Flexible knowledge repertoires: communication by leaders in trauma teams

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Christine Brulin²  Magnus Hultin¹  Maria Hargestam²  Maritha Jacobsson³ 

[1] Department of Surgical and Perioperative Sciences, Umeå University, Umeå S-90187, Sweden;Department of Nursing, Umeå University, Umeå S-90187, Sweden;Department of Social Work, Umeå University, Umeå S-90187, Sweden

关键词: Discourse psychology;    Simulation;    Teamwork;    Communication;    Leadership;   

Others  :  826495
DOI  :  10.1186/1757-7241-20-44

 received in 2012-01-16, accepted in 2012-05-01,  发布年份 2012

【 摘 要 】

Background

In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is “closed-loop communication”, which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team.

Methods

Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader), one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED). The communication was transcribed and analyzed, inspired by discourse psychology and Strauss’ concept of “negotiated order”. The data were organized and coded in NVivo 9.

Results

The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level.

Conclusion

This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members.

【 授权许可】

   
2012 Jacobsson et al.; licensee BioMed Central Ltd.

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