The surgical ensemble: choreography as a simulation and training tool

Satava, Richard M.; Hunter, Anne

doi:10.1007/s00464-011-1673-6

Cited by 12 publications

(5 citation statements)

References 7 publications

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“…One gets to know the rhythm of the morning report quickly as it is simple and repeated in its structure, and easily learned as in a simple version of a “line dance”. In their study of surgery teams, Satava and Hunter used choreography to capture the implicit, discursive and bodily patterns in operation teams [ 35 ]. Congruent with this, we found that none of the departments explicated the pattern, e.g., by writing it down, yet the doctors still performed it.…”

Section: Discussionmentioning

confidence: 99%

How doctors build community and socialize into a clinical department through morning reports. A positioning theory study

et al. 2023

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Phenomenon The morning report is one of the longest surviving hospital practices. Most studies of the morning report focus on the effectiveness of formal medical training, while focus on social and communicative aspects is rarer. This study explores the social interactions and communication in morning reports, examining the ways in which they contribute to the construction of professional identity and socialization into the community of the clinical department. Approach We used a qualitative explorative design with video observations of morning reports. Our data consisted of 43 video-recorded observations (in all, 15.5 hours) from four different hospital departments in Denmark. These were analyzed using the theoretical framework of positioning theory. Findings A key finding was that each department followed its own individual structure. This order was not articulated as such but played out implictly. Two alternative storylines unfolded in the elements of the morning report: 1) being equal members of the specialty and department, and 2) preserving the hierarchical community and its inherent positions. Insights The morning report can be seen as playing an important role in community making. It unfolds as a “dance” of repeated elements in a complex collegial space. Within this complexity, the morning report is a space for positioning oneself and others as a collegial “we”, i.e., equal members of a department and specialty, at the same time as “having a place” in a hierarchal community. Thus, morning reports contribute to developing professional identity and socialization into the medical community.

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Section: Discussionmentioning

confidence: 99%

How doctors build community and socialize into a clinical department through morning reports. A positioning theory study

et al. 2023

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“…3a for an illustration drawn by Jessica). Choreography (also known as spatial reconfiguration [62]) in healthcare is the process of coordinating among a team through space, time, energy, and rhythm [72]. Lauren explained the concept of choreography as below:…”

Section: Choreography Generationmentioning

confidence: 99%

Coordinating Clinical Teams

Taylor

Lee

Kubota

et al. 2019

Proc. ACM Hum.-Comput. Interact.

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Patient safety errors account for over 400,000 preventable deaths annually in US in hospitals alone, 70% of which are caused by team communication breakdowns, stemming from hierarchical structures and asymmetrical power dynamics between physicians, nurses, patients, and others. Nurses are uniquely positioned to identify and prevent these errors, but they are often penalized for speaking up, particularly when physicians are responsible. Nevertheless, empowering nurses and building strong interdisciplinary teams can lead to improved patient safety and outcomes. Thus, our group has been developing a series of intelligent systems that support teaming in safety critical settings, Robot-Centric Team Support System (RoboTSS), and recently developed a group detection and tracking system for collaborative robots. In this paper, we explore how RoboTSS can be used to empower nurses in interprofessional team settings, through a three month long, collaborative design process with nurses across five US-based hospitals. The main findings and contributions of this paper are as follows. First, we found that participants envisioned using a robotic crash cart to guide resuscitation procedures to improve efficiency and reduce errors. Second, nurses discussed how RoboTSS can generate choreography for efficient spatial reconfigurations in co-located clinical teams, which is particularly important in time-sensitive situations such as resuscitation. Third, we found that nurses want to use RoboTSS to "stop the line", and disrupt power dynamics by policing unsafe physician behavior, such as avoiding safety protocols using a robotic crash cart. Fourth, nurses envisioned using our system to support real-time error identification, such as breaking the sterile field, and then communicating those errors to physicians, to relieve them of responsibility. Finally, based on our findings, we propose robot design implications that capture how nurses envision utilizing RoboTSS. We hope this work promotes further exploration in how to design technology to challenge authority in asymmetrical power relationships, particularly in healthcare, as strong teams save lives.

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“…[53][54][55] The surgical "dance," as such, involves a myriad of participants including anesthetists, surgeons, nurses, and assistants, referred to by one review as choreography. 56 Teamwork has been assessed for several years now in generic training courses such as Advanced Trauma and Life Support (ATLS), but it has been proposed that actors can be used to portray members of an operating room team to simulate a full surgical environment and in a small study, actors were used to emulate operating room staff. Participants perceived the actors as realistic and data from 12 surgeons enrolled indicated the model was a success.…”

Section: Role Of Simulation In Team Trainingmentioning

confidence: 99%

Simulation and Its Role in Training

Samia

Khan

Lawrence

et al. 2013

Clinics in Colon and Rectal Surgery

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Despite its short history, surgical simulation has been successfully introduced into surgical residency programs in an effort to augment training. A wide range of simulator types and levels of complexity have proven an effective teaching method for surgical trainees. They have been used for training in areas such as general surgery, urology, gynecology, and ophthalmology among others. Coincident with the introduction of simulators is the need for objective evaluation of skills learned on them, which has led to the development and validation of multiple evaluation tools. This article evaluates the drivers for simulation, types of simulators, training, and evaluation of them especially as it pertains to laparoscopic colorectal surgery.

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The surgical ensemble: choreography as a simulation and training tool

Cited by 12 publications

References 7 publications

How doctors build community and socialize into a clinical department through morning reports. A positioning theory study

How doctors build community and socialize into a clinical department through morning reports. A positioning theory study

Coordinating Clinical Teams

Simulation and Its Role in Training

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