Near Misses in Financial Trading: Skills for Capturing and Averting Error

Measuring Failures Proneness: Scale Development and Preliminary Validations

Behavioral failures can serve as precursors for accidents. Yet, individual differences in the predisposition to behavioral failures have predominantly been investigated within relatively narrow parameters, with the focus limited to subsets of behaviors or specific domains. A broader perspective might prove useful in illuminating correlations between various forms of accidents. The current research was undertaken as one step toward developing the concept of behavioral failures proneness in its multidimensional aspect. We report the initial stage of the development and validation of the Failures Proneness questionnaire (FP): a brief, multifaceted, self-report scale of common behavioral failures in everyday settings. In a preliminary phase we conceived an extensive pool of prospective items. Study 1 identified and validated the factor-structure of FP and reduced the scale to a brief measure of 16 items. Study 2 corroborated the factor structure of the FP and evaluated its construct validity by assessing its relationship with the Five Factor Model (FFM) of personality traits. Study 3 tested the criterion-related validity of the FP by assessing its ability to predict deviant behaviors. These studies provide evidence of the FP's performance in generating valuable information on a broad range of behavioral antecedents of accidents.

Comparison of nontechnical skills grading rubrics for OR in situ simulation for general surgery and Obstetrician/Gynecologist residents

BACKGROUND

This study utilized the Team Strategies and Tools to Enhance Performance and Patient Safety and the Nontechnical Skills for Surgeons grading systems to evaluate the nontechnical skills of general surgery and obstetrician/gynecologist residents to see if these grading systems were concordant. These simulations were also intended to teach about crisis resources available at our institution.

METHODS

Nineteen teams were created consisting of either one general surgery resident or 2 Obstetrician/Gynecologist residents plus 2 Anesthesia residents and 2 to 4 nurses. Each team was given a short briefing on Team Strategies and Tools to Enhance Performance and Patient Safety, then performed 2 simulated operating room crises. All exercises were graded by 2 independent observers with experience in the operating room and in using the Team Strategies and Tools to Enhance Performance and Patient Safety and Nontechnical Skills for Surgeons grading systems.

RESULTS

Averaged general surgery Team Strategies and Tools To Enhance Performance and Patient Safety score increased between scenarios (14.3-17; P ≤ .01), as did obstetrician/gynecologist Team Strategies and Tools to Enhance Performance and Patient Safety score (14.9-19.2; P ≤ .01). Averaged general surgery Nontechnical Skills for Surgeons score increased between scenarios (10.3-12.2; P ≤ .02), as did obstetrician/gynecologist Nontechnical Skills for Surgeons score (10.2-14.3; P ≤ .01). Surgery Team Strategies and Tools to Enhance Performance and Patient Safety scores demonstrated a strong correlation of movement with Nontechnical Skills for Surgeons scores (r = 0.83), as did obstetrician/gynecologist (r = 0.91). On average both general surgery (11%-100%; P ≤ .01) and obstetrician/gynecologist (50%-90%; P ≤ .01) saw a statistically significant increase in their awareness of the crisis checklist.

CONCLUSION

Team Strategies and Tools to Enhance and Patient Safety scores and Nontechnical Skills for Surgeons are effective and concordant tools for gauging general surgery and obstetrician/gynecologist resident nontechnical skills. In situ simulations are an effective way to teach general surgery and obstetrician/gynecologist residents about available crisis resources.

Can Teamwork Promote Safety in Organizations?

In this review, we conceptualize teamwork as the linchpin driving safety performance throughout an organization. Safety is promoted by teams through various mechanisms that interact in a complex and dynamic process. We press pause on this dynamic process to organize a discussion highlighting the critical role played by teamwork factors in the engagement of safe and unsafe behavior, identifying five team-level emergent states that enable effective teamwork and safety: psychological safety, team trust, collective efficacy, shared mental models, and situation awareness. Additionally, we consider foundational conditions that support team-driven safety, the development of safety culture, and the importance of team safety climate in shaping performance. We discuss leveraging teams to generate safety and identify directions for future research investigating the relationship between teamwork and safety. Overall, we submit that researchers and practitioners would benefit from taking a systems perspective of safety by integrating principles of team science to better understand and promote safety in organizations.