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Improving teamwork in medicine by brief, attention-focusing interventions: Basis and applied aspects
Responsable du projet Franziska Tschan
Stephan U. Marsch
Norbert K. Semmer
   
Résumé 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.
   
Mots-clés Group processes, High fidelity simulator research, Medical education, Attention-focusing interventiions, Group and team performance, Post-task briefings, Pre-tasks briefing
   
Type de projet Recherche fondamentale
Domaine de recherche Psychologie
Source de financement FNS - Encouragement de projets (Div. I-III)
Etat Terminé
Début de projet 1-2-2014
Fin du projet 31-1-2017
Budget alloué 372'012.00
Contact Franziska Tschan