson TL, McIntyre RM: A conceptual framework for teamwork measurement. Team performance and measurement. Edited by: Brannick MT, Salas E, Prince C. 1997, Mahwah, New Jersey: Lawrence Erlbaum Associates Dickinson TL, McIntyre RM: A conceptual framework for teamwork measurement. Team performance and measurement. Edited by: Brannick MT, Salas E, Prince C. 1997, Mahwah, New Jersey: Lawrence Erlbaum Associates
21.
go back to reference Ferguson GA: Statistical analysis in psychology and education. 1981, New York: McGraw-Hill Ferguson GA: Statistical analysis in psychology and education. 1981, New York: McGraw-Hill
22.
go back to reference Pallant J: SPSS survival manual: a step by step guide to data analysing using SPSS for windows. 2007, Maidenhead: McGraw-Hill Pallant J: SPSS survival manual: a step by step guide to data analysing using SPSS for windows. 2007, Maidenhead: McGraw-Hill
23.
go back to reference Cannon-Bowers J, Tannenbaum S, Salas E, Volpe C: Defining team competencies and establishing team training requirements. Team Effectiveness and Decision Making in Organizations. Edited by: Guzzo R, Salas E. 2003, San Francisco, CA: Jossey-Bass, 333-380. Cannon-Bowers J, Tannenbaum S, Salas E, Volpe C: Defining team competencies and establishing team training requirements. Team Effectiveness and Decision Making in Organizations. Edited by: Guzzo R, Salas E. 2003, San Francisco, CA: Jossey-Bass, 333-380.
24.
go back to reference Flin R, O'Connor P, Crichton M: Safety at the sharp end - a guide to Non-Technical Skills. 2008, Hampshire: Ashgate Publishing Limited Flin R, O'Connor P, Crichton M: Safety at the sharp end - a guide to Non-Technical Skills. 2008, Hampshire: Ashgate Publishing Limited
25.
go back to reference Salas E, Sims DE, Burke CS: Is there a "big five" in teamwork?. Small group research. 2005, 36: 555-599. 10.1177/1046496405277134.CrossRef Salas E, Sims DE, Burke CS: Is there a "big five" in teamwork?. Small group research. 2005, 36: 555-599. 10.1177/1046496405277134.CrossRef
26.
go back to reference Porter OLH, Hollenbeck JR, Ilgen DR, Ellis APJ, West BJ, Moon HK: Backing up behaviours in teams: the role of personality and legitimacy of need. 2002, East Lancing, MI: Michigan State University; Eli Broad Graduate School of Management Porter OLH, Hollenbeck JR, Ilgen DR, Ellis APJ, West BJ, Moon HK: Backing up behaviours in teams: the role of personality and legitimacy of need. 2002, East Lancing, MI: Michigan State University; Eli Broad Graduate School of Management
27.
go back to reference Mathieu JE, Heffner TS, Goodwin GF, Salas E, Cannon-Bowers JA: The influence of shared mental models on team process and performance. J App Psych. 2000, 85: 273-283. 10.1037/0021-9010.85.2.273.CrossRef Mathieu JE, Heffner TS, Goodwin GF, Salas E, Cannon-Bowers JA: The influence of shared mental models on team process and performance. J App Psych. 2000, 85: 273-283. 10.1037/0021-9010.85.2.273.CrossRef
28.
go back to reference Lim BC, Klein KJ: Team mental models and team performance: A field study of the effects of team mental model similarity and accuracy. J Org Beh. 2006, 27: 403-418. 10.1002/job.387.CrossRef Lim BC, Klein KJ: Team mental models and team performance: A field study of the effects of team mental model similarity and accuracy. J Org Beh. 2006, 27: 403-418. 10.1002/job.387.CrossRef
29.
go back to reference Kohn LT, Carrigan JM, Donaldson MS: To err is human: building a safer health system. 2000, Washington, DC: National Academy Press Kohn LT, Carrigan JM, Donaldson MS: To err is human: building a safer health system. 2000, Washington, DC: National Academy Press
30.
go back to reference Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, Bohnen J, Orser B, Doran D, Grober E: Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004, 13: 330-334. 10.1136/qshc.2003.008425.PubMedCentralCrossRefPubMed Lingard L, Espin S, Whyte S, Regehr G, Baker GR, Reznick R, Bohnen J, Orser B, Doran D, Grober E: Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care. 2004, 13: 330-334. 10.1136/qshc.2003.008425.PubMedCentralCrossRefPubMed
31.
go back to reference Marks MA, Sabella MJ, Burke CS, Zaccaro SJ: The impact of cross-training on team effectiveness. J App Psych. 2002, 87: 3-13. 10.1037/0021-9010.87.1.3.CrossRef Marks MA, Sabella MJ, Burke CS, Zaccaro SJ: The impact of cross-training on team effectiveness. J App Psych. 2002, 87: 3-13. 10.1037/0021-9010.87.1.3.CrossRef
Metadata
Title
Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design
Authors
Heidi Kristina Westli
Bjørn Helge Johnsen
Jarle Eid
Ingvil Rasten
Guttorm Brattebø
Publication date
01-12-2010
Publisher
BioMed Central
DOI
https://doi.org/10.1186/1757-7241-18-47

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