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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

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  • Publication
    Métadonnées seulement
    ABC versus CAB for cardiopulmonary resuscitation: a prospective, randomized simulator-based trial
    (2013-9-6)
    Marsch, Stephan U
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Zobrist, Roger
    ;
    Hunziker, Patrick R
    ;
    Hunziker, Sabina
    QUESTIONS UNDER STUDY: After years of advocating ABC (Airway-Breathing-Circulation), current guidelines of cardiopulmonary resuscitation (CPR) recommend CAB (Circulation-Airway-Breathing). This trial compared ABC with CAB as initial approach to CPR from the arrival of rescuers until the completion of the first resuscitation cycle. METHODS: 108 teams, consisting of two physicians each, were randomized to receive a graphical display of either the ABC algorithm or the CAB algorithm. Subsequently teams had to treat a simulated cardiac arrest. Data analysis was performed using video recordings obtained during simulations. The primary endpoint was the time to completion of the first resuscitation cycle of 30 compressions and two ventilations. RESULTS: The time to execution of the first resuscitation measure was 32 ± 12 seconds in ABC teams and 25 ± 10 seconds in CAB teams (P = 0.002). 18/53 ABC teams (34%) and none of the 55 CAB teams (P = 0.006) applied more than the recommended two initial rescue breaths which caused a longer duration of the first cycle of 30 compressions and two ventilations in ABC teams (31 ± 13 vs.23 ± 6 sec; P = 0.001). Overall, the time to completion of the first resuscitation cycle was longer in ABC teams (63 ± 17 vs. 48 ± 10 sec; P <0.0001). CONCLUSIONS: This randomized controlled trial found CAB superior to ABC with an earlier start of CPR and a shorter time to completion of the first 30:2 resuscitation cycle. These findings endorse the change from ABC to CAB in international resuscitation guidelines.
  • Publication
    Métadonnées seulement
    Importance of leadership in cardiac arrest situations: from simulation to real life and back
    (2013-4-18)
    Hunziker, Sabina
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Marsch, Stephan
    The 2010 American Heart Association guidelines now re- commend leadership training in Advanced Cardiac Life Support courses. In this review we provide a comprehens- ive summary of data derived from clinical studies that in- vestigated the importance of leadership in cardiopulmon- ary resuscitation (CPR). Only a few, mostly observational, studies have been conducted under real-life conditions be- cause of the high heterogeneity of the situations, diffi- culties in capturing the initial phase of CPR, and ethical issues. Well-controlled studies in the human simulator can fill existing gaps and provide important insights. High-fi- delity video-assisted simulator studies from different re- search groups have shown that a prolonged process of teambuilding is associated with significant shortcomings in CPR, whereas effective leadership improves team per- formance. In addition, randomised controlled studies have provided evidence that medical students receiving leader- ship training subsequently showed improved CPR perform- ance, which was sustained after a follow up of 4 months. In addition, leadership is influenced by gender and other factors such as emotional stress. Future studies are needed to investigate cultural differences and how findings from the simulator can be transferred to real-life situations.
  • Publication
    Métadonnées seulement
    Illegitimate Tasks and Counterproductive Work Behavior
    (2010)
    Semmer, Norbert
    ;
    Tschan, Franziska 
    ;
    Meier, Laurenz
    ;
    Facchin, Stephanie
    ;
    Jacobshagen, Nicola 
    Illegitimate tasks represent a new stressor concept that is specifically tied to feeling offended. Tasks are legitimate to the extent that they conform to norms about what can reasonably be expected from a given person, and they are illegitimate to the extent that they violate such norms. Illegitimate tasks therefore are conceived as offending one's professional identity, and thus, the self. Previous research has shown illegitimate tasks to be related to indicators of well-being and strain, controlling for other stressors. We now present two Studies showing that illegitimate tasks relate to counterproductive work behavior, controlling for effort-reward imbalance in Study 1, for personality (conscientiousness and agreeableness) and organisational justice in Study 2. Thus, illegitimate tasks are associated with behavior that may be labeled "active, but in the wrong direction".
  • Publication
    Métadonnées seulement
    Proficiency in cardiopulmonary resuscitation of medical students at graduation: a simulator-based comparison with general practitioners
    (2010)
    Lüscher, Fabian
    ;
    Hunziker, Sabina
    ;
    Gaillard, Vincent
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Hunziker, Patrick
    ;
    Marsch, Stephan
  • 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.
  • Publication
    Métadonnées seulement
    Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: a prospective randomised simulator-based trial
    (2009)
    Hunziker, Sabina
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Zobrist, Roger
    ;
    Spychiger, Martin
    ;
    Breuer, Marc
    ;
    Hunziker, Patrick
    ;
    Marsch, Stephan
  • 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
    Emotion in work settings
    (Oxford: RJ Davidson, K. Scherer and Goldsmith, H. Hill (Eds.), Oxford Companion to the Affective Sciences. Oxford: Oxford University Press, 2009)
    Rafaeli, Anat
    ;
    Semmer, Norbert
    ;
    Tschan, Franziska 
    ;
    Sanders, David
    ;
    Scherer, Klaus
  • Publication
    Métadonnées seulement
    Temporal aspects of processes in ad-hoc groups: A conceptual scheme and some research examples
    (Londres: Routledge, 2008)
    Tschan, Franziska 
    ;
    McGrath, Joseph
    ;
    Semmer, Norbert
    ;
    Arametti, Maurizio
    ;
    Bogenstätter, Yvonne
    ;
    Marsch, Stephan
    ;
    Roe, Robert
    ;
    Waller, Mary
    ;
    Clegg, Stewart
  • Publication
    Métadonnées seulement
    Team process and diagnostic success in medical emergency driven teams: A simulator study
    (2008)
    Tschan, Franziska 
    ;
    Semmer, Norbert
    ;
    Gurtner, Andrea
    ;
    Bizarri, Lara
    ;
    Spychiger, Martin
    ;
    Marsch, Stephan