Explicit Reasoning, Confirmation Bias, and Illusory Transactive Memory

Tschan, Franziska; Semmer, Norbert K.; Gurtner, Andrea; Bizzari, Lara; Spychiger, Martin; Breuer, Marc; Märsch, Stephan

doi:10.1177/1046496409332928

Cited by 119 publications

(104 citation statements)

References 66 publications

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“…Another study investigated the influence of ambiguous information on team function and clinical reasoning (49). Resuscitation teams were confronted with a patient undergoing penicillin-induced anaphylactic shock; however, the patient also reported pain due to a failed attempt to insert a central venous catheter, which could indicate a tension pneumothorax.…”

Section: Human Errors and Adverse Eventsmentioning

confidence: 99%

Teamwork and Leadership in Cardiopulmonary Resuscitation

Hunziker

Johansson

Tschan

et al. 2011

Journal of the American College of Cardiology

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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.

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Section: Human Errors and Adverse Eventsmentioning

confidence: 99%

Teamwork and Leadership in Cardiopulmonary Resuscitation

Hunziker

Johansson

Tschan

et al. 2011

Journal of the American College of Cardiology

Self Cite

261

200

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“…Observers of postoperative handovers found that much critical information (eg, allergies or intraoperative problems) was not communicated from OR doctors to ward nurses 26 27. There is also evidence suggesting that specific techniques to improve information sharing can improve clinical management, such as, in the high acuity setting, declaring an emergency and sharing information about a crisis with the team28 or ‘thinking aloud’—verbalising observations and decision-making processes to the team to share your mental model 29…”

Section: Introductionmentioning

confidence: 99%

Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare

Weller

Boyd

Cumin

2014

Postgraduate Medical Journal

533

397

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Modern healthcare is delivered by multidisciplinary, distributed healthcare teams who rely on effective teamwork and communication to ensure effective and safe patient care. However, we know that there is an unacceptable rate of unintended patient harm, and much of this is attributed to failures in communication between health professionals. The extensive literature on teams has identified shared mental models, mutual respect and trust and closed-loop communication as the underpinning conditions required for effective teams.

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“…However, research on teamwork has also shown that teams do not like explicit coordination; they prefer to coordinate implicitly 41. Whereas teams of novices may have no choice other than to coordinate explicitly, team of experts may be at higher risk for developing team phenomena such as illusionary transactive memory23 or avoidance of overt discussions about teamwork 42. Although this result needs to be validated in further studies, ideally incorporating performance outcomes, it highlights the importance of teamwork training in healthcare emphasising direct communication and leadership,43 44 particularly for expert teams.…”

Section: Discussionmentioning

confidence: 99%

Differences in talking-to-the-room behaviour between novice and expert teams during simulated paediatric resuscitation: a quasi-experimental study

2018

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BackgroundTeam coordination represents an important factor for clinical performance. Research in this area suggests that not only behaviour frequencies but also patterns of team coordination constitute a central aspect of teamwork. However, little is known about potential differences in coordination patterns between novice teams (ie, teams of inexperienced members) and expert teams (ie, teams of experienced members). The current study addresses this gap by investigating the use of talking-to-the-room—an important implicit coordination behaviour—in novice teams versus expert teams.AimTo illustrate differences in coordination behaviour between novice and expert teams. This will provide important knowledge for simulation-based training.MethodsThe study was conducted in the context of two resuscitation training courses (introductory course and refresher course) for staff members at a children’s hospital. Volunteers from both courses participated in the study. They were randomly assigned to 16 teams each consisting of one physician and two nurses. The study used a quasi-experimental design with two conditions (novice vs expert). Participants of the introductory course were assigned to the novice condition (eight teams), and participants of the refresher course were assigned to the expert condition (eight teams). All teams completed the same standardised paediatric resuscitation scenario. They were videotaped during the simulation, and team coordination behaviour was coded using Co-ACT.ResultsLag-sequential analysis of 1902 distinct coordination acts revealed that novice teams and expert teams differed significantly in their coordination behaviour. Expert teams were characterised by patterns in which implicit coordination behaviour (ie, talking to the room) was followed by further implicit coordination behaviour and not followed by explicit coordination behaviour (ie, instructions), whereas the reverse was found for novice teams.ConclusionThe current study highlights role of coordination patterns for understanding teamwork in healthcare and provides important insights for team training.

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Explicit Reasoning, Confirmation Bias, and Illusory Transactive Memory

Cited by 119 publications

References 66 publications

Teamwork and Leadership in Cardiopulmonary Resuscitation

Teamwork and Leadership in Cardiopulmonary Resuscitation

Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare

Differences in talking-to-the-room behaviour between novice and expert teams during simulated paediatric resuscitation: a quasi-experimental study

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