Anesthesia providers and nursing staff made decisions that increased clinical work per unit time in each OR, even when doing so resulted in an increase in over-utilized OR time, higher staffing costs, unpredictable work hours, and/or mandatory overtime. Organizational culture and socialization during clinical training may be a cause. Command displays showed promise in mitigating this tendency. Additional investigations are in our companion paper.
Abstract:Research on the microscale neural dynamics of social interactions has yet to be translated into improvements in the assembly, training and evaluation of teams. This is partially due to the scale of neural involvements in team activities, spanning the millisecond oscillations in individual brains to the minutes/hours performance behaviors of the team. We have used intermediate neurodynamic representations to show that healthcare teams enter persistent (50-100 s) neurodynamic states when they encounter and resolve uncertainty while managing simulated patients. Each of the second symbols was developed situating the electroencephalogram (EEG) power of each team member in the contexts of those of other team members and the task. These representations were acquired from EEG headsets with 19 recording electrodes for each of the 1-40 Hz frequencies. Estimates of the information in each symbol stream were calculated from a 60 s moving window of Shannon entropy that was updated each second, providing a quantitative neurodynamic history of the team's performance. Neurodynamic organizations fluctuated with the task demands with increased organization (i.e., lower entropy) occurring when the team needed to resolve uncertainty. These results show that intermediate neurodynamic representations can provide a quantitative bridge between the micro and macro scales of teamwork.
Information models provide a generalizable quantitative method for separating a team's neurodynamic organization into that of individual team members and that shared among team members.
The initial models of team and team member dynamics using biometric data in healthcare will likely come from simulations. But how confident are we that the simulation-derived high-resolution dynamics will reflect those of teams working with live patients? We have developed neurodynamic models of a neurosurgery team while they performed a peroneal nerve decompression surgery on a patient to approach this question. The models were constructed from EEG-derived measures that provided second-by-second estimates of the neurodynamic responses of the team and team members to task uncertainty. The anesthesiologist and two neurosurgeons developed peaks, often coordinated, of elevated neurodynamic organization during the patient preparation and surgery which were similar to those seen during simulation training, and which occurred near important episodes of the patient preparation and surgery. As the analyses moved down the neurodynamic hierarchy, and the simulation and live patient neurodynamics occurring during the intubation procedure were compared at progressively smaller time scales, differences emerged across scalp locations and EEG frequencies. The most significant was the pronounced suppression of gamma rhythms detected by the frontal scalp sensors during the live patient intubation which was absent in simulation trials of the intubation procedure. These results indicate that while profiles of the second-by-second neurodynamics of teams were similar in both the simulation and live patient environments, a deeper analysis revealed differences in the EEG frequencies and scalp locations of the signals responsible for those team dynamics. As measures of individual and team performance become more micro-scale and dynamic, and simulations become extended into virtual environments, these results argue for the need for parallel studies in live environments to validate the dynamics of cognition being observed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.