Adaptive coordination and heedfulness make better cockpit crews

A Safety Approach for Improving Security - Effective Coordination Strategies at the Airport Security Screening Checkpoint

OBJECTIVE

This study aimed to analyze effective teamwork at security checkpoints by investigating how security crews communicate in different (routine and threat) situations.

BACKGROUND

Working at an airport security screening checkpoint is challenging. Although tasks and processes are highly regulated and standardized due to legal requirements, security screeners must be trained to deal with unforeseen threat situations involving high levels of uncertainty. Therefore, security crews need to engage in flexible and adaptive coordination according to the situation and circumstances.

METHOD

We conducted a field study with 20 airport security screening crews comprising 100 security screeners. Teamwork in terms of interaction between crew members was measured, differentiating between proactive "push" communication and information on request representing "pull" communication. Furthermore, non-task related communication was assessed.

RESULTS

While crews showed non-task related communication more in routine situations, both task-related "push" and "pull" communication occurred more in threat situations. In terms of team performance, we could show significant positive effects of proactive "push" communication and non-task related interaction in threat situations.

CONCLUSION

Our results underscore the specific setting of airport security screening and the challenges that arise for teamwork. This study investigates professional screeners and passengers in the field. In contrast to other high-risk areas, security crews are confronted with a third party that complicates coordination strategies considered effective in previous studies.

APPLICATION

Our findings recommend situation-specific communication strategies for practical training for airport security screening crews.

Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings

BACKGROUND

Debriefings help teams learn quickly and treat patients safely. However, many clinicians and educators report to struggle with leading debriefings. Little empirical knowledge on optimal debriefing processes is available. The aim of the study was to evaluate the potential of specific types of debriefer communication to trigger participants' reflection in debriefings.

METHODS

In this prospective observational, microanalytic interaction analysis study, we observed clinicians while they participated in healthcare team debriefings following three high-risk anaesthetic scenarios during simulation-based team training. Using the video-recorded debriefings and INTERACT coding software, we applied timed, event-based coding with DE-CODE, a coding scheme for assessing debriefing interactions. We used lag sequential analysis to explore the relationship between what debriefers and participants said. We hypothesised that combining advocacy (ie, stating an observation followed by an opinion) with an open-ended question would be associated with participants' verbalisation of a mental model as a particular form of reflection.

RESULTS

The 50 debriefings with overall 114 participants had a mean duration of 49.35 min (SD=8.89 min) and included 18 486 behavioural transitions. We detected significant behavioural linkages from debriefers' observation to debriefers' opinion (z=9.85, p<0.001), from opinion to debriefers' open-ended question (z=9.52, p<0.001) and from open-ended question to participants' mental model (z=7.41, p<0.001), supporting our hypothesis. Furthermore, participants shared mental models after debriefers paraphrased their statements and asked specific questions but not after debriefers appreciated their actions without asking any follow-up questions. Participants also triggered reflection among themselves, particularly by sharing personal anecdotes.

CONCLUSION

When debriefers pair their observations and opinions with open-ended questions, paraphrase participants' statements and ask specific questions, they help participants reflect during debriefings.

Exceeding the Ordinary: A Framework for Examining Teams Across the Extremeness Continuum and Its Impact on Future Research

Work teams increasingly face unprecedented challenges in volatile, uncertain, complex, and often ambiguous environments. In response, team researchers have begun to focus more on teams whose work revolves around mitigating risks in these dynamic environments. Some highly insightful contributions to team research and organizational studies have originated from investigating teams that face unconventional or extreme events. Despite this increased attention to extreme teams, however, a comprehensive theoretical framework is missing. We introduce such a framework that envisions team extremeness as a continuous, multidimensional variable consisting of environmental extremeness (i.e., external team context) and task extremeness (i.e., internal team context). The proposed framework allows every team to be placed on the team extremeness continuum, bridging the gap between literature on extreme and more traditional teams. Furthermore, we present six propositions addressing how team extremeness may interact with team processes, emergent states, and outcomes using core variables for team effectiveness and the well-established input–mediator–output–input model to structure our theorizing. Finally, we outline some potential directions for future research by elaborating on temporal considerations (i.e., patterns and trajectories), measurement approaches, and consideration of multilevel relationships involving team extremeness. We hope that our theoretical framework and theorizing can create a path forward, stimulating future research within the organizational team literature to further examine the impact of team extremeness on team dynamics and effectiveness.

A Strategic Core Role Perspective on Team Coordination: Benefits of Centralized Leadership for Managing Task Complexity in the Operating Room

OBJECTIVE

We examine whether surgical teams can handle changes in task requirements better when their formal leader and strategic core role holder-that is, the main surgeon-is central to team coordination.

BACKGROUND

Evidence regarding the benefits of shared leadership for managing complex tasks is divided. We tested whether a strategic core role holder's centrality in team coordination helps teams to handle different types of task complexity.

METHOD

We observed coordination as specific leadership behavior in 30 surgical teams during real-life operations. To assess the strategic core role holder's coordination centrality, we conducted social network analyses. Task complexity (i.e., surgical difficulty and unexpected events) and surgical goal attainment were rated in a questionnaire.

RESULTS

In the critical operation phase, surgical difficulty impaired goal attainment when the strategic core role holder's coordination centrality was low, while this effect was nonsignificant when his/her coordination centrality was high. Unexpected events had a negative effect on surgical goal attainment. However, coordination centrality of the strategic core role holder could not help manage unexpected events.

CONCLUSION

The results indicate that shared leadership is not beneficial when teams face surgical difficulty during the critical operation phase. In this situation, team coordination should rather be centralized around the strategic core role holder. Contrarily, when unexpected events occur, centralizing team coordination around a single leader does not seem to be beneficial for goal attainment.

APPLICATION

Leaders and team members should be aware of the importance of distributing leadership differently when it comes to managing different types of task complexity.

The four-phase team adaptation process: a first empirical investigation

Purpose

Several theoretical models have been developed to describe the process of successful team adaptation. Testing the models through empirical research is lacking. This study aims to empirically examine the way teams adapt to unexpected or novel circumstances and investigate the four-phase team adaptation process (i.e. situation assessment → plan formulation → plan execution → team learning), as proposed by Rosen et al. (2011).

Design/methodology/approach

To test the positive relationship between the four team adaptation phases and their suggested sequence, a cross-sectional field study was conducted. Data were collected from 23 teams participating during an 8-week team project.

Findings

Results from random intercept models confirmed that the team adaptation process consisted of four phases that were positively related to each other. As expected, plan formulation mediated the positive relationship between situation assessment and plan execution. However, team learning was independently related to all three previous phases, and not only to situation assessment as theory suggests.

Originality/value

To the best of the authors’ knowledge, the present study is one of the first attempts to test the theoretical model of the team adaptation process presented by Rosen et al. (2011). Findings illustrated that the team adaptation process is not a simple four-phase sequence, but it constitutes four dynamic phases that are strongly interrelated to each other.

Coordination breakdowns in nuclear power plant control rooms: cause identification and behaviour-sequence analysis

This study aims to identify the causes of coordination breakdowns among control crews and to understand their coordination-behaviour patterns during emergencies in nuclear power plants (NPPs). On the basis of in-depth interviews with 18 control-crew operators, we identified 25 causes of coordination breakdown related to work processes, personnel, and situation and organisation. In addition, we observed 12 control-crew training sessions that dealt with emergencies and conducted lag-sequential analysis. The levels of coordination effectiveness were evaluated using the proportion of coordination breakdowns and the anticipation ratio. We found that higher-performing teams exhibited more non-random coordination behavioural patterns than did lower-performing teams. Coordination-behaviour patterns specific to the higher-performing teams included adaptive workload management (from senior operators) and proactive seeking performance monitoring (from junior operators). The findings of the study enrich our understanding of the critical factors and processes that influence coordination effectiveness of NPP control crews. Practitioner summary: Causes of coordination breakdowns among control crews of NPPs were identified based on in-depth interviews with control-crew operators, and behavioural-pattern analysis of control crews in 12 training sessions were analysed to reveal the patterns that differentiate higher- and lower-performing teams. The findings of the study enrich our understanding of the critical factors and processes that influence the coordination effectiveness of NPP control crews. Abbreviations: NPP: nuclear power plant; RO: reactor operator; TO: turbine operator; CO: coordinator; SRO: senior reactor operator.

Immersive simulations with extreme teams

Extreme teams (ETs) work in challenging, high pressured contexts, where poor performance can have severe consequences. These teams must coordinate their skill sets, align their goals, and develop shared awareness, all under stressful conditions. How best to research these teams poses unique challenges as researchers seek to provide applied recommendations while conducting rigorous research to test how teamwork models work in practice. In this article, we identify immersive simulations as one solution to this, outlining their advantages over existing methodologies and suggesting how researchers can best make use of recent advances in technology and analytical techniques when designing simulation studies. We conclude that immersive simulations are key to ensuring ecological validity and empirically reliable research with ETs.

Can Teamwork Promote Safety in Organizations?

In this review, we conceptualize teamwork as the linchpin driving safety performance throughout an organization. Safety is promoted by teams through various mechanisms that interact in a complex and dynamic process. We press pause on this dynamic process to organize a discussion highlighting the critical role played by teamwork factors in the engagement of safe and unsafe behavior, identifying five team-level emergent states that enable effective teamwork and safety: psychological safety, team trust, collective efficacy, shared mental models, and situation awareness. Additionally, we consider foundational conditions that support team-driven safety, the development of safety culture, and the importance of team safety climate in shaping performance. We discuss leveraging teams to generate safety and identify directions for future research investigating the relationship between teamwork and safety. Overall, we submit that researchers and practitioners would benefit from taking a systems perspective of safety by integrating principles of team science to better understand and promote safety in organizations.

Building team effectiveness through adaptation: Team knowledge and implicit and explicit coordination

We develop a theory of team adaptation that centers on team knowledge structures and coordination processes. Specifically, we explain that when a team’s task changes, there may be a disruption in the extent to which their team mental model (TMM) fits the current situation. Whether this is the case is likely to depend on team compositional factors, emergent states, and structural characteristics of the team. When there is a lack of correspondence between the TMM and the situation, this then requires a shift in the extent to which the team uses implicit or explicit coordination processes. We also explain that the team performance phase matters, such that during action phases, a prevalence of implicit coordination relative to explicit coordination results in greater effectiveness; during a transition phase, the opposite is likely. In this way, we address central questions in the field: what types of task changes require team adaptive response, what happens during the adaptation process, and how this influences team effectiveness over time.

Laborious but Elaborate: The Benefits of Really Studying Team Dynamics

In this manuscript we discuss the consequences of methodological choices when studying team processes "in the wild." We chose teams in healthcare as the application because teamwork cannot only save lives but the processes constituting effective teamwork in healthcare are prototypical for teamwork as they range from decision-making (e.g., in multidisciplinary decision-making boards in cancer care) to leadership and coordination (e.g., in fast-paced, acute-care settings in trauma, surgery and anesthesia) to reflection and learning (e.g., in post-event clinical debriefings). We draw upon recently emphasized critique that much empirical team research has focused on describing team states rather than investigating how team processes dynamically unfurl over time and how these dynamics predict team outcomes. This focus on statics instead of dynamics limits the gain of applicable knowledge on team functioning in organizations. We first describe three examples from healthcare that reflect the importance, scope, and challenges of teamwork: multidisciplinary decision-making boards, fast-paced, acute care settings, and post-event clinical team debriefings. Second, we put the methodological approaches of how teamwork in these representative examples has mostly been studied centerstage (i.e., using mainly surveys, database reviews, and rating tools) and highlight how the resulting findings provide only limited insights into the actual team processes and the quality thereof, leaving little room for identifying and targeting success factors. Third, we discuss how methodical approaches that take dynamics into account (i.e., event- and time-based behavior observation and micro-level coding, social sensor-based measurement) would contribute to the science of teams by providing actionable knowledge about interaction processes of successful teamwork.

There Is Light and There Is Darkness: On the Temporal Dynamics of Cohesion, Coordination, and Performance in Business Teams

This study examines teams as complex adaptive systems (tCAS) and uses latent growth curve modeling to test team cohesion as an initial condition conducive to team performance over time and the mediational effect of team coordination on this relationship. After analyzing 158 teams enrolled in a business game simulation over five consecutive weeks, we found that change in team coordination was best described by a continuous linear change model, while change in team performance was best described by a continuous nonlinear change model; and the mediation latent growth curve model revealed a negative indirect effect of team cohesion on the level of change in team performance over time, through the level of change in team coordination. This study contributes to the science of teams by combining the notions of initial conditions with co-evolving team dynamics, hence creating a more refined temporal approach to understanding team functioning.

Evaluating non-technical skills and mission essential competencies of pilots in military aviation environments

To develop and validate a classification of non-technical skills (NTS) in military aviation, a study was conducted, using data from real operations of F16 aircraft formations. Phase 1 developed a NTS classification based on the literature review (e.g. NOTECHS) and a workshop with pilots. The Non-TEChnical-MILitary-Skills (NOTEMILS) scheme was tested in Phase 2 in a series of Principal Component Analysis with data from After-Action-Review sessions (i.e. 900 records from a wide range of operations). The NTS were found to make a good prediction of Mission Essential Components (R² > 0.80) above the effect of experience. Phase 3 undertook a reliability analysis where three raters assessed the NOTEMILS scheme with good results (i.e. all r_wg > 0.80). To look into the consistency of classifications, another test indicated that, at least, two out of three raters were in agreement in over 70% of the assessed flight segments. Practitioner Summary: A classification scheme of Non-Technical Skills (NTS) was developed and tested for reliability in military aviation operations. The NTS scheme is a valuable tool for assessing individual and team skills of F-16 pilots in combat. It is noteworthy that the tool had a good capability of predicting Mission Essential Competencies.

Burnout among pilots: psychosocial factors related to happiness and performance at simulator training

In this study among airline pilots, we aim to uncover the work characteristics (job demands and resources) and the outcomes (job crafting, happiness and simulator training performance) that are related to burnout for this occupational group. Using a large sample of airline pilots, we showed that 40% of the participating pilots experience high burnout. In line with Job Demands-Resources theory, job demands were detrimental for simulator training performance because they made pilots more exhausted and less able to craft their job, whereas job resources had a favourable effect because they reduced feelings of disengagement and increased job crafting. Moreover, burnout was negatively related to pilots' happiness with life. These findings highlight the importance of psychosocial factors and health for valuable outcomes for both pilots and airlines. Practitioner Summary: Using an online survey among the members of a European pilots' professional association, we examined the relationship between psychosocial factors (work characteristics, burnout) and outcomes (simulator training performance, happiness). Forty per cent of the participating pilots experience high burnout. Job demands were detrimental, whereas job resources were favourable for simulator training performance/happiness. Twitter text: 40% of airline pilots experience burnout and psychosocial work factors and burnout relate to performance at pilots' simulator training.

The dual nature of adaptive coordination in teams

Adaptive team coordination is a central topic in the team dynamics literature. Most team adaptation research to date addresses team responses to demands for flexibility triggered by dynamic external forces. Little explicit attention has been paid to demands for stability created by continued pressures on efficiency and control. To capture this dual nature of adaptive coordination, we propose to characterize adaptation triggers in terms of stability and flexibility demands and suggest four modes of adaptive coordination that enable teams to adequately balance these demands. Grounded in team as well as organizational literatures, we explicate the specific patterns of coordination mechanisms comprising each mode of coordination, termed experiential, exploitative, exploratory, and ambidextrous coordination. The new insights offered into team adaptive coordination can spur research that further integrates team and organizational perspectives on adaptation processes.

Training Needs for Adaptive Coordination: Utilizing Task Analysis to Identify Coordination Requirements in Three Different Clinical Settings

A team’s ability to coordinate and adapt their performance to meet situational demands is critical to excellent patient care. The goal of this article is to identify common coordination characteristics that enable health care action teams to ensure effective patient care and to discuss specific examples of adaptive coordination within the health care setting. Task analyses were conducted to identify situational demands, in three different clinical settings: cardiac anesthesia, pediatric sepsis simulation, and trauma resuscitation. Each task analysis identified specific coordination requirements for pertinent tasks. The research team compared these task analyses, identified emerging themes, and agreed on core coordination characteristics common across all three environments by consensus through iterative abductive analysis. Findings across these diverse clinical settings showed that expert action teams (a) continually appraise their dynamic environment, (b) identify and define points of coordination, and (c) respond to the demands of nonroutine events by making coordination highly explicit. Specific examples of adaptive coordination within the health care setting are discussed, and implications for training are articulated. Findings are also pertinent outside of health care and may contribute to the understanding of coordination behaviors within action teams across multiple settings.

Differences in talking-to-the-room behaviour between novice and expert teams during simulated paediatric resuscitation: a quasi-experimental study

Background

Team coordination represents an important factor for clinical performance. Research in this area suggests that not only behaviour frequencies but also patterns of team coordination constitute a central aspect of teamwork. However, little is known about potential differences in coordination patterns between novice teams (ie, teams of inexperienced members) and expert teams (ie, teams of experienced members). The current study addresses this gap by investigating the use of talking-to-the-room—an important implicit coordination behaviour—in novice teams versus expert teams.

Aim

To illustrate differences in coordination behaviour between novice and expert teams. This will provide important knowledge for simulation-based training.

Methods

The study was conducted in the context of two resuscitation training courses (introductory course and refresher course) for staff members at a children’s hospital. Volunteers from both courses participated in the study. They were randomly assigned to 16 teams each consisting of one physician and two nurses. The study used a quasi-experimental design with two conditions (novice vs expert). Participants of the introductory course were assigned to the novice condition (eight teams), and participants of the refresher course were assigned to the expert condition (eight teams). All teams completed the same standardised paediatric resuscitation scenario. They were videotaped during the simulation, and team coordination behaviour was coded using Co-ACT.

Results

Lag-sequential analysis of 1902 distinct coordination acts revealed that novice teams and expert teams differed significantly in their coordination behaviour. Expert teams were characterised by patterns in which implicit coordination behaviour (ie, talking to the room) was followed by further implicit coordination behaviour and not followed by explicit coordination behaviour (ie, instructions), whereas the reverse was found for novice teams.

Conclusion

The current study highlights role of coordination patterns for understanding teamwork in healthcare and provides important insights for team training.

Developing a taxonomy of coordination behaviours in nuclear power plant control rooms during emergencies

This study aims to develop a taxonomy of coordination behaviours during emergencies in nuclear power plants (NPPs). We summarised basic coordination behaviours from literature in aviation, health care and nuclear field and identified coordination behaviours specific to the nuclear domain by interviewing and surveying control crew operators. The established taxonomy includes 7 workflow stages and 24 basic coordination behaviours. To evaluate the reliability and feasibility of the taxonomy, we analysed 12 videos of operators' training sessions by coding coordination behaviours with the taxonomy and the inter-rater reliability was acceptable. Further analysis of the frequency, the duration and the direction of the coordination behaviours revealed four coordination problems. This taxonomy provides a foundation of systematic observation of coordination behaviours among NPP crews, advances researchers' understanding of the coordination mechanism during emergencies in NPPs and facilitate the possibility to deepen the understanding of the relationships between coordination behaviours and team performance. Practitioner Summary: A taxonomy of coordination behaviours during emergencies in nuclear power plants was developed. Reliability and feasibility of the taxonomy was verified through the analysis of 12 training sessions. The taxonomy can serve as an observation system for analysis of coordination behaviours and help to identify coordination problems of control crews.

DE-CODE: a coding scheme for assessing debriefing interactions

Debriefings are crucial for learning during simulation-based training (SBT). Although the quality of debriefings is very important for SBT, few studies have examined actual debriefing conversations. Investigating debriefing conversations is important for identifying typical debriefer–learner interaction patterns, obtaining insights into associations between debriefers’ communication and learners’ reflection and comparing different debriefing approaches. We aim at contributing to the science of debriefings by developing DE-CODE, a valid and reliable coding scheme for assessing debriefers’ and learners’ communication in debriefings. It is applicable for both direct, on-site observations and video-based coding.

Methods

The coding scheme was developed both deductively and inductively from literature on team learning and debriefing and observing debriefings during SBT, respectively. Inter-rater reliability was calculated using Cohen’s kappa. DE-CODE was tested for both live and video-based coding.

Results

DE-CODE consists of 32 codes for debriefers’ communication and 15 codes for learners’ communication. For live coding, coders achieved good inter-rater reliabilities with the exception of four codes for debriefers’ communication and two codes for learners’ communication. For video-based coding, coders achieved substantial inter-rater reliabilities with the exception of five codes for debriefers’ communication and three codes for learners’ communication.

Conclusion

DE-CODE is designed as micro-level measurement tool for coding debriefing conversations applicable to any debriefing of SBT in any field (except for the code medical input). It is reliable for direct, on-site observations as well as for video-based coding. DE-CODE is intended to allow for obtaining insights into what works and what does not work during debriefings and contribute to the science of debriefing.

Mind the gap - Deriving a compatible user mental model of the home heating system to encourage sustainable behaviour

Householders' behaviour with their home heating systems is a considerable contributor to domestic energy consumption. To create a design specification for the 'scaffolding' needed for sustainable behaviour with home heating controls, Norman's (1986) Gulf of Execution and Evaluation was applied to the home heating system. A Home Heating Design Model (DM) was produced with a home heating expert. Norman's (1986) 7 Stages of Activity were considered to derive a Compatible User Mental Model (CUMM) of a typical Heating System. Considerable variation in the concepts needed at each stage was found. Elements that could be derived from the DM supported stages relating to action specification, execution, perception and interpretation, but many are not communicated in the design of typical heating controls. Stages relating to goals, intentions and evaluation required concepts beyond the DM. A systems view that tackles design for sustainable behaviour from a variety of levels is needed.

Distributed cognition in Search and Rescue: loosely coupled tasks and tightly coupled roles

The perceptual cycle model (PCM) underpins much Ergonomics research, particularly in a team context, for example in its theoretical underpinning of distributed situation awareness. Despite this, the PCM framework it has not been explicitly applied to explore team processes, which is surprising given the prevalence of teamwork in safety critical systems. This paper explores team processes in the context of search and rescue (SAR) by applying the PCM and an association classification scheme with a network analysis approach utilising the event analysis of systemic teamwork (EAST) method. Data were collected via observations and communication recordings during training flights with SAR crews and were amalgamated into a representative case study. The analysis demonstrates how the SAR team function within a distributed perceptual cycle whereby the actions of one team member become world information for another team member. Advancements to the EAST method are proposed and the implications of the research are discussed. Practitioner Summary: This paper explores the perceptual cycle interactions of SAR crews using a novel EAST approach. The analysis demonstrates how the crew function as a distributed cognitive unit and applications in terms of training and design are discussed.

Adaptive coordination in surgical teams: an interview study

Background

Effective teamwork has been recognised as a major contributor to safe patient care in surgery. Previous research has highlighted the importance of adaptive coordination for effective performance in acute care settings. Expanding this line of research this study explores the coordination behaviours and adaptive coordination strategies employed by surgical teams and identifies relevant situational characteristics influencing those coordination processes.

Method

We conducted a qualitative content analysis of semi-structured interviews with 33 surgical team members (nurses and physicians) from different specialties and hospitals.

Results

We identified coordination behaviours (i.e. task management, information management, teaching and leadership) and adaptive coordination strategies triggered by varying requirements due to non-routine events, intraoperative complications and differing level of experience among operating room staff. Interviewees highlighted the importance of effectively managing challenging moments and the supporting effect of positive climate on teamwork.

Conclusions

This study complements previous research on the non-technical skills underpinning safe performance in surgical teams. It highlights the central role of coordination and points out the ways in which situational variability requires the team to behave adaptively.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-015-0792-5) contains supplementary material, which is available to authorized users.

The collective construction of safety: a trade-off between "understanding" and "doing" in managing dynamic situations

This exploratory research aims to understand how teams organize themselves and collectively manage risky dynamic situations. The objective is to assess the plausibility of a model of a collective trade-off between "understanding" and "doing". The empirical study, conducted in the pediatric anesthesia service of a French university hospital, was supported by a "high fidelity" simulation with six teams. Data on the teams' behavior and on the verbal communications were collected through video recordings. The results highlight three modes for management of dynamic situations (determined management, cautious management, and overwhelmed management). These modes are related to the way in which teams manage their cognitive resources. More precisely, they are related to the teams' ability to collectively elaborate a trade-off between "understanding" and "doing". These results question existing perspectives on safety and suggest improvements in the design of crisis management training (concerning for example the recommendation of "calling for help").

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.

Models of models: filtering and bias rings in depiction of knowledge structures and their implications for design

Mental models are poorly specified in three ways: in their defining criteria, their source and the bias to which they have been subjected. Literature from psychology, HCI and human factors sources was reviewed to determine the utility of 'mental models' as a design tool. The definitions and theories offered by key contributors to the notion of mental models were compared. Schematics, representing both the knowledge structures proposed in cognitive processing, as well as the layers of bias evident when forming or accessing mental models, were constructed. Fundamental similarities and differences in the use of this notion, as well as ambiguities in definition, were highlighted graphically. The need for specificity in the use of mental models was emphasised as essential for pragmatic application in design. The use of graphical comparison was proposed as a means of identifying the risk of bias and a means to categorise approaches to mental model research. Practitioner Summary: Mental models are considered significant in user centred design. To apply this notion pragmatically, its definition and methods of construction and access need to be sufficiently specified. This article offers a graphical method to compare existing research in mental models, highlighting similarities, differences and ambiguities.

Dynamical analysis in real time: detecting perturbations to team communication

Dynamical systems methods characterise patterns of change over time. Typically, such methods are applied only after data collection is complete. However, brief disturbances - perturbations - can occur as a process unfolds and can result in undesirable outcomes if not acted on. The application of dynamics in real time would be useful for detecting these sudden changes. Real-time analysis was accomplished by updating dynamical estimates simultaneously across different window sizes. We calculated the largest Lyapunov exponent, a measure of dynamical stability, to detect a perturbation to team communication in a simulated uninhabited air vehicle (UAV) reconnaissance mission. The perturbation consisted of information demands from a confederate that occurred unexpectedly during performance of a UAV mission. We demonstrate the use of real-time methods in detecting that perturbation as it occurred. In application, this technique would have enabled real-time intervention. Extensions of the real-time dynamical method to other domains of psychological inquiry are discussed.

PRACTITIONER SUMMARY

A real-time dynamical analysis method that was developed to detect unexpected perturbations in team communication is described. The use of the method is demonstrated on perturbed communication from a three-person uninhabited air vehicle command-and-control team. The generalisability of the method is considered with respect to physiological and motor coordination dynamics.

Applying aviation factors to oral and maxillofacial surgery--the human element

There are many similarities between flying commercial aircraft and surgery, particularly in relation to minimising risk, and managing potentially fatal or catastrophic complications, or both. Since 1979, the development of Crew Resource Management (CRM) has improved air safety significantly by reducing human factors that are responsible for error. Similar developments in the operating theatre have, to a certain extent, lagged behind aviation, and it is well recognised that we can learn much from the industry. An increasing number of publications on aviation factors relate to surgery but to our knowledge there is a lack of research in our own specialty. We discuss how aviation principles related to human factors can be translated to the operating theatre to improve teamwork and safety for patients. Clinical research is clearly needed to develop this fascinating area more fully.

Adaptive coordination development in student anaesthesia teams: a longitudinal study

Although adaptive coordination has been highlighted by several studies, research dealing with how adaptive coordination develops is still rare. Thus, the aim of this study was to investigate the development of coordination mechanisms and their task-related adaptation in a longitudinal observation of medical simulation-based training of final year students. We recorded six anaesthesia teams during a sequence of four task scenarios, and each scenario comprised of a routine and a complication phase. After trained observers rated sub-tasks within each scenario for explicit and implicit coordination, statistical analysis revealed a statistically significant effect of previous scenarios on coordination development in the routine phases. While the amount of explicit coordination decreased, implicit coordination increased, revealing adaptive coordination as a skill developed through repeated group interaction. We conclude that anaesthesia training should consider cost- and patient safety-benefits of implicit and explicit coordination and focus on adaptive coordination.

PRACTITIONER SUMMARY

Group coordination is crucial to anaesthesia team performance. Results of this longitudinal observation of six anaesthesia teams during four medical simulation-based training scenarios document that teams develop adaptive patterns of coordination. This study also demonstrates that adaptive coordination is a trainable skill within crisis resource management training.

Description of dynamic shared knowledge: an exploratory study during a competitive team sports interaction

This exploratory case study describes the sharedness of knowledge within a basketball team (nine players) and how it changes during an official match. To determine how knowledge is mobilised in an actual game situation, the data were collected and processed following course-of-action theory (Theureau 2003). The results were used to characterise the contents of the shared knowledge (i.e. regarding teammate characteristics, team functioning, opponent characteristics, opposing team functioning and game conditions) and to identify the characteristic types of change: (a) the reinforcement of a previous element of shared knowledge; (b) the invalidation of an element of shared knowledge; (c) fragmentation of an element of shared knowledge; (d) the creation of a new element of shared knowledge. The discussion deals with the diverse types of change in shared knowledge and the heterogeneous and dynamic nature of common ground within the team. STATEMENT OF RELEVANCE: The present case study focused on how the cognitions of individual members of a team coordinate to produce a team performance (e.g. surgical teams in hospitals, military teams) and how the shared knowledge changes during team activity. Traditional methods to increase knowledge sharedness can be enhanced by making use of 'opportunities for coordination' to optimise team adaptiveness.

A multi-level approach of evaluating crew resource management training: a laboratory-based study examining communication skills as a function of team congruence

The article proposes a multi-level approach for evaluating communication skills training (CST) as an important element of crew resource management (CRM) training. Within this methodological framework, the present work examined the effectiveness of CST in matching or mismatching team compositions with regard to hierarchical status and competence. There is little experimental research that evaluated the effectiveness of CRM training at multiple levels (i.e. reaction, learning, behaviour) and in teams composed of members of different status and competence. An experiment with a two (CST: with vs. without) by two (competence/hierarchical status: congruent vs. incongruent) design was carried out. A total of 64 participants were trained for 2.5 h on a simulated process control environment, with the experimental group being given 45 min of training on receptiveness and influencing skills. Prior to the 1-h experimental session, participants were assigned to two-person teams. The results showed overall support for the use of such a multi-level approach of training evaluation. Stronger positive effects of CST were found for subjective measures than for objective performance measures. STATEMENT OF RELEVANCE: This work provides some guidance for the use of a multi-level evaluation of CRM training. It also emphasises the need to collect objective performance data for training evaluation in addition to subjective measures with a view to gain a more accurate picture of the benefits of such training approaches.

Training adaptive teams

OBJECTIVE

We report an experiment in which three training approaches are compared with the goal of training adaptive teams.

BACKGROUND

Cross-training is an established method in which team members are trained with the goal of building shared knowledge. Perturbation training is a new method in which team interactions are constrained to provide new coordination experiences during task acquisition. These two approaches, and a more traditional procedural approach, are compared.

METHOD

Assigned to three training conditions were 26 teams. Teams flew nine simulated uninhabited air vehicle missions; three were critical tests of the team's ability to adapt to novel situations. Team performance, response time to novel events, and shared knowledge were measured.

RESULTS

Perturbation-trained teams significantly outperformed teams in the other conditions in two out of three critical test missions. Cross-training resulted in significant increases in shared teamwork knowledge and highest mean performance in one critical test. Procedural training led to the least adaptive teams.

CONCLUSION

Perturbation training allows teams to match coordination variability during training to demands for coordination variability during posttraining performance. Although cross-training has adaptive benefits, it is suggested that process-oriented approaches, such as perturbation training, can lead to more adaptive teams.

APPLICATION

Perturbation training is amenable to simulation-based training, where perturbations provide interaction experiences that teams can transfer to novel, real-world situations.