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Tschan, Franziska

Nom
Tschan, Franziska
Affiliation principale
Fonction
Professeure ordinaire
Email
franziska.tschan@unine.ch
Identifiants
https://libra.unine.ch/handle/123456789/497
_
0000-0003-3330-1144

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  • Publication
    Métadonnées seulement
    How Accurate Is Information Transmitted to Medical Professionals Joining a Medical Emergency? A Simulator Study
    (2009)
    Bogenstätter, Yvonne
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Spychiger, Martin
    ;
    Breuer, Marc
    ;
    Marsch, Stephan
    Objective: This study used a high-fidelity simulation to examine factors influencing the accuracy of 201 pieces of information transmitted to nurses and physicians joining a medical emergency situation. Background: Inaccurate or incomplete information transmission has been identified as a major problem in medicine. However, only a few studies have assessed possible causes of transmission errors. Method: Each of 20 groups was composed of two or three nurses (first responders), one resident joining the group later, and one senior doctor joining last. Groups treated a patient suffering a cardiac arrest. Results: Multilevel binomial analyses showed that 18% of the information given to newcomers was inaccurate. Quantitative information requiring repeated updating was particularly error prone. Information generated earlier (i.e., older information) was more likely to be transmitted inaccurately. Explicitly encoding information to be transmitted after the physicians arrived at the scene enhanced accuracy, supporting transfer-appropriate processing theory. Conclusion: Information transmitted to nurses and physicians who join an ongoing emergency is only partly reliable. Therefore, medical professionals should not take accuracy for granted and should be aware of the nature of transmission errors. Application: Medical professionals should be trained in adequate encoding of information and in standardized communication procedures with regard to error-prone information. In addition, technical devices should be implemented that reduce reliance on memory regarding information with error-prone characteristics.
  • Publication
    Métadonnées seulement
    Explicit Reasoning, Confirmation Bias, and Illusory Transactive Memory A Simulation Study of Group Medical Decision Making
    (2009)
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Gurtner, Andrea
    ;
    Bizarri, Lara
    ;
    Spychiger, Martin
    ;
    Breuer, Marc
    ;
    Marsch, Stephan
    Teamwork is important in medicine, and this includes team-based diagnoses. The influence of communication on diagnostic accuracy in an ambiguous situation was investigated in an emergency medical simulation. The situation was ambiguous in that some of the patient's symptoms suggested a wrong diagnosis. Of 20 groups of physicians, 6 diagnosed the patient, 8 diagnosed with help, and 6 missed the diagnosis. Based on models of decision making, we hypothesized that accurate diagnosis is more likely if groups (a) consider more information, (b) display more explicit reasoning, and (c) talk to the room. The latter two hypotheses were supported. Additional analyses revealed that physicians often failed to report pivotal information after reading in the patient chart. This behavior suggested to the group that the chart contained no critical information. Corresponding to a transactive memory process, this process results in what we call illusory transactive memory. The plausible but incorrect diagnosis implied that the two lungs should sound differently. Despite objectively identical sounds, some physicians did hear a difference, indicating confirmation bias. Training physicians in explicit reasoning could enhance diagnostic accuracy.