BackgroundCommunication errors can reduce patient safety, especially in emergency situations that require rapid responses by experts in a number of medical specialties. Talking to each other is crucial for utilizing the collective expertise of the team. Here we explored the functions of “team talk” (talking between team members) with an emphasis on the talk-work relationship in interdisciplinary emergency teams.MethodsFive interdisciplinary medical emergency teams were observed and videotaped during in situ simulations at an emergency department at a university hospital in Norway. Team talk and simultaneous actions were transcribed and analysed. We used qualitative discourse analysis to perform structural mapping of the team talk and to analyse the function of online commentaries (real-time observations and assessments of observations based on relevant cues in the clinical situation).ResultsStructural mapping revealed recurring and diverse patterns. Team expansion stood out as a critical phase in the teamwork. Online commentaries that occurred during the critical phase served several functions and demonstrated the inextricable interconnections between team talk and actions.DiscussionDiscourse analysis allowed us to capture the dynamics and complexity of team talk during a simulated emergency situation. Even though the team talk did not follow a predefined structure, the team members managed to manoeuvre safely within the complex situation. Our results support that online commentaries contributes to shared team situation awareness.ConclusionsDiscourse analysis reveals naturally occurring communication strategies that trigger actions relevant for safe practice and thus provides supplemental insights into what comprises “good” team communication in medical emergencies.
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SAMMENDRAGMøter mellom Nav-veileder og bruker er viktige både for samfunnets mål om flest mulig i arbeid, og for den enkelte bruker som har behov for veiledning, økonomisk eller praktisk hjelp. Gjennom FOU-satsingen «Interaksjon med brukere» legger Nav vekt på brukermøtene og hvordan kvaliteten i disse henger sammen med målene om aktivisering og brukermedvirkning.Denne metodologiske artikkelen bruker norsk og internasjonal forskning om samtaler i arbeids-og velferdssektoren som empirisk grunnlag for å diskutere hvordan ulike metoder er egna til å belyse ulike problemstillinger. Detaljert analyse av samarbeidet og samspillet i faktiske brukermøter er en lite brukt metode i forskning om Nav. I denne artikkelen diskuterer vi derfor hva som kan oppnås gjennom å gjøre naerstudier av interaksjonen i brukermøter med utgangspunkt i lyd-/bildeopptak og med verktøy fra samtaleforskning. Vi gir eksempler på hvordan analyse av samtaledata kan gi grunnlag for å nyansere standardiserte råd om kommunikasjon og belyse hvordan brukermøtets interaksjonelle forløp skaper vilkår for deltakelse i samtalen.Å vaere samtaleleder i brukermøter er en viktig del av Nav-veilederes jobb. Denne artikkelen bidrar med en forskningsbasert begrunnelse for hvorfor bevisstgjøring om samtalens dynamikk i brukermøtene bør vaere del av fagutviklingen i Nav. NøkkelordNav, brukermøter, brukermedvirkning, samtaledata, interaksjon med brukere ABSTRACT Meetings between service users and counsellors in the Norwegian Labour and Welfare Administration (NAV) are vital both for achieving the goals of increased employment in the labour and welfare sector and for the individual service user with needs for counselling or economic assistance. Detailed analysis of interaction in service user meetings, based on audio/video recordings of authentic meetings, is a method that is rarely used in research on social work. In this methodological paper, we discuss what can be achieved by studying interactional data with micro-analytic tools. This paper gives a research-based motivation for why detailed analysis of interaction can create awareness and insights into the dynamics of service user meetings and provide a foundation for professional development in NAV.Keywords NAV, service user involvement, interaction, service user meetings, micro-analysis Veiledere i Nav tilbringer mye tid i møter med brukere av offentlige tjenester. Brukerne har ulike behov, ønsker og livssituasjoner, og Nav tilbyr et bredt spekter av tjenester innafor rammene av offentlige budsjetter, lover og forskrifter og statlige og kommunale mål for tjenestene. Felles for alle disse ulike brukermøtene er etatens mål om flest mulig i arbeid og
Successful teamwork, constitutive of team talk, depends largely on shared responsibility in the coordination of tasks in a goal-oriented way. This paper examines how specific modes of talk or 'discourse types' are utilised by a healthcare team in simulated emergency care. The data corpus comprises six video-recorded simulation training sessions in an emergency department at a large Norwegian hospital. Our analysis focuses on the critical moment when the original healthcare team is joined by other specialists in an ad hoc manner, which necessitates the (re)distribution of expert responsibility in the management of the patient's condition. We examine the interactional trajectories and, in particular, the discourse types surrounding the critical moment which marks the incorporation of the new team members. The analysis centres on three discourse types (online commentary, offline commentary and metacommentary) that are utilised in accomplishing the multiple tasks in a collaborative and coordinated fashion. We suggest that team talk overlays and overlaps with distributed medical work in highly charged decision-making contexts such as emergency care. The findings have relevance for how healthcare professionals and students are trained in multidisciplinary team talk and teamwork.
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