High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance

Bjørn Helge Johnsen,Torben Wisborg,Heidi Kristina Westli,Guttorm Brattebø,Roar Espevik

doi:10.1186/s13049-017-0452-3

Abstract

BackgroundHigh quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management.MethodTraining video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader’s frequency of shared mental model behavioral markers.ResultsThe results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information (“push” of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of “push” of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers.ConclusionThe results of this study emphasize the team leader’s role in initiating and updating a team’s shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

Highlights

High quality team leadership is important for the outcome of medical emergencies
The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information (“push” of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior
The results suggested that leadership was a critical factor in team performance, and the researchers argued that leadership could be seen as an integral component in centralizing communication, Johnsen et al Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2017) 25:109 facilitating coordination, allocating resources, and keeping an accurate shared mental model (SMM) of the evolving scenario as a whole [5]

Summary

Introduction

High quality team leadership is important for the outcome of medical emergencies. the behavioral marker of leadership are not well defined. From a series of studies conducted on military tactical expert teams, these authors found that effective team performance under a high workload depended on team members’ ability to apply a shared understanding of the task, the structure of the team, and each team member’s role within it. This proposed beneficial cognitive construct was referred to as a SMM [6] and is assumed to enable individual team members to predict task needs and the intended actions of other members. Westli et al [7] investigated the behavioral indicators of SMM for complete teams rather than for the team leaders; the specific behavioral characteristics of the team leaders of high-performing medical teams still need to be characterized

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