Team communication in medical emergency teams under simulation

Background: Emergency medicine practitioners are faced with complex challenges in stressful situations, and coordination and communication between and among individuals and teams are critical for optimal care of the patient (Small et al, 1999). Simulation offers the possibility to train non-technical skills in a safe setting, and such training has been shown to improve early trauma care in clinical settings (Steinemann et al 2011). However, the relationship between communication in simulation and in real-life critical care settings is as yet unclear: would practitioners in simulation perform differently with an actual patient? In simulated settings, as opposed to clinical ones, observation and recording may be planned in advance, and with no risk of compromising patient anonymity. Therefore, simulation presents ample opportunities for empirical ground work needed to develop the robust analytical tools needed to investigate real-life communication. Objectives: The aims of the present study are 1) to develop analytical tools that can capture the dynamics and complexity of team communication, and 2) to provide an empirical basis for comparing communication under simulation with communication in real life situations. Research question:What are the characteristics of team communication in critical care for a simulated patient? Data and methodology: 6 training sessions on one scenario were videotaped and transcribed in detail, and the full training sessions were observed. Sessions took place at a full-scale simulation centre, and unfolded through several phases including familiarization, medical scenario, and facilitated debriefing. The video tapes are transcribed and analyzed according to principles of integrated activity analysis (Sarangi, 2000, 2010). The communication is complex and dynamic, with many participants and frequent sequences of parallel talk. While making use of discourse analytical tools from sociology and applied linguistics, focal themes are developed in close cooperation between medical and communication professionals. We seek to identify critical moments in the interaction as well as good practice. While the project is still at an early stage, in our paper we hope to present and discuss preliminary findings. References: • Sarangi, Srikant 2000: Activity types, discourse types and interactional hybridity. In Sarangi and Coulthard (eds): Discourse and Social Life. London, etc: Longman • Sarangi, Srikant 2010: Sarangi, S. (2010) Healthcare interaction as an expert communicative system: An activity analysis perspective. In J. Streeck (ed.) New Adventures in Language and Interaction. Amsterdam: Benjamins: 167‐197. • Small, Stephen D. et al 1999: High-fidelity Simulation Team Training for Emergency Medicine. Academic Emergency Medicine, 6,2: 312-323 • Steinemann, Susan et al 2011: In Situ, Multidisciplinary, Simulation-Based Teamwork Training Improves Early Trauma Care. Journal of Surgical Education 68,6: 472-477.