Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Abstract

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Surgeons’ perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

“…When enquired about the most effective tools to support clinical decision-making, surgeons declare to rely more on training, clinical guidelines, and the support of their multidisciplinary staff and colleagues. Interestingly, these three items represent central and “classical” elements in the trauma and emergency surgery context [ 14 ] and in the action of the leading scientific societies like the WSES, which promotes training modules for both physicians and nurses [ 26 ], clinical guidelines covering several aspects of the clinical profession [ 27 ], and studies on multidisciplinary team dynamics [ 14 , 15 ]. AI and Machine Learning tools got one of the lowest rates (3.56), with the highest standard deviation (1.07).…”

“…The exploratory study of the international trauma and emergency surgeons’ community used a population-based online questionnaire to gather demographic, knowledge, and practice-based information regarding the adoption of new technological tools to support clinical decision-making. The online questionnaire was generated in English through Google Forms [ 14 , 15 ], and followed the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) [ 16 ].…”

“…The initiative was also shared on the society's website and Twitter account. Additionally, the members of the Team Dynamics Study Group [ 14 , 15 ] were also invited via e-mail. Four e-mail reminders were sent.…”

“…The first group of questions aimed at understanding the participants’ features. The questions’ structure and list were derived from the previous Team Dynamics investigation [ 14 , 15 ]. Surgeons were asked to disclose their gender, years of experience in trauma/emergency surgery, type of institution (academic versus non-academic), the country in which they work, role, eventual participation within a trauma team (institutionalized or not, and of which type), the kind of trauma leader, the educational training attended, and the eventual presence of diverse team members.…”

Why non-technical skills matter in surgery. New paradigms for surgical leaders

“…In emergency and trauma contexts, NTS have proved to be essential in facilitating communication among team members, especially when there is little time to decide or when the patient’s life is in danger [ 5 , 6 , 33 , 39 ]. According to a recent investigation [ 4 , 40 ], trauma and emergency surgeons underline many difficulties in efficiently conducting their work within their assigned teams. The main issues concern a lack of trust with colleagues and authoritarian and generally demanding relations with their team leaders.…”