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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
    Impact of team familiarity in the operating room on surgical complications
    (2014)
    Kurmann, A.
    ;
    Keller, S.
    ;
    Tschan, Franziska 
    ;
    Seelandt, J.
    ;
    Semmer, N. K.
    ;
    Candinas, D.
    ;
    Beldi, G.
  • Publication
    Métadonnées seulement
    Activities during interruptions in cardiopulmonary resuscitation: a simulator study
    (2011)
    Tschan, Franziska 
    ;
    Vetterli, Maria
    ;
    Semmer, Norbert K.
    ;
    Hunziker, Sabina
    ;
    Marsch, Stephan U
    OBJECTIVE: Studies investigating the quality of cardiopulmonary resuscitation (CPR) have revealed frequent unnecessary interruptions of life support. The primary objective of the study is to analyze what happens during interruptions. We investigated (a) whether interruptions are filled with "secondary activities", i.e., activities only indirectly related to the primary task of providing life support (e.g., preparatory and diagnostic activities), and (b) whether all group members focus on the same secondary activity during interruptions, thus impeding group coordination, and detracting from the primary task of providing life support. DESIGN: Prospective observational study. SETTING: Twenty teams of general practitioners were videotaped during a simulated cardiac arrest. OUTCOME MEASURES: Resuscitation performance was assessed as hands-on time according to resuscitation guidelines. Unnecessary interruptions were defined as periods the patient received no hands-on support. RESULTS: Teams of general practitioners achieved hands-on time in accordance with the resuscitation guidelines (chest compression/ventilation/defibrillation) during 62% of the time the patient had no pulse. Unnecessary interruptions consumed 32% of the available time. During most of the unnecessary interruption time, team members engaged in secondary medical activities, particularly observing the monitor (47%) and dealing with the defibrillator (47%). During 56% of the unnecessary interruption time, all team members focussed their attention on the same secondary activity, thus neglecting the need for task distribution among team members. CONCLUSIONS: Unnecessary interruptions of CPR occur frequently and consume approximately one-third of the time patients should receive continuous life support. Unnecessary interruptions are mainly characterized by secondary medical activities that may be perceived as meaningful. During the majority of unnecessary interruptions, all team members focus on the same secondary activity, indicating shortcomings in task distribution in the resuscitation team. The findings emphasize the importance of team training with particular emphasis on situational awareness and task distribution.
  • Publication
    Métadonnées seulement
    Leadership in medical emergencies depends on gender and personality
    (2011)
    Streiff, Seraina
    ;
    Tschan, Franziska 
    ;
    Hunziker, Sabina
    ;
    Buehlmann, Cyrill
    ;
    Semmer, Norbert K.
    ;
    Hunziker, Patrick
    ;
    Marsch, Stephan U
    NTRODUCTION: Leadership is an important predictor of team performance in medical emergencies. There are no data on why some healthcare workers take the lead in emergencies while others do not. Accordingly, the aim of the study was to determine predictors of leadership in a medical emergency. METHODS: Two hundred thirty-seven medical students in fourth year of medical school participated and filled in a questionnaire assessing knowledge, experience, and personality traits. Students were randomly assigned to 79 groups of three. Each group was confronted with a standardized scenario of a simulated witnessed cardiac arrest. The primary outcome was the predictors of the number of leadership statements during the first 3 minutes of the cardiac arrest. RESULTS: In the first 3 minutes of the cardiac arrest, the participants made a median of five leadership statements (range, 0-22; interquartile range, 2). Thirteen participants (5.5%) made no single leadership statement. Multivariate analysis revealed that male gender (unstandardized coefficient, 1.9; P = 0.01), extraversion (unstandardized coefficient, 0.9; P = 0.02), and agreeableness (unstandardized coefficient, -1.1; P = 0.023) predicted leadership statements. Context knowledge, context experience, and other personality traits had no significant effect on leadership. CONCLUSIONS: During the initial phase of a medical emergency, there is a substantial interindividual variation in the amount of leadership. Leadership behavior as assessed by the number of leadership statements is determined by gender and personality and not by knowledge or experience.
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    Métadonnées seulement
  • Publication
    Métadonnées seulement
    Teamwork and Leadership in Cardiopulmonary Resuscitation
    (2011-3-8)
    Hunziker, Sabina
    ;
    Johansson, Anna C
    ;
    Tschan, Franziska 
    ;
    Semmer, Norbert K.
    ;
    Rock, Laura
    ;
    Howell, Michael D
    ;
    Marsch, Stephan U
    Despite substantial efforts to make cardiopulmonary resuscitation (CPR) algorithms known to healthcare workers, the outcome of CPR has remained poor during the past decades. Resuscitation teams often deviate from algorithms of CPR. Emerging evidence suggests that in addition to technical skills of individual rescuers, human factors such as teamwork and leadership affect adherence to algorithms and hence the outcome of CPR. This review describes the state of the science linking team interactions to the performance of CPR. Because logistical barriers make controlled measurement of team interaction in the earliest moments of real-life resuscitations challenging, our review focuses mainly on high-fidelity human simulator studies. This technique allows in-depth investigation of complex human interactions using precise and reproducible methods. It also removes variability in the clinical parameters of resuscitation, thus letting researchers study human factors and team interactions without confounding by clinical variability from resuscitation to resuscitation. Research has shown that a prolonged process of team building and poor leadership behavior are associated with significant shortcomings in CPR. Teamwork and leadership training have been shown to improve subsequent team performance during resuscitation and have recently been included in guidelines for advanced life support courses. We propose that further studies on the effects of team interactions on performance of complex medical emergency interventions such as resuscitation are needed. Future efforts to better understand the influence of team factors (e.g., team member status, team hierarchy, handling of human errors), individual factors (e.g., sex differences, perceived stress), and external factors (e.g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients.
  • Publication
    Métadonnées seulement
    Perceived stress and performance during a simulated resuscitation: A pilot study
    (2011-9-1)
    Hunziker, Sabina
    ;
    Laschinger, Laura
    ;
    Portmann, S
    ;
    Semmer, Norbert K.
    ;
    Tschan, Franziska 
    ;
    Marsch, Stephan U
  • Publication
    Métadonnées seulement
  • 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
    It's not only clients: Studying emotion work with clients and co-workers with an event-sampling approach
    (2005)
    Tschan, Franziska 
    ;
    Rochat, Sylvie
    ;
    Zapf, Dieter
    A group of 78 young employees in service and non-service professions reported 848 task related interactions at work over I week using a variant of the Rochester Interaction Record which measured emotion work requirements, emotional dissonance, and deviance. Multi-level analyses showed that dissonance was more likely in interactions with customers, whereas deviance, that is, the violation of display rules by acting out one's felt emotion, was more likely in co-worker interactions. Well-being in the interaction was lower (a) for interactions with emotion work requirements, (b) for dissonance, even after controlling for felt negative emotions, and (c) for deviance. Negative emotion displayed partially mediated the relationship between deviance and well-being. Regarding the relationship of more stable job related attitudes, psychosomatic complaints, and aggregated scores of social interactions, fewer effects were found than in questionnaire studies, which may be due to the fact that only interactions that lasted at least 10 minutes were assessed, as is customary in research with this instrument. Among the effects found, however, many involved proportions rather than frequency of interactions, which raises the possibility of balancing and legitimizing effects of non-stressful interactions.
  • Publication
    Métadonnées seulement
    First years in job: A three-wave analysis of work experiences
    (2007)
    Elfering, Achim
    ;
    Semmer, Norbert
    ;
    Tschan, Franziska 
    ;
    Kälin, Wolfgang
    ;
    Bucher, Adrian
    A sample of 423 Swiss job entrants reported major change in general, as well as positive and negative work experiences one, two, and four years after finishing vocational training. Qualitative data analysis showed change in responsibility, increase in decision latitude, acquisition of new status (professional work status, full team member status), increased salary, and change in work rhythm to be characteristic for the transition from apprenticeship into "real work". In terms of costs and benefits participants reported transition-specific combinations of work experiences, with responsibility and social recognition as positive experiences combined with high demands as negative experiences. Reports of increasing demands and task intensity were frequent throughout the first four years of job experience. Cooperation and social exchange always were of major concern, both as positive and negative experiences. The number of positive and negative experiences reported predicted job satisfaction over and above previous job satisfaction, background variables, stressors, and resources. Results point to a rather smooth transition, in which negative experiences are embedded in, and outweighed by, positive ones. (c) 2006 Elsevier Inc. All rights reserved.