Lay summary
The overall aim of our research group is to enhance patients’ safety. The present research project focuses on the importance of human factors in medical emergencies. Specifically, the project aims at investigating 1) which aspects of leadership and co-operation behaviour are related to a high team performance; 2) how efficient leadership and co-ordination behaviour of health-care professionals dealing with emergency situations can be improved by training; and 3) whether and how team performance during a medical emergency can be predicted by observing team performance during a standard operational procedure.
Modern medicine is a team endeavour. Human factors are important for ensuring high performance and avoiding adverse events in teams working in high-risk environments such as aviation, nuclear power plants, and indeed medicine. Previous research showed that ensuring high performance in an emergency situation depends on specialised knowledge and skills of the professionals involved, but also on how well members of emergency teams co-operate. In our own previous studies, we found that leadership and co-ordination be-hav-iour were less efficient if members joined the group sequentially rather than being present right from the beginning.Shortcomings in leadership and co-ordination behaviour led to poorer performance and hence less favourable patients’ outcome. It is important to note that these results were obtained in a situation where a) it was not difficult to diagnose the problem and b) the algorithms to be followed in this situation are well known and specified. Nevertheless, team performance was not uniformly good. Insight into the importance of human factors in medical teams may have important implications for both practice and training of medicine. By contributing to minimising errors and performance failures, our results might have important medical, social and economic implications. However, our project is also relevant for basic research in the field of groups and teams and team performance in high-risk domains other than medicine.
The research is conducted in a high-fidelity patient simulator at the University of Basel. Participants include nurses, physicians, and medical students. In order to answer the research questions, scenarios are specifically designed around a medically relevant problem, and, whenever possible, different scenarios are applied in a randomised fashion. Data analysis is performed using videotapes recorded during simulations. A particular strength of our methodology is micro-coding with regard to behaviour and communication, as developed by our research group.