"Achieving Ensemble": Communication in Orthopaedic Surgical Teams and the Development of Situation Awareness--An Observational Study Using Live Videotaped Examples

Autor/inn/en	Bleakley, Alan; Allard, Jon; Hobbs, Adrian
Titel	"Achieving Ensemble": Communication in Orthopaedic Surgical Teams and the Development of Situation Awareness--An Observational Study Using Live Videotaped Examples
Quelle	In: Advances in Health Sciences Education, 18 (2013) 1, S.33-56 (24 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-012-9351-6
Schlagwörter	Surgery; Group Dynamics; Interpersonal Communication; Communication Skills; Verbal Communication; Classification; Video Technology; Dialogs (Language); Vertical Organization; Power Structure; Safety + Suchen Sie Ihr Suchwort? Chirurgie; Gruppendynamik; Interpersonale Kommunikation; Kommunikationsstil; Classification system; Klassifikation; Klassifikationssystem; Dialog; Dialogs; Dialogue; Dialogues; Sicherheit
Abstract	Focused dialogue, as good communication between practitioners, offers a condition of possibility for development of high levels of situation awareness in surgical teams. This has been termed "achieving ensemble". Situation awareness grasps what is happening in time and space with regard to one's own unfolding work in relation to that of colleagues, and is necessary to maintain patient safety throughout a surgical list. We refined a typology, initially developed for use in studying the dynamics of teams in aviation safety, of 10 kinds of communication within two broad areas: "Reports", or authoritative acts of communication setting up a monological or authoritative climate; and "Requests", or facilitative acts of communication setting up a dialogical or participatory climate. We systematically mapped how orthopaedic surgical teams use verbal communication through analysis of videotaped operations using the typology. We asked: "do orthopaedic surgical teams set up the conditions of possibility for the emergence of situation awareness through effective communication?" We found that orthopaedic surgical teams tend to produce monological rather than dialogical climates. Dialogue increases with more complex cases, but in routine work, communication levels are depressed and one-way, influenced by surgeons working within a traditionally hierarchical and authoritative culture. We suggest that such a monological climate inhibits development of situation awareness and then compromises patient safety. The same teams, however, generate potentially rich educational climates through exchange of profession-specific knowledge and skills, and we suggest that where technical skill exchange is good, non-technical or interpersonal communication skill levels can follow. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10