The Nature of Transactive Memory Systems in Emergency Medicine Teams Based on Observations and Communication Analysis

Abstract

Transactive Memory Systems (TMS) is one of the theoretical constructs used to account for how team members in high stress, high pressure emergency department (ED) distribute their cognitive and work load for more effective team performance. This study investigated the nature of TMS in ED teams by observing resuscitation team simulations and analyzing behaviours and communications reflecting this construct. The credibility of team members was pre-established based on the team members' titles. There was an overwhelming propagation and distribution of unsolicited information between members which indicated the efficiency of TMS in these educational settings. However, it also raised some concerns. This study has implications for training and the design of programs, tools, and electronic interfaces to help improve the efficiency of TMS and ultimately ensure the care and safety of patients. Acknowledgement I would like to thank Dr. Avi Parush, my supervisor, for his invaluable guidance and support, especially in the past few months. I would also like to thank my family, particularly, my husband for his support and amazing programming skills, my sister for helping me with going through rows and rows of data, and my son for his encouragement and support. Furthermore, I would like to thank Dr. Lisa Calder and Dr. George Mastoras for their inputs and suggestions, and acknowledge the generous financial support of the Academic Health Science Centre Alternate Fund Plan (AHSC AFP) Innovation Fund from The Ottawa Hospital. I would also like to thank all the emergency department healthcare workers and professionals who participated in the interviews or consented to having their resuscitation simulations to be viewed and transcribed for this study. Finally, I would like to thank my committee members, Dr. Mantler, Dr. MacLeod, and a special thank to Dr. Logan for providing invaluable input for my thesis. TRANSACTIVE MEMORY SYSTEMS IN EMERGENCY MEDICINE iii TABLE OF CONTENTS

Modelling the “transactive memory system” in multimodal multiparty interactions

“…Yoo and Kanawattanachai [82] and Rahimpour [70] noted that the amount of communication plays a crucial role in establishing TMS and, after that, its role gradually becomes less relevant. For example, to build a TMS, Yoo & Kanawat-tanachai asked teams to communicate remotely to manage a company's finances and thus to share different areas of expertise (marketing, finance, production, operations and human resources).…”