TAILIEUCHUNG - Safer Surgery Edited by Rhona Flin and Lucy Mitchell Analysing Behaviour in the Operating Theatre - Part 2 (end)

Since the primitive beginnings of operative surgery, surgeons have had a need to work with assistance, even if it was, in those early times, merely for the purposes of physical restraint. As surgical and anaesthetic practice became more sophisticated, so were the tasks becoming more complex and the demand on the surgical team ever increasing. It is only recently, however, with surgery becoming an ever more complex and technology-based clinical science that the dynamic and interaction between all members of the surgical team has become more important and seen as an element that contributes to a successful outcome or not as the case may be. As the severity. | Chapter 14 Identifying Characteristics of Effective Teamwork in Complex Medical Work Environments Adaptive Crew Coordination in Anaesthesia Tanja Manser Steven K. Howard and David M. Gaba Introduction The aim of psychological research on the relationship between human performance and patient safety is to support healthcare professionals and their organizations to provide patient care more safely in a wider variety of clinical situations with greater efficiency and with increased satisfaction to both patients and practitioners. Such recommendations require an improved understanding of the performance of clinicians in terms of the strengths and vulnerabilities pertaining to their work environment. Although performance is an intuitively meaningful concept research on human performance in complex work environments usually has to integrate the complementary pieces of information provided by different research approaches none of which by itself captures the entire picture Gaba et al. 1998 Rall and Gaba 2004 Salvendy 2006 . Sources of information include retrospective analyses of incident reports . reconstructive approach to human performance prospective observation of routine patient care . naturalistic approach to human performance prospective observation of the response to simulated events . quasi-experimental approach to human performance and objective data from artificial laboratory tasks . experimental approach to human performance . Both work organizational psychology and applied cognitive psychology have successfully developed methodological approaches to address human performance issues in complex work environments. The methodological spectrum ranges from ethnographic field studies to experimental studies in laboratory settings and from qualitative interviews to survey instruments Bungard and Herrmann 1993 Salvendy 2006 . However methods need to be adapted to the specifics of the complex medical work environment. For example systems to evaluate the .

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