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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.

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Validation of the French version of the team reflexivity scale of Carter and West, 1998

2006, Facchin, Stephanie, Tschan, Franziska, Gurtner, Andrea, Cohen, Dalia, Dupuis, Annick

Several studies found reflexivity -the extent to which team discuss objectives, strategies and processes and adapt them to changes- to be related to team efficacy. Two studies were conducted with 80 teams (320 participants) to validate French version of reflexivity scale. In study 1 exploratory factor analysis revealed 3 factors which partly confirms the 2 factor structure (task reflexivity and social reflexivity) expected from the original study (Carter and West, 1998). Two items of the original task reflexivity scale load on a third factor we named strategic reflexivity. The three factor structure was replicated in study 2 with confirmatory factor analysis. Criterion validity is proved by correlations between reflexivity and team performance. Task, social and strategic reflexivity correlate with different aspects of team effectiveness. The French version of reflexivity scale is reliable and appropriate for evaluating team reflexivity. (c) 2006 Association internationale de psychologie du travail de langue francaise. Publie par Elsevier Masson SAS. Tons droits reserves.

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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.

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All in the timing - Considering time at multiple stages of group research

2008, Ballard, Dawna, Tschan, Franziska, Waller, Mary

The role of time in measuring group and team temporality constitutes more than a methodological issue-it is a theoretical question. That is, if group interaction is theorized as processual and processes occur through time, then research on team temporality, as well as a range of other issues, must grapple with the methodological implications of our theories. This article contributes to INGRoup's aim to advance theory and methods for understanding groups by exploring methodological approaches that allow us to capture a variety of team processes over time. Three case studies address the practical issues involved with employing various types of time-sensitive data collection, time-dependent coding, and time-based analysis, including their advantages and disadvantages. Together, the authors describe diverse field and analytical methods useful for interrogating theoretical assumptions about time in groups. Doing so expands the notion of group temporality to consider the role of both epochal and fungible times at multiple stages of group research.