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16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

Number of instances. 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2. Number of instances. 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2. Number of instances. 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2. Number of instances. 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2. Number of instances. Number of instances.

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16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

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  1. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

  2. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

  3. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

  4. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

  5. Number of instances Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1

  6. Attending physician Junior resident Team leader (resident) Anesthesiologist TEAM Nurse Technician Recorder

  7. Event # 3 – Overall communication pattern for some roles ATP Attending physician 1.7 % 1 % 4.4 % 1.4 % 0.7 % TL Team leader PNR Primary nurse 1.4 % 1 % 1 % 3.4 % 7.2 % 1.7 % 4.1 % REC Recorder nurse TEAM 5.1 % 14.4 %

  8. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 (a) (b)

  9. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 (a) (b)

  10. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Simulation #1 Actors Observation Decision making Communication Memory Intervention Tasks

  11. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Simulation #2 Actors Observation Decision making Communication Memory Interv Tasks

  12. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Event #3 Actors Observation Decision making Communication Memory Intervention Tasks

  13. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Event #4 63 36 Actors Observation Decision making Communication Memory Interv Tasks

  14. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Average of 2 Simulations and Event #3 Actors Observation Decision making Communication Memory Interv Tasks

  15. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 Attending Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Technician Pharmacist Respiratory th. X-ray tech. Other EMS para. Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Event #3 Actors Observation Decision making Communication Memory Intervention Tasks

  16. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Attending Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Technician Pharmacist Respiratory th. X-ray tech. Other EMS Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT Average of 2 Simulations and 2 Events Actors Observation Decision making Communication Memory Intervention Tasks

  17. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Average 5 Events Attending Sr. resident Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Actors Technician Pharmacist Respiratory th. X-ray tech. Other EMS Setup Inquiry Sensing Takeover Coaching Reporting Directives Response Recording Instr. Read. Clarification Intervention Task coord. Examination Strateg. plan. Exernal mem. Knowlg. recall Man. Measure Group dec.mk. Situation recall Observing Communication Nonverbal proc. Memory Decisions Tasks

  18. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Average 10 Events Attending Chief resident Team leader Anesthes. Jr. resident 16 - 32 Orthopedist 8 - 16 Primary nurse Recorder 4 - 8 Actors Technician 2 - 4 Pharmacist 1 - 2 Respiratory th. X-ray tech. 0 - 1 Other EMS Setup Inquiry Sensing Takeover Coaching Reporting Directives Response Recording Instr. Read. Clarification Intervention Task coord. Examination Strateg. plan. Exernal mem. Knowlg. recall Man. Measure Group dec.mk. Situation recall Observing Communication Nonverbal proc. Memory Decisions Tasks

  19. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Average 10 Events, prepared on 2 Aug 2008

  20. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Average 10 Events Attending Chief resident Team leader Anesthes. Jr. resident 16 - 32 Orthopedist 8 - 16 Primary nurse Recorder 4 - 8 Actors Technician 2 - 4 Pharmacist 1 - 2 Respiratory th. X-ray tech. 0 - 1 Other EMS Setup Inquiry Sensing Reporting Directives Response Recording Instr. Read. Clarification Intervention Task coord. Examination Solo dec.mk. Strateg. plan. Exernal mem. Knowlg. recall Man. Measure Group dec.mk. Situation recall Observing Communication Nonverbal proc. Memory Decisions Tasks

  21. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Average 10 Events, prepared on 17 Dec 2008

  22. Event #3 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH Actors OTHER EMS Observation Decision making Communication Memory Intervention Tasks Q IR JU TA CL SP TO RP ED INT MM RLY LTM SEN STM TC ASM RMT GDM MEXT

  23. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 Attending Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed Event #3 Actors EMS Other TEAM Recorder Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Orthopedist Team leader Primary nurse Respiratory th. Subjects

  24. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH OTHER EMS Event #3 Actors JR RT TL ATP CCT PNR REC ORT EMS ANST TEAM OTHER PHARM X-TECH Subjects

  25. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Attending Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed Actors vs. Subjects, on ALL Tasks Average (10 events) Actors EMS Other TEAM Recorder PATIENT Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Orthopedist Team leader Primary nurse Respiratory th. Subjects

  26. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 Actors vs. Subjects, on ALL Tasks SAME AS PREVIOUS, with SR. RESIDENT Average (10 events) Attending Sr. resident Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Actors Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed EMS Other TEAM Recorder PATIENT Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Sr. resident Orthopedist Team leader Primary nurse Respiratory th. Subjects

  27. Amount > 8 6 - 8 4 - 6 2 - 4 0 - 2 Attending Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed Actors vs. Subjects, on ALL Tasks Standard Deviation (10 events) Actors EMS Other TEAM Recorder PATIENT Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Orthopedist Team leader Primary nurse Respiratory th. Subjects

  28. Amount > 8 6 - 8 4 - 6 2 - 4 0 - 2 Actors vs. Subjects, on ALL Tasks SAME AS PREVIOUS, with SR. RESIDENT Standard Deviation (10 events) Attending Sr. resident Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Actors Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed EMS Other TEAM Recorder PATIENT Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Sr. resident Orthopedist Team leader Primary nurse Respiratory th. Subjects

  29. Number of instances Amount > 8 6 - 8 4 - 6 2 - 4 0 - 2 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1

  30. Number of instances Amount > 8 6 - 8 4 - 6 2 - 4 0 - 2 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2 0 - 1 SAME AS PREVIOUS, with SR. RESIDENT

  31. 33 33 27 27 Percent answers (%) 15 14 13 Percent questions (%) 12 11 11 9 Patient Team leader UNANSWERED Primary nurse EMS Technician Pharmacist Jr. resident Recorder Orthopedic Other/Unknown Anest./Resp. ther Chief resident 8 7 6 6 Team leader Recorder Attending Primary nurse Orthopedic Jr. resident Chief resident Technician Other/Unknown Anest./Resp. therap. Pharmacist 4 4 4 4 3 2 2 2 1 1 1 Who asked Who answered

  32. Number of instances > 4.0 2.0 - 4.0 1.0 - 2.0 0.5 - 1.0 0.1 - 0.5 Actors vs. Subjects, on Inquiries (Q) Tasks Only Average (10 events) Attending Chief resident Team leader Anesthes. Jr. resident Orthopedist Primary nurse Recorder Actors Technician Pharmacist Respiratory th. X-ray tech. Other EMS paramed EMS Other TEAM Recorder PATIENT Attending Anesthes. Technician X-ray tech. Jr. resident Pharmacist Orthopedist Team leader Chief resident Primary nurse Respiratory th. Subjects

  33. Number of instances > 4.0 2.0 - 4.0 1.0 - 2.0 0.5 - 1.0 0.1 - 0.5 (a) Total questions: 581 (in 10 resuscitations) (b)

  34. Average of 2 Simulations and 1 Event ATP TL ANST JR ORT PNR REC CCT PHARM RT X-TECH Actors Actors OTHER EMS Observation Decision making Communication Memory Intervention Tasks

  35. OLD

  36. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

  37. Number of instances 16 - 32 8 - 16 4 - 8 2 - 4 1 - 2

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