De la cabina al quirófano / From the cockpit to the operating room

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Shared leadership in multiteam systems: how cockpit and cabin crews lead each other to safety.

OBJECTIVE: In this study, we aimed to examine the effect of shared leadership within and across teams in multiteam systems (MTS) on team goal attainment and MTS success. BACKGROUND: Due to different and sometimes competing goals in MTS, leadership is required within and across teams. Shared leadership, the effectiveness of which has been proven in single teams, may be an effective strategy to cope with these challenges. METHOD: We observed leadership in 84 cockpit and cabin crews that collaborated in the form of six-member MTS aircrews (N = 504) during standardized simulations of an in-flight emergency. Leadership was coded by three trained observers using a structured observation system. Team goal attainment was assessed by two subject matter experts using a checklist-based rating tool. MTS goal attainment was measured objectively on the basis of the outcome of the simulated flights. RESULTS: In successful MTS aircrews, formal leaders and team members displayed significantly more leadership behaviors, shared leadership by pursers and flight attendants predicted team goal attainment, and pursers' shared leadership across team boundaries predicted cross-team goal attainment. In cockpit crews, leadership was not shared and captains' vertical leadership predicted team goal attainment regardless of MTS success. CONCLUSION: The results indicate that in general, shared leadership positively relates to team goal attainment and MTS success,whereby boundary spanners' dual leadership role is key. APPLICATION: Leadership training in MTS should address shared rather than merely vertical forms of leadership, and component teams in MTS should be trained together with emphasis on boundary spanners' dual leadership role. Furthermore, team members should be empowered to engage in leadership processes when required.

Forensic medical examination of the corpse of General Wladyslaw Sikorski, a putative victim of assassination in 1943.

The Krakow Department of Forensic Medicine was granted a unique opportunity to examine the body of a historical figure, i.e. General Wladyslaw Sikorski, the Prime Minister of the Polish government in exile, deceased in 1943. General Sikorski died in the crash of a Liberator aircraft at Gibraltar, and the British commission investigating the crash decided it had been an accident. In the past several decades, doubts have been repeatedly expressed as to the circumstances of the General's death and the theory of assassination has become very popular. On November 25, 2008, the General's corpse buried in the cathedral of the Royal Castle on Wawel Hill in Krakow was exhumed and the body was thoroughly examined. The examinations demonstrated numerous fractures of the cranium, spine and extremities, the character of which corresponded to effects of an air crash. Based on corpse examination alone it was impossible to establish whether the air crash had been an effect of sabotage or an ill-fated accident. Although no typical evidence of intravitality was found, such as bruises or fat embolisms, yet the character of some fractures suggested that they had been incurred intravitally. These were represented by a spiral fracture of the femoral bone shaft, a fracture of the sustentaculum tali of the calcaneal bone and fractures of the transverse processes of the lumbar vertebrae.

The hunt for 1LT Kenneth R. Shoemaker Jr., CRNA.

Little was known about 1LT Kenneth R. Shoemaker Jr, 1 of 2 nurse anesthetists killed during the Vietnam War, outside of his family and friends. This column examines the life, death, and legacy of Shoemaker as seen through the eyes of his family, former classmates, and fellow nurse anesthetists who served in Vietnam.

Joseph Beuys: trauma and catharsis.

Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the 'Tartar Legend' or 'Tartar Myth'. Profoundly affected by the crash, the severe trauma, the near-death experience and his rescue, which he perceived as a "rebirth", Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards "the healing of the world" to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself.

Reported in-flight incapacitation: the early birds of 1911.

Numerous fatal accidents marred the early years of aviation, but not until 1911 was the first accident attributed to inflight incapacitation of the pilot. Two such accidents occurred in 1911 and were reported due to medical causes. Our review of the circumstances surrounding these two accidents lead to different conclusions. We believe them to have been caused by pilot error, and not by medical causes. So the first accident due to inflight incapacitation of the aircrew for medical reasons still remains unknown.