Content analysis of team communication in an obstetric emergency scenario

Abstract

We studied a random sample of four teams of doctors and midwives who participated in a videotaped simulated obstetric emergency, postpartum haemorrhage, before and after 'on-site' clinical training. We aimed to assess the validity of mixed techniques for the analysis of team communication and whether clinical and non-clinical team training improve communication. Two of the four teams received extra training in specific teamwork behaviours (TW+), the other half received only clinical training (TW-). We used content analysis to identify changes in communication patterns. There was a reduction in the total number of communications after training. Teams that received additional teamwork training used more directed commands after training. When commands were directed to specific individuals, tasks were more likely to be acknowledged and performed. We conclude that 'on-site' clinical drills can improve team communication in simulated emergencies, and additional teamwork training might improve this further, but it has to be refined and made obstetric specific first.

Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review

“…Fifteen articles met our inclusion criteria, which represented 12 independent studies (Boet et al, 2013;Crofts et al, 2007Crofts et al, , 2008Daniels et al, 2010;Ellis et al, 2008;Frengley et al, 2011;Jankouskas, Haidet, Hupcey, Kolanowski, & Murray, 2011;LeFlore & Anderson, 2009;Miller, Crandall, Washington, & McLaughlin, 2012;Phipps et al, 2012;Riley et al, 2011;Shapiro et al, 2004;Siassakos, Draycott, Montague, & Harris, 2009;Thomas et al, 2007Thomas et al, , 2010. Four of the articles included in the review were companion reports from the UK SaFE trial and, together were considered one independent study (Crofts et al, 2007Ellis et al, 2008;Siassakos et al, 2009).…”

“…Five studies involved interprofessional teams (Crofts et al, 2007Daniels et al, 2010;Ellis et al, 2008;Frengley et al, 2011;Jankouskas et al, 2011;Shapiro et al, 2004;Siassakos et al, 2009), and five were both interprofessional and interdisciplinary (Boet et al, 2013;LeFlore & Anderson, 2009;Miller et al, 2012;Phipps et al, 2012;Riley et al, 2011), while two only involved interdisciplinary teams (Thomas et al, 2007(Thomas et al, , 2010. Physicians and nursing were the most common professions, represented in 12 and 9 studies, respectively.…”

“…Ten of the included articles were RCTs (Boet et al, 2013;Crofts et al, 2007Crofts et al, , 2008Daniels et al, 2010;Ellis et al, 2008;Frengley et al, 2011;Jankouskas et al, 2011;LeFlore & Anderson, 2009;Riley et al, 2011;Shapiro et al, 2004;Siassakos et al, 2009;Thomas et al, 2007Thomas et al, , 2010 and two were ITS studies (Miller et al, 2012;Phipps et al, 2012). Approximately 1099 participants or 202 teams were included in the review.…”

“…Examples of acute/critical care event include trauma activations (Miller et al, 2012), cardiac arrhythmias in the operating room (Boet et al, 2013), airway emergencies (Frengley et al, 2011), and basic life support (Jankouskas et al, 2011). Emergencies involving obstetric teams involved post-partum haemorrhage (Siassakos et al, 2009); eclampsia (Daniels et al, 2010;Ellis et al, 2008); uterine rupture and placental abruption (Riley et al, 2011); and dystocia (Daniels et al, 2010).…”

Sustaining simulation training programmes – experience from maternity care

“…15 However, a detailed analysis of this study demonstrated that additional teamwork training resulted in an improvement in directed and addressed messages, as opposed to those called out in the air, but this was not associated with improved clinical performance. 22 It has been shown recently that some teamwork characteristics are important for a healthcare team to work efficiently, 23,24 and in a manner that is evaluated positively by patient-actors. 25 Therefore, generic teamwork training may be important, but may need to become more context specific before it can translate into better outcomes.…”