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An analysis of trauma team communication using the verbal response mode taxonomy
Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology. Region Östergötland, Local Health Care Services in East Östergötland, Department of Acute Health Care in Norrköping.
Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
Linköping University, Department of Computer and Information Science, Human-Centered systems. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
2021 (English)In: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 170, no 6, p. 1849-1854Article in journal (Refereed) Published
Abstract [en]

Background: Although 40 years has passed since the Institute of Medicine released its report "To Err Is Human," error counts are still high in healthcare. The understanding and training of nontechnical skills and teamwork thus remains a pertinent area for improvement. Most evaluation of nontechnical skills of trauma teams takes place in simulation rooms. The aim of this study was to determine if real trauma resuscitation communication could be analyzed using the speech classification system of verbal response modes, otherwise known as the verbal response mode taxonomy and, if so, if there is a predominant approach of verbally delivering messages. Methods: Video and audio recordings of 5 trauma team resuscitations were transcribed. Communication was coded using the verbal response mode taxonomy for both form and intent. The rate of mixed-mode communication (unmatched form and intent) and pure-mode communication were calculated and compared between the participants roles. Comparisons were made with simulated material published in other research. Results: The most frequent mixed-mode communication was acknowledgment in service of confirmation. Question in service of a question was the most used pure-mode communication. Six predominant roles were seen, which matched well with the roles in the simulations. Conclusion: The verbal response mode taxonomy can be used to study communication during real trauma resuscitation, and it was found that pure-mode communication was predominant, meaning that the grammatical form matches the intent. Verbal response mode methodology is time consuming and requires analysts with domain knowledge. Comparisons show some differences between simulations and our material indicating that verbal response modes can be used to evaluate differences in communication. (C) 2021 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER , 2021. Vol. 170, no 6, p. 1849-1854
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-183214DOI: 10.1016/j.surg.2021.05.043ISI: 000756142800043PubMedID: 34217502OAI: oai:DiVA.org:liu-183214DiVA, id: diva2:1641066
Note

Funding Agencies|Region Ostergotland [LIO-627951, SC-2016-00261-02, 551-53173]

Available from: 2022-02-28 Created: 2022-02-28 Last updated: 2024-04-02
In thesis
1. How we talk: aspects of communication and team cognition of trauma resuscitation teams
Open this publication in new window or tab >>How we talk: aspects of communication and team cognition of trauma resuscitation teams
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A trauma team consists of professionals assembling in an ad hoc manner to resuscitate a patient with life-threatening injuries. In such a team, how the team manages to use non-technical skills, such as communication is important to achieve task management and decision making.  Communication is practised in simulations, and the simulation environment has also been used in research to understand teamwork processes. This thesis is based on video observations of trauma teams working in real life (IRL) and in situ simulations of trauma resuscitations. The aim was to assess the creation of team cognition IRL and in simulation, to analyse verbal communication in the teams and the effects of real-time communication on team structure. In Study I, a grounded theory analysis was undertaken to understand how verbal and non-verbal interactions create team cognition. The analysis resulted in a theory pointing to “split vision” as a team’s ability to alter process modes between team positioning and sensitivity to the patient that was dependent on patient and situational values absorbed from team members’ implicit actions. In Study II, the verbal response modes taxonomy was applied to analyse both the grammatical and pragmatic meaning of verbal interactions that were compared between team roles. In the six most communicative team roles in the context of IRL trauma teamwork, pure mode communication dominated the way of delivering messages. In Study III, the structures of four IRL and four simulated trauma teams were analysed using a social network analysis of real-time communication. Overall, the teams were highly centralised, with the examining physician functioning as an information hub. In Study IV, communication from the same teams was categorised according to information and task management, as well as different coordination behaviours. We compared the IRL and simulation domains based on the proportions of utterances of each category/code, and found that “Give information after request” and closed-loop communication were more prevalent in simulation. Observing real-time communications using different methodologies gave a perspective on the conditions and possibilities for adaptation in terms of work prescriptions and team training, such as room for more communication and possible congestions of nodes in terms of occupancy and tacit communications and working modes thus far unnoticed by us and unreported. Such understanding complements established knowledge about coordination behaviours and interactive team cognition and should be taken into consideration in the practise and training of trauma teams.  

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2024. p. 175
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1899
National Category
Communication Studies
Identifiers
urn:nbn:se:liu:diva-201986 (URN)10.3384/9789180755382 (DOI)9789180755375 (ISBN)9789180755382 (ISBN)
Public defence
2024-05-03, Fornborgen, Vingården, Campus Norrköping, Norrköping, 09:00 (Swedish)
Opponent
Supervisors
Note

2024-04-02: The thesis was first published online. The online published version reflects the printed version. 

2024-05-14: The thesis was updated with an errata list which is also downloadable from the DOI landing page. Before this date the PDF has been downloaded 164 times.

Available from: 2024-04-02 Created: 2024-04-02 Last updated: 2024-12-10Bibliographically approved

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Molin, IdaFornander, LiselottBerggren, Peter
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Department of Biomedical and Clinical SciencesFaculty of Medicine and Health SciencesCenter for Disaster Medicine and TraumatologyDepartment of Acute Health Care in NorrköpingDepartment of Anaesthesiology and Intensive Care in NorrköpingHuman-Centered systemsFaculty of Arts and Sciences
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