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  • Publication
    Métadonnées seulement
    Explicit Reasoning, Confirmation Bias, and Illusory Transactive Memory A Simulation Study of Group Medical Decision Making
    (2009) ;
    Semmer, Norbert
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    Gurtner, Andrea
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    Bizarri, Lara
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    Spychiger, Martin
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    Breuer, Marc
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    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
    Getting groups to develop good strategies: Effects of reflexivity interventions on team process, team performance, and shared mental models
    (2007)
    Gurtner, Andrea
    ;
    ;
    Semmer, Norbert
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    Nägele, Christof
    This study examines the effect of guided reflection on team processes and performance, based on West's (1996, 2000) concept of reflexivity. Communicating via e-mail, 49 hierarchically structured teams (one commander and two specialists) performed seven 15 min shifts of a simulated team-based military air-surveillance task (TAST) in two meetings, a week apart. At the beginning of the second meeting, teams were assigned either to a reflexivity (individual or group) or to a control condition. Results show that reflexivity enhanced performance, the link between reflexivity and team performance being mediated by communication and implementation of strategies as well as by similarity of mental models. Contrary to expectations, individual reflexivity was superior to group reflexivity. Additional analyses suggested that group reflexivity decreased the commanders' active behavior and increased discussion of strategies that were too general to be helpful. Results point to the usefulness of reflexivity as a generic intervention but underscore the importance of focusing on strategies that are task-specific. (c) 2006 Elsevier Inc. All rights reserved.