The impact of team characteristics and context on team communication: An integrative literature review

Resilient performance in building maintenance: A macro-cognition perspective during sudden breakdowns

Building maintenance encompasses multiple tightly inter-connected agents (e.g., technicians, occupants, supervisors, and equipment). Variable working conditions and limited resources may affect the safety and sustainability of the activities. Although recent studies have explored how complex systems can perform resilient behavior in facing the complexity of everyday activities, the factors that effectively contribute to resilient performance are still paired with limited empirical evidence. We studied the performance of the maintenance team during sudden breakdowns of air-conditioning devices in a large university campus, using the Functional Resonance Analysis Method (FRAM). A FRAM diagram containing 30 functions was organized including six macro-cognitive functions (expertise, sensemaking, communication, coordination, collaboration, and adaptation/improvisation), examining their role in anticipating, and responding to emergencies, and eight functional units that are directly impacted by disturbances were analyzed in more detail. Results indicate that macro-cognitive functions can greatly impact the functionality of the maintenance team in pursuit of their goals. Moreover, we noted those macro-cognitive functions here analyzed depend on each other to produce resilient performance.

Exploring the Effect of Head-Worn Displays on Prehospital Teamwork Using Online Simulation: A Crossover Randomized Controlled Trial

INTRODUCTION

Prehospital teamwork occurs in dynamic environments where paramedics work together using technologies to care for patients. Despite increasing interest in using head-worn displays (HWDs) to support prehospital workers, little is known about how HWDs affect teamwork.

METHODS

We tested the effect of HWDs on the team processes and patient care of paramedic trainee teams in a laboratory study using an online prehospital simulation environment, SPECTRa. In a randomized crossover design, 20 two-person teams worked in the SPECTRa laptop environment from separate physical rooms to assess and treat 2 simulated patients in 3 prehospital patient care scenarios. In each scenario, each trainee used either an HWD, a tablet computer (TAB), or no mobile device (CON) to help them monitor the vital signs of both patients. We measured team processes based around 3 themes of mutual understanding, team performance, and administered an 18-item questionnaire about teamwork and use of the devices.

RESULTS

The mean number (HWD = 11; TAB = 7; P = 0.061) and duration (HWD = 1746 milliseconds; TAB = 1563 milliseconds; P = 0.504) of attention switches that teams made toward the mobile device did not differ with HWDs or TABs. However, teams switched attention between patients less with HWDs than with TABs (P = 0.026) or CON (P = 0.007) (medians: HWD = 5; TAB = 8; CON = 8). Teams communicated less when using HWDs than TABs (P = 0.017) (medians: HWD = 76; TAB = 96; CON = 83), but there were other mixed effects on communication. Team performance did not differ across device conditions on the timeliness to notice critical patient changes (P = 0.387) (medians: HWD = 244 seconds; TAB = 246 seconds; CON = 168 seconds) or to complete the scenarios (P = 0.212) (medians: HWD = 800 seconds; TAB = 913 seconds; CON = 835 seconds). Questionnaire results revealed some perceived benefits of the HWD.

CONCLUSIONS

Head-worn displays may let prehospital teams monitor each other's performance more efficiently than TABs or CON, requiring less communication to maintain patient care performance with lower workload than with TABs. However, improvements in mutual understanding with HWDs compared with CON were more evident in teams' preferences than in actual behavior. Further research is needed to confirm and extend these results.

Team Coordination Style Is an Adaptive, Emergent Property of Interactions Between Critical Care Air Transport Team Personnel

OBJECTIVE

Critical Care Air Transport (CCAT) teams care for critically ill or injured patients during long-duration flights. Despite the differences between the CCAT domain and a more traditional clinical setting, CCAT clinicians are not explicitly trained how to coordinate care in the aircraft environment. We characterized the team coordination patterns adopted by CCAT teams and explored any links between team coordination style and performance.

METHODS

This retrospective study used transcripts from 91 CCAT teams as they completed simulated patient care scenarios during an advanced training course. Qualitative and quantitative measures were used to characterize team behavior.

RESULTS

Vocalized content varied by team role, with physicians acting as leaders. The type of content verbalized by each team role depended on the team coordination style. The team coordination style and the content of vocalized messages were not affected by prior team member deployment or the characteristics of particular scenarios, and the team coordination style did not predict measures related to patient status.

CONCLUSION

Individual team member coordination behaviors vary depending on the coordination style used by the team as a whole. Coordination style appears to arise from the interactions among individual team members rather than in response to situational factors external to the team.

Influencing factors of novice pilot SA based on DEMATEL-AISM method: From pilots' view

Pilot situation awareness (SA) regulates flight safety, and inexperience may impair novice pilot reliability in SA. This study aims to determine the key influencing factors of novice pilot SA and to analyze the interrelationship and interaction mechanism of the factors. We investigated 55 novice pilots trained at aviation schools and identified the influencing factor index system by the Delphi survey. The method of Decision Making Trial and Evaluation (DEMATEL) combined with Adversarial Interpretive Structure Modeling (AISM) was adopted. The results show that: (1) The influencing factor index system includes 18 factors, divided into four categories: individual factors, team factors, task and human-machine system factors, and cockpit environment factors. (2) Team communication, team cooperation, basic cognitive ability, interface design, occupational age and experience, and authority gradient are the six crucial influencing factors. The former three have the greatest association with other factors, while the latter three are most likely to affect other factors. (3) Team communication, basic cognitive ability, and interface design are root-cause factors, of which team communication is the most fundamental. (4) The results of DEMATEL and AISM are consistent, both disclosing team communication as the fundamental factor with the highest priority, and cockpit environmental factors as the direct influencing factors but most susceptible to other factors. The present study can be viewed as a conducive attempt to extract vital influencing factors of novice pilot SA, and to provide ergonomic insights for determining the priorities to improve novice pilot SA in training and aircraft design for flight safety.

A review of the effects of head-worn displays on teamwork for emergency response

Head-Worn Displays (HWD) can potentially support the mobile work of emergency responders, but it remains unclear whether teamwork is affected when emergency responders use HWDs. We reviewed studies that examined HWDs in emergency response contexts to evaluate the impact of HWDs on team performance and on team processes of situation awareness, communication, and coordination. Sixteen studies were identified through manual and systematic literature searches. HWDs appeared to improve the quality of team performance but they increased time to perform under some conditions; effects on team processes were mixed. We identify five challenges to explain the mixed results. We discuss four theoretical perspectives that might address the challenges and guide research needs-joint cognitive systems, distributed cognition, common ground, and dynamical systems. Researchers and designers should use process-based measures and apply greater theoretical guidance to uncover mechanisms by which HWDs shape team processes, and to understand the impact on team performance. Practitioner Summary: This review examines the effects of head-worn displays on teamwork performance and team processes for emergency response. Results are mixed, but study diversity challenges the search for underlying mechanisms. Guidance from perspectives such as joint cognitive systems, distributed cognition, common ground, and dynamical systems may advance knowledge in the area. Abbreviations: HWD: head-worn display; RC: remote collaboration; DD: data display; ARC: augmented remote collaboration; ACC: augmented collocated collaboration; SA: situation awareness; TSA: team situation awareness; CPR: cardiopulmonary resuscitation; SAGAT: situation awareness global assessment technique; SART: situation awareness rating technique.

Improved team communication in endoscopic procedures by digital enhanced telecommunication during the COVID-19 pandemic

Background and study aims  Unbiased communication is crucial for excellent teamwork in high-quality endoscopy. Personal protective equipment (PPE) (FFP-masks and face-shields) worn by endoscopists that are ubiquitous in the current COVID-19 pandemic strikingly impair communication. Digital enhancement approaches to maintain team communication, especially during complex endoscopic procedures, are urgently warranted. Materials and methods  A prospective, two-armed interventional study was performed at an endoscopy unit at a tertiary center in Germany. Two hundred and three endoscopic procedures with PPE se according to pandemic risk level were randomly assigned (1:1) to a group performed by an endoscopy team equipped with digital enhanced cordless telecommunication (DECT) or one without digital-enhanced communication. The primary outcome was the team-reported number of communication-associated events (CAEs) defined as misunderstandings that impaired workflow during endoscopic examination. Secondary outcomes included perceived voice and headphone quality and overall comfort with DECT during endoscopic work. Results  The use of DECT was associated with a significant reduction in communication-associated events in endoscopic procedures and overall, was perceived positively. Conclusions  Digital enhancement of communication is a promising and easy-to- establish tool for improving team communication quality in endoscopy.

Surveying work-as-done in post-operative delirium risk factors collection and diagnosis monitoring

Post-operative delirium (POD) is a health hazard condition for the patients and it is associated with increased costs for the healthcare system. Following a system-theoretic approach, firstly a model, then a questionnaire, have been designed to probe the collective awareness about POD throughout the entire patient's perioperative pathway. The 58 reported answers pointed out that most of the information, specifically associated with POD, are routinely recorded but not used to stratify the patients' individual risk to develop POD. The results suggest the need for design a new socio-technical role within modern health care systems: the POD analyst. A Systems-Theoretic Accident Model and Processes (STAMP) model is proposed both to propel the awareness about POD and as a template for future POD risk factors collections.

Time to go wild: How to conceptualize and measure process dynamics in real teams with high-resolution

Team processes are interdependent activities among team members that transform inputs into outputs, vary over time, and are critical for team effectiveness. Understanding the temporal dynamics of team processes and related team phenomena with a high-resolution lens (i.e., methods with high sampling rates) is particularly challenging when going “into the wild” (i.e., studying teams operating in their full situated context). We review quantitative field studies using high-resolution methods (e.g., video, chat/text data, archival, wearables) and map out the various temporal lenses for studying team dynamics. We synthesize these different lenses and present an integrated temporal framework that is of help in theorizing about team dynamics. We also provide readers with a “how to” guide that summarizes four essential steps along with analytical methods (e.g., sequential and pattern analyses, mixed-methods research, abductive reasoning) that are applicable to the broad scope of high-resolution methods.

Impacts of Wearable Augmented Reality Displays on operator performance, Situation Awareness, and communication in safety-critical systems

Wearable Augmented Reality Displays (WARDs) present situated, real-time information visually, providing immediate access to information to support decision making. The impacts of WARD use on operator performance, Situation Awareness (SA), and communication in one safety-critical system, marine transportation, were examined in a real-time physical simulator. WARD use improved operator trackkeeping performance, the practice of good seamanship, and SA, although operator responsiveness decreased. WARD users who used more closed-loop communication and information sharing showed improved threat avoidance, suggesting that operators can avoid accidents and failure through WARD use that promotes sharing and confirming information. WARD use also promoted information source diversity, a means of developing requisite variety. These operational impacts are important in safety-critical settings where failures can be catastrophic.