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Improving teamwork in medicine by brief, attention-focusing interventions: Basis and applied aspects

English title Improving teamwork in medicine by brief, attention-focusing interventions: Basis and applied aspects
Applicant Tschan Semmer Franziska
Number 149734
Funding scheme Project funding
Research institution IPTO - Institut de Psychologie du Travail et des Organisations Université de Neuchâtel
Institution of higher education University of Neuchatel - NE
Main discipline Psychology
Start/End 01.02.2014 - 30.09.2018
Approved amount 372'012.00
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Keywords (7)

Group processes; High fidelity simulator research; Medical education; Attention-focusing interventiions; Group and team performance; Post-task briefings; Pre-tasks briefing

Lay Summary (German)

Lead
Die Qualität der Behandlung in einem medizinischen Notfall hängt nicht zuletzt von der Zusammenarbeit im Team ab. In dem Projekt werden verschiedene kurze Interventionen getestet, die zu einer Verbesserung der Zusammenarbeit in medizinischen Notfällen führen können.
Lay summary

Bei der Zusammenarbeit im Team muss man die Aufmerksamkeitauf zwei Dinge gleichzeitig lenken: Man muss sich auf die eigene Aufgabekonzentrieren, aber gleichzeitig muss man auf die Teamkoordination achten. BeiTeamarbeit muss die Aufmerksamkeit zwischen der eigenen Aufgabe und der Koordinationhin- und hergehen. Dieser Aufmerksamkeitswechsel ist generell schwierig, er istaber besonders anspruchsvoll, wenn die Teammitglieder sich nicht gut kennen,die Aufgabe ungewohnt ist, und das Team unter Stress steht –das ist in Notfallsituationenin medizinischen Teams oft der Fall. In solchen Situation kommt es vor, dassdie Teammitglieder sich so sehr auf die eigene Aufgabe konzentrieren, dass siedie Koordination vernachlässigen – vor allem, wenn sie auf Probleme stossen.Das kann dann zu Fehlern führen.

Wir untersuchen Interventionen, die es erleichtern sollen,die Aufmerksamkeit stärker auf die Koordination zu lenken. Z.B. fordern wir Teammitgliederdazu auf, während der Notfallsituation laut zu sagen, was sie gerade machen, überlegen,und planen. Das lenkt die Aufmerksamkeit aller auf den Teamprozess und erlaubtbessere Koordination, aber auch gegenseitige Korrektur. Wir arbeitenexperimentell und vergleichen Teamprozesse und Teamleistung in Teams mit oderohne Intervention.

Wir erwarten Erkenntnisse über das Zusammenspiel vonKommunikation und Mikro-Koordination bei komplexen Aufgaben in Notfallsituationen.Wir erwarten auch, dass wir zeigen können, an welchen Stellen Koordinationwährend Notfallaufgaben besonders viel Aufmerksamkeit erfordert und wie dasWissen um Teamprozesse mit dem Wissen um medizinische Notwendigkeiten am bestenverknüpft werden kann.

Unsere Ergebnisse können in die Ausbildung von medizinischenTeams einfliessen und damit einen Beitrag zur Qualität der Behandlung vonPatienten leisten. Zusem leisten sie einen Beitrag zum vertieften Wissen überTeamprozesse, so dass auch Schlussfolgerungen gezogen werden können, die überNotfallteams hinausgehen.

Direct link to Lay Summary Last update: 23.12.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
More than experience: a post-task reflection intervention among team members enhances performance in student teams confronted with a simulated resuscitation task—a prospective randomised trial
Kündig Patrizia, Tschan Franziska, Semmer Norbert K, Morgenthaler Camille, Zimmerman Jasmin, Holzer Eliane, Huber Simon Andreas, Hunziker Sabina, Marsch Stephan (2020), More than experience: a post-task reflection intervention among team members enhances performance in student teams confronted with a simulated resuscitation task—a prospective randomised trial, in BMI Stel, 6, 81-86.
Predicting team-performance and leadership in emergency situations by observing standardised operational procedures: a prospective single-blind simulator-based trial
Tschan Franziska, Semmer Norbert K, Vetterli Maria, Hunziker Patrick R, Marsch Stephan U (2018), Predicting team-performance and leadership in emergency situations by observing standardised operational procedures: a prospective single-blind simulator-based trial, in BMJ Simulation & Technology enhanced learning, 00-01.
Führen optimierte Teamarbeit und Führungsverhalten zu besseren Reanimationsergebnissen?Was können wir daraus für andere Notfälle lernen?
Becker C., Marsch S., Eppich W., Hunziker S. (2018), Führen optimierte Teamarbeit und Führungsverhalten zu besseren Reanimationsergebnissen?Was können wir daraus für andere Notfälle lernen?, in Notfall + Rettungsmedizin, 21(3), 171-176.
Rules for coding scheme development
TschanFranziska, ZimmermannJasmin, Semmer Norbert K. (2018), Rules for coding scheme development, in Brauner Elisabeth , Boos Margarete, Kolbe Michaela (ed.), Cambridge University Press, Cambridge, 191-207.
Influence of Gender on the Performance of Cardiopulmonary Rescue TeamsA Randomized, Prospective Simulator Study
Amacher Simon Adrian, Schumacher Cleo, Legeret Corinne, Tschan Franziska, Semmer Norbert Karl, Marsch Stephan, Hunziker Sabina (2017), Influence of Gender on the Performance of Cardiopulmonary Rescue TeamsA Randomized, Prospective Simulator Study, in Critical Care Medicine, 45(7), 1184-1191.
Two minutes CPR versus five cycles CPR prior to reanalysis of the cardiac rhythm: A prospective, randomized simulator-based trial
Weichert Veronika, Sellmann Timur, Wetzchewald Dietmar, Gasch Bernd, Hunziker Sabina, Marsch Stephan (2015), Two minutes CPR versus five cycles CPR prior to reanalysis of the cardiac rhythm: A prospective, randomized simulator-based trial, in Resuscitation, 96, 142-147.

Resource not found: '22893752-1820-4c1c-8a61-f636f7f7c98b'

Resource not found: '8158ab1d-ea8e-4243-8c2a-8c406208490c' Resource not found: 'cb54b791-567a-419e-b809-e139ff910e8f'
Types of collaboration
Kardiotours Arnsberg/University of Witten Herdecke: Drs Sellmann; Wethschenwald, Prof Russo Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Dr. Peter Dieckmann Denmark (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Dr. Richard Moreland, University of Pittsburgh United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
University of Washington DC. Collaborators: Profs Radall Burd and Karen O’Connell United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Dr. Sabina Hunziker / Universitätsspital Basel Switzerland (Europe)
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
BSAS 2019, Amsterdam Talk given at a conference Do We Need an Extended Approach to Investigating Implicit Coordination? 29.11.2019 Amsterdam , Netherlands Marsch Stephan Christoph Ulrich; Semmer Norbert Karl; Tschan Semmer Franziska;
BSAS 2019, Amsterdam Talk given at a conference Impact of reflexivity quality on resuscitation performance improvement 29.11.2019 Amsterdam , Netherlands Semmer Norbert Karl; Marsch Stephan Christoph Ulrich; Morgenthaler Camille; Tschan Semmer Franziska;
16th SPS SGP SSP Conference in Bern Poster Importance of quality of reflexivity inresuscitation performance 09.09.2019 Bern, Switzerland Semmer Norbert Karl; Marsch Stephan Christoph Ulrich; Tschan Semmer Franziska; Huber Simon; Morgenthaler Camille;
16th SPS SGP SSP Conference in Bern Poster Implicit coordination: A Review and New Approach 09.09.2019 Bern , Switzerland Marsch Stephan Christoph Ulrich; Semmer Norbert Karl; Tschan Semmer Franziska;
14th Annual INGroup Conference, Lisbon, Portugal Talk given at a conference Three minutes well spent: the quality of a short self-led reflection enhances medical team performance in a simulated resuscitation scenario 18.07.2019 Lisabon, Portugal Marsch Stephan Christoph Ulrich; Semmer Norbert Karl; Morgenthaler Camille; Huber Simon; Tschan Semmer Franziska;
BSAS 2018, Munich Poster Understanding implicit cooordination in acute care teams 20.10.2018 München, Germany Marsch Stephan Christoph Ulrich; Semmer Norbert Karl; Tschan Semmer Franziska;
13th Annual INGRoup Conference, Washington, DC Talk given at a conference Towards Implicit Coordination: How Medical Teams Coordinate by Reducing Communication and Changing the Way They Communicate 19.07.2018 Washington DC, United States of America Semmer Norbert Karl; Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich;
13th Annual INGRoup Conference, Washington, DC Poster The effects of task-focused, team-focused, and combined reflexivity intervention on performance in teams of medical students confronted with a cardiac arrest: A simulation study 19.07.2018 Washington DC, United States of America Morgenthaler Camille; Huber Simon; Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich; Semmer Norbert Karl;
13th Annual INGRoup Conference, Washington, DC Talk given at a conference Group Interaction Analysis as Challenge and as Chance 19.07.2018 Washington DC, United States of America Tschan Semmer Franziska;
BSAS 2017 (International Meeding for Behavioural Sciences in Surgery & Acute Care Settings) Poster Medical, technical and teamwork skills in multidisciplinary, ad hoc formed teams of experienced ICU medical professionals 21.10.2017 Zürich, Switzerland Marsch Stephan Christoph Ulrich; Morgenthaler Camille; Tschan Semmer Franziska; Semmer Norbert Karl;
Kongress der Schweizer Gesellschaft für Psychologie 2017 Poster How to train and assess team performance in multidisciplinary ad-hoc formed teams of experienced ICU medical professionals - A proposal of a simulatoin scenario and performance rating checklist 04.09.2017 Lausanne, Switzerland Morgenthaler Camille; Marsch Stephan Christoph Ulrich; Semmer Norbert Karl; Tschan Semmer Franziska;
Kongress der Schweizer Gesellschaft für Psychologie 2017 Poster Team and task topics discussed in a reflexivity session after a simulated resuscitation task 04.09.2017 Lausanne, Switzerland Huber Simon; Tschan Semmer Franziska; Semmer Norbert Karl; Marsch Stephan Christoph Ulrich; Morgenthaler Camille;
12th Annual INGRoup Conference, St. Louis Talk given at a conference Brief technical instructions to overcome gender-specific delays in defibrillation in all-female resuscitation teams: a prospective randomized simulator-based trial 21.07.2017 St.Louis, United States of America Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich; Semmer Norbert Karl;
12th Annual INGRoup Conference, St. Louis Talk given at a conference Predicting the quality of team-performance in emergency situations by the quality of team-performance during standardized operational procedures: a simulator-based study in critical care 21.07.2017 St.Louis, United States of America Tschan Semmer Franziska; Semmer Norbert Karl; Marsch Stephan Christoph Ulrich;
12th Annual INGRoup Conference, St. Louis Poster Development of a simulation scenario and behavioral marker checklist to assess team performance in interdisciplinary ICU ad-hoc teams confronted with a complex medical task 20.07.2017 St.Louis, United States of America Tschan Semmer Franziska; Morgenthaler Camille; Marsch Stephan Christoph Ulrich; Semmer Norbert Karl;
12th Annual INGRoup Conference, Poster What do groups reflect about when asked to? Topics discussed during a reflection phase 20.07.2017 St.Louis, United States of America Semmer Norbert Karl; Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich; Huber Simon; Morgenthaler Camille;
10th Anniversary BSAS (International Meeting for Behavioural Science in Surgery & Acute Care Settings) Poster How to develop obeservational coding systems to observe interactions. Guidelines and an example from research in the medical field 11.11.2016 Aberdeen, Great Britain and Northern Ireland Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich; Semmer Norbert Karl;
InSim 2016 (Interdisziplinäres Symposium zur Simulatoin in der Medizin) Talk given at a conference Können sich medizinische Teams auch selbst instruieren? 13.10.2016 Dresden, Germany Tschan Semmer Franziska;
Resuscitation 2015 - European Resuscitation Council ERC congress on Education Talk given at a conference Leadership 24.08.2016 Reykjavik, Iceland Tschan Semmer Franziska;
SESAM 2016 Talk given at a conference In search for reflection in simulation debriefings 15.06.2016 Lissabon, Portugal Tschan Semmer Franziska;
9th Annual INGRoup Conference, Raleigh, NC Talk given at a conference Effects of team interaction and "prospective shared mental model" of anticipated treatement on information handed over after a medical emergency: A simulator study 17.07.2014 Raleigh, NC, United States of America Tschan Semmer Franziska; Semmer Norbert Karl; Marsch Stephan Christoph Ulrich;
Resuscitation 2014 - the pathway to new Guidelines Talk given at a conference We all work in teams, so what is the problem with team performance? 15.05.2014 Bilbao , Spain Semmer Norbert Karl; Tschan Semmer Franziska; Marsch Stephan Christoph Ulrich;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
5. Symposium retten & Lernen, Nottwil, Schweiz, 2018 Talk 30.11.2018 Nottwil , Switzerland Tschan Semmer Franziska;
Medart, Basel, Simulator-based workshops 2018 Workshop 18.06.2018 Basel , Switzerland Marsch Stephan Christoph Ulrich;
Simulator-based workshops for physicians working in intensive care Workshop 19.04.2018 Basel , Switzerland Marsch Stephan Christoph Ulrich;
Medart, Basel, Simulator-based workshops 2017 Workshop 19.06.2017 Basel, Switzerland Marsch Stephan Christoph Ulrich;
Fortbildung Pneumologie/Thoraxchirurgie Inselspital Bern 2017 Talk 29.05.2017 Bern , Switzerland Tschan Semmer Franziska;
Medart, Basel, Simulator-based workshops 2016 Workshop 20.06.2016 Basel, Switzerland Marsch Stephan Christoph Ulrich;
Colloques de formation postgraduee du mardi matin, département de médecine Talk 08.09.2015 La Chaux-de-fonds, Switzerland Tschan Semmer Franziska;
Medart, Basel, Simulator-based workshops 2015 Workshop 22.06.2015 Basel , Switzerland Marsch Stephan Christoph Ulrich;
11. Schweizerische Fachtagung über die Sterilisation Talk 20.06.2015 Biel, Switzerland Tschan Semmer Franziska;
Leadership Teaching im Simulator (BeSiC Fortbildungsworkshops für Simulationsinstruktoren Workshop 08.04.2015 Bern , Switzerland Tschan Semmer Franziska;
Echanges scientifiques Talk 15.03.2015 Neuchâtel, Hôpital Pourtales, Switzerland Tschan Semmer Franziska;
Colloques du DGOG, Département de Gynécologie-Obstetrique CHUV, Lausanne Talk 11.09.2014 Lausanne, CHUV, Maternité, Switzerland Tschan Semmer Franziska;


Awards

Title Year
Premier place ET prix du publique - Ma thèse en 180 secondes, Université de Neuchâtel: Camille Morgenthaler - "Reflexivity in Medical Simulation" (Le concours Ma thèse en 180 secondes permet à des doctorants de présenter leur sujet de recherche en termes simples à un large public. Chaque candidat doit faire, en trois minutes, un exposé clair, concis et convaincant sur son projet de recherche, en français et sans autre accessoire qu'un unique visuel non animé.) 2019
Best poster award for The Effects of Task-focused, Team-Focused, and Combined Reflexivity Interventions on Performance in Teams of Medical Students Confronted with a Cardiac Arrest: A Simulation Study Camille Morgenthaler, Franziska Tschan, Norbert K Semmer, Jasmin Zimmermann, Simon A Huber & Stephan U Marsch 2018
Best poster award for: Understanding implicit coordination in acute care teams J. Zimmermann, F. Tschan, N. K. Semmer, R. Meyer, S. U. Marsch BSAS München, 20. 10.2018 2018

Associated projects

Number Title Start Funding scheme
103724 Human factors in medicine: Team-building in action 01.05.2005 Project funding

Abstract

This project aims at testing the effectiveness of short pre-briefing interventions and several self-regulated debriefing interventions on the process and on the performance of teams of medical specialist dealing with medical emergencies. More specifically, we will focus on the problem of fostering the application of teamwork knowledge and skills by using appropriate cues.The significance of this project is that we contribute to basic research by enhancing the understanding of effects of interventions focusing the attention of the group members on specific teamwork cooperation. We also contribute to the development of interventions in medical education that will allow medical teams to improve team coordination and team learning processes related to emergency situations. The project is a cooperation between psychologists and physicians. Conceptually, we draw on theories of groups as information processing and acting systems. These theories emphasize that group performance depends on the successful integration of taskwork and team cooperation (teamwork) processes with regard to specific tasks. We also draw on empirical findings that support the attentional focus model of group processes, which assumes that groups often fail to successfully and adaptively switch their attention between taskwork and teamwork requirements. Finally, we draw on theories and studies that indicate that even short interventions may enhance coordination processes and improve team performance if they appropriately guide the attention of teams to teamwork aspects. Empirically, using high fidelity simulator technology, we will investigate the effectiveness of a pre-briefing and a debriefing intervention aimed at supporting self-regulated learning in medical teams dealing with emergency situations. (1) The first study contains two experiments; both will test the effects of a pre-briefing intervention aimed at directing the attention of a team of medical experts to engaging in behaviors that foster the development of a shared mental model, but the two experiments will differ in demands. Experiment 1 will contain “only” a complex non-standard emergency situation, whereas Experiment 2 adds an additional complication, thus requiring team multitasking. We expect that the pre-briefing intervention will lead to better coordination, more task-adapted strategies and better medical performance in the intervention groups; we also expect that intervention groups develop a better mental model of the situation and thus are able to deliver more accurate information to an incoming specialist. (2) In the second study we compare the effect of four self-regulated (i.e. no external instructor present) post-briefing procedures in teams of medical students dealing with a standard emergency situation (cardiac arrest) on subsequent process and performance. Goal is to determine the optimal level of cues necessary for an effective self-regulating debriefing. We expect that task-adaptive coordination cues lead to a larger increase in optimal strategies and to superior results in dealing with a standard emergency than cues related to only task-aspects or to general team skills or no cues. The novelty in this project is twofold. First, we investigate teamwork behavior of teams composed of medical experts or advanced medical students dealing with complex emergencies. Previous studies relied mostly on student participants dealing with relatively simple task. Second, we investigate the link between intervention and team outcomes in terms of team processes. By contrast, most previous studies investigating effects of team training evaluated participant reactions and attitude changes only.
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