Team talk and team activity in simulated medical emergencies: a discourse analytical approach.
Team talk and team activity in simulated medical emergencies: a discourse analytical approach.
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DOI：
10.1186/s13049-016-0325-1
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发表时间：
2016-11-14
期刊：
影响因子：
--
通讯作者：
Thomassen G
中科院分区：
文献类型：
--
作者：
Gundrosen S;Andenæs E;Aadahl P;Thomassen G
沟通错误可能会降低患者的安全，特别是在需要多个医学专业专家快速反应的紧急情况下。相互交谈对于利用团队的集体专业知识至关重要。在这里，我们探讨了“团队对话”(团队成员之间的对话)的功能，重点是跨学科应急团队中的对话与工作关系。在挪威一所大学医院的急诊科进行了现场模拟，观察了五支跨学科的医疗急救队，并对其进行了录像。团队谈话和同步行动被转录和分析。我们使用定性话语分析对团队谈话进行结构映射，并分析在线评论的功能(实时观察和基于临床情况相关线索的观察评估)。结构图显示了反复出现的和不同的模式。团队扩展是团队合作中的一个关键阶段。在关键阶段出现的在线评论起到了几个作用，并证明了团队谈话和行动之间密不可分的相互联系。话语分析使我们能够在模拟的紧急情况下捕捉团队谈话的动态和复杂性。尽管团队谈话没有遵循预定义的结构，但团队成员设法在复杂的情况下安全地进行了演习。我们的结果支持在线评论有助于分享团队情况。话语分析揭示了自然发生的沟通策略，这些策略触发了与安全实践相关的行动，从而提供了对医疗紧急情况下什么是“良好的”团队沟通的补充见解。
Communication 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. Five 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). Structural 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. Discourse 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. Discourse 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.
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