Team talk and team activity in simulated medical emergencies: a discourse analytical approach

Abstract

BackgroundCommunication errors can reduce patient safety, especially in emergency situations that require rapid responses by experts in a number of medical specialties. Talking to each other is crucial for utilizing the collective expertise of the team. Here we explored the functions of “team talk” (talking between team members) with an emphasis on the talk-work relationship in interdisciplinary emergency teams.MethodsFive interdisciplinary medical emergency teams were observed and videotaped during in situ simulations at an emergency department at a university hospital in Norway. Team talk and simultaneous actions were transcribed and analysed. We used qualitative discourse analysis to perform structural mapping of the team talk and to analyse the function of online commentaries (real-time observations and assessments of observations based on relevant cues in the clinical situation).ResultsStructural mapping revealed recurring and diverse patterns. Team expansion stood out as a critical phase in the teamwork. Online commentaries that occurred during the critical phase served several functions and demonstrated the inextricable interconnections between team talk and actions.DiscussionDiscourse analysis allowed us to capture the dynamics and complexity of team talk during a simulated emergency situation. Even though the team talk did not follow a predefined structure, the team members managed to manoeuvre safely within the complex situation. Our results support that online commentaries contributes to shared team situation awareness.ConclusionsDiscourse analysis reveals naturally occurring communication strategies that trigger actions relevant for safe practice and thus provides supplemental insights into what comprises “good” team communication in medical emergencies.

Is in situ simulation in emergency medicine safe? A scoping review

“…LST evaluation 24 (25) Chan et al 31 Hamman et al 59 Hamman et al 60 Hunt et al 44 Kerner et al 62 Kobayashi et al 52 Kobayashi et al 63 O'Leary et al 64 Patterson et al 10 Shrestha et al 34 Theilen et al 41 Ullman et al 67 Walsh et al 68 Whitfill et al 69 Zimmermann et al 70 Bradley et al 71 Couto et al 36 Geis et al 72 Lakissian et al 73 Shah et al 37 Wong et al 74 Petrosoniak et al 75 Aljahany et al 76 Zern et al 77 Shrestha et al 78 Gray et al 42 Others (survey, qualitative analysis) Bischof et al 80 Burke et al 81 Couto et al 13 Davison et al 82 Gangadharan et al 83 Gundrosen et al 84 Hunt et al 44 Mannenbach et al 85 Meurling et al 86 O'Leary et al 87 Shrestha et al 34 Sørensen et al 88 Ullman et al 67 Katznelson et al 89 KP 2: knowledge and skills 10 Walsh et al 68 Bradley et al 71 Thomas et al 90 Lemke et al 91 Kalidindi et al…”

Pre-Hospital Intervention in a Case of Airway Obstruction in a Child: Communication and Clinical Decision-Making in a Challenging Social Context

“…Nevertheless, communication failures occur frequently in the pre-hospital setting and can delay diagnosis and decision-making in emergency situations [5]. This can lead to severe clinical complications or even death [6]. Effective communication is still a challenge for many health professionals, and one of the important gaps in the training of the health professionals [7].…”

Team talk and team decision processes: a qualitative discourse analytical approach to 10 real-life medical emergency team encounters

“…We followed a standard procedure previously described. 36 37 Briefly, all 10 videotapes were first viewed repeatedly before making detailed depersonalised transcriptions marking parallel talk, pauses and non-verbal activities. All authors reviewed the transcripts, and the first and the second author performed the analyses together.…”

“… 35 Previous reports have also uncovered specific modes of talk constructing and supporting coordination in emergency team activity during standardised scenario in situ simulation training. 36 37 …”