This talk on resus room management was given at SMACC 2013 and follows on from my ‘Own The Resus‘ talk from 2012.
The slides can be downloaded as a PDF here.
An audio only version is available here:
Here are the slides embedded (they are not designed to stand alone as an educational resource without the talk but those who were there may find them useful to review).
Here are the references.
On Leadership & Teamwork:
Directive leadership is more effective when a patient is severely injured, whereas empowering leadership is more effective when a patient is not severely injured. Also, directive leadership is better when a trauma team is inexperienced, but empowering leadership is better when a trauma team has a high level of experience.
Team leadership and coordination in trauma resuscitation,
Advances in Interdisciplinary Studies of Work Teams 2003 Vol 9:pp.189-214, Emerald Group Publishing Limited
Deviating from standard protocols – Successful VT/VF CPR Sim team completed greater number of critical tasks but deviated more from protocol than unsuccessful team, demonstrating ‘greater skill in the intervention process’. Unsuccessful team did more information-finding and confirmation whereas successful team did more non-leader provided suggestion (situational awareness better)
The Cognitive Basis of Effective Team Performance: Features of Failure and Success in Simulated Cardiac Resuscitation
AMIA Annu Symp Proc. 2009 Nov 14;2009:599-603
Shared mental models – specific indicators of shared mental models were significantly related to performance in trauma teams, over and above specific teamwork skills
Teamwork skills, shared mental models, and performance in simulated trauma teams: an independent group design.
Scand J Trauma Resusc Emerg Med. 2010 Aug 31;18:47 (Open Access)
Mental models can be task-work and team-work oriented. Taskwork mental model similarity and teamwork mental model similarity were both signiﬁcantly positively related to team processes (e.g., coordination, cooperation, and communication), which were in turn signiﬁcantly related to team performance.
Team mental models and team performance: a field study of the effects of team mental model similarity and accuracy
Journal of Organizational Behavior, 27(4), 403–418 Full Text Here
Hands-off team leaders and more effective performance. A study on real ward and ICU-based resuscitations showed less structure in teams where the leaders participated ‘hands on’, with less effective resuscitation. Advanced Life Support training did not enhance leadership performance. The team worked more effectively together where the leader ‘demonstrated the use of uniform guidelines’, ‘made sure his part was understood by team members’, and ‘decided what should be done’.
Leadership of resuscitation teams: “Lighthouse Leadership’
Resuscitation. 1999 Sep;42(1):27-45
Doctors and other healthcare professionals ‘described a good leader as one who verbally declares being the leader, communicates clear objectives, and allocates critical tasks’, which concurred with findings from simulation studies.
Teamwork for clinical emergencies: interprofessional focus group analysis and triangulation with simulation
Qual Health Res. 2012 Oct;22(10):1383-94
Medical performance depends on the quality of leadership and team-structuring
Better performing teams have hands-off leaders, better role allocation and explicit task distribution. Performanced is impaired in ad hoc formed teams compared with pre-formed teams
Human factors in resuscitation: Lessons learned from simulator studies
J Emerg Trauma Shock. 2010 Oct;3(4):389-94 Free Full Text
Voicing mental models. Providers who openly shared information by thinking aloud, performing periodic reviews of data, and voicing specific findings were found to perform better.
Leading to recovery: Group performance and coordinative activities in medical emergency driven groups
Human Performance, 19(3), 277-304
On Persuasion & Influence
Following the group: we have a tendency to go along with the ‘herd’. Check the Asch Conformity Experiment
Professor Robert Cialdini has extensively researched the influence / persuasion literature and published excellent works that make it accessible to the rest of us. Here he summarises his priniciples to Australian skeptic Lawrence Leung:
Here Prof Cialdini and Steve Martin summarise the Science Of Persuasion using illustrations. As you watch it, consider how you might be able to apply the principles in the resus room to gain compliance from the members of your team.
For further information, the Changing Minds website has excellent resources
Choosing your language
When persuading, try using presuppositions
In presupposition, we embed a foregone conclusion into a sentence so that the recipient assumes it to be true without questioning it.
The paper that showed people who watched road crash videos were more likely to remember seeing ‘the’ broken headlamp than ‘a broken headlight’ (even when it wasn’t there!)
Leading questions and the eyewitness report Cognitive Psychology 1975;7(4): 560–572 Full Text
A thoughtful and more in depth analysis of presupposition can be found here
Try employing The Power of ‘Because’
Finally…. I was asked at SMACC about my thoughts on Neurolinguistic Programming (NLP) Here are some reviews of NLP viewed through the lens of scientific and skeptical scrutiny: