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1.
Ergonomics ; 53(2): 211-28, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20099175

ABSTRACT

Team coordination during a simulated clean approach performed by 42 civil aviation cockpit crews was analysed. Several hypotheses regarding the adaptive use of implicit and explicit coordination, leadership and heedful interrelating were tested. The results indicate the adaptiveness of coordination to different levels of standardisation and task load and the general importance of explicit coordination for good performance. Leadership seems to be required mainly for work phases with little standardisation. In exploratory lag sequential analyses, heedful behaviour in the seven best and six worst performing crews was examined. The coordination sequences in high performance crews were found to be more succinct and well balanced, indicating that a shared sense of heedfulness is crucial for effectiveness. Theoretical implications for the conceptualisation of adaptive coordination and heedfulness and practical implications for improving crew training are discussed. Statement of Relevance: Analyses of team coordination during a simulated clean approach performed by civil aviation cockpit crews demonstrated the occurrence and effectiveness of adaptive coordination in response to different levels of task load and standardisation. Results also indicated the importance of heedful interrelating, both as a form of coordination and as a way of regulating the adaptiveness of coordination efforts. These findings have important implications for improving crew training, leadership practices and possibly also standard operating procedures.


Subject(s)
Aviation/standards , Awareness , Cooperative Behavior , Adult , Humans , Leadership , Male , Middle Aged , Safety Management/methods , Task Performance and Analysis , Videotape Recording
2.
Qual Saf Health Care ; 18(2): 127-30; 1 p following 130, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19342527

ABSTRACT

BACKGROUND: The use of different forms of coordination according to situational demands plays a crucial role in teams working in complex environments. This study aimed to describe patterns of coordinative actions (CAs) as they occur during anaesthesia induction and to analyse the influence of two crucial situational factors on these patterns, namely the amount of existing standards and the level of task load. METHODS: 23 anaesthesia inductions were videotaped, and CAs of the anaesthesia teams were coded. The coding system distinguished between implicit and explicit coordination, coordination via leadership and heedful inter-relating as the individual effort to reach smooth coordination. Five phases within anaesthesia inductions were determined according to their level of standardisation and task load. RESULTS: Overall, 67.7% of all CAs were rated as explicit CA and 32.3% as implicit CAs. When we considered the duration of those CAs, we found the reverse tendency (coordination was explicit 40% of the time and implicit 60% of the time). In highly standardised phases, we observed less explicit coordination, less leadership behaviour and less heedful interrelating compared with less standardised phases. In high-task-load phases, we observed more heedful interrelating than in low-task-load phases. CONCLUSIONS: The anaesthesia teams relied greatly on implicit coordination, which contrasts with findings indicating a performance benefit through explicit coordination in other work settings. Standardisation in the form of written departmental directives may have a supportive effect on coordination by partially substituting for other forms of coordination. The effect of high task load should be tested further in a simulator setting, where high task load can be induced in a more controlled fashion.


Subject(s)
Anesthesiology/organization & administration , Cooperative Behavior , Patient Care Team/organization & administration , Task Performance and Analysis , Anesthesia , Humans , Workload
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