Trauma, Teams, and Telemedicine: Evaluating Telemedicine and Teamwork in a Mass Casualty Simulation

Autor:	Ashley M. Hughes, Shirley C. Sonesh, Megan E. Gregory, Rachel E. Mason, Eduardo Salas, Antonio Marttos, Carl I. Schulman
Rok vydání:	2021
Předmět:	Telemedicine media_common.quotation_subject Poison control Psychological safety 050105 experimental psychology Occupational safety and health 03 medical and health sciences 0302 clinical medicine medicine Humans Mass Casualty Incidents Computer Simulation 0501 psychology and cognitive sciences 030212 general & internal medicine Simulation Training media_common Patient Care Team Teamwork 05 social sciences Public Health Environmental and Occupational Health Virtual team Human factors and ergonomics General Medicine medicine.disease Leadership Mass-casualty incident Medical emergency Psychology
Zdroj:	Military Medicine. 186:e811-e818
ISSN:	1930-613X 0026-4075
DOI:	10.1093/milmed/usaa434
Popis:	Introduction Mass casualty events (MASCAL) are on the rise globally. Although natural disasters are often unavoidable, the preparation to respond to unique patient demands in MASCAL can be improved. Utilizing telemedicine can allow for a better response to such disasters by providing access to a virtual team member with necessary specialized expertise. The purpose of this study was to examine the positive and/or negative impacts of telemedicine on teamwork in teams responding to MASCAL events. Methods We introduced a telemedical device (DiMobile Care) to Forward Surgical Teams during a MASCAL simulated training event. We assessed teamwork-related attitudes, behaviors, and cognitions during the MASCAL scenario through pre-post surveys and observations of use. Analyses compare users and nonusers of telemedicine and pre-post training differences in teamwork. Results We received 50 complete responses to our surveys. Overall, clinicians have positive reactions toward the potential benefits of telemedicine; further, participants report a significant decrease in psychological safety after training, with users rating psychological safety as significantly higher than non-telemedicine users. Neither training nor telemedicine use produced significant changes in cognitive and behavioral-based teamwork. Nonetheless, participants reported perceiving that telemedicine improved leadership and adaptive care plans. Conclusions Telemedicine shows promise in connecting Forward Surgical Teams with nuanced surgical expertise without harming quality of care metrics (i.e., teamwork). However, we advise future iterations of DiMobile Care and other telemedical devices to consider contextual features of information flow to ensure favorable use by teams in time-intensive, high-stakes environments, such as MASCAL.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f68d3af1a765b74149d46a5c9fbe3a52 https://doi.org/10.1093/milmed/usaa434 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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