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Workload of Team Leaders and Team Members During a Simulated Sepsis Scenario
Nancy M Tofil1, Yiqun Lin, John Zhong
11Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 2KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, Department of Pediatrics, University of Calgary, Calgary, AB, Canada. 3Department of Pediatrics, University of Texas Southwestern, Dallas, TX. 4Department of Pediatrics, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United Kingdom. 5Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada. 6Department of Pediatrics, Yale Medical School, New Haven, CT. 7Department of Pediatrics, Northwestern University School of Medicine, Chicago, IL 8Department of Pediatrics, Tufts University School of Medicine, Boston, MA.
Insights
During simulated pediatric sepsis emergencies, team leaders experience high mental workload, while both leaders and members face moderate overall workloads. Adjusting leader responsibilities could improve workload distribution for better crisis management.
Area of Science:
- Emergency Medicine
- Human Factors Engineering
- Medical Simulation
Background:
- Effective crisis resource management emphasizes balanced workload distribution to prevent team member overload.
- Workload dynamics during pediatric emergencies remain under-researched.
- The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a validated tool for assessing workload across various settings.
Purpose of the Study:
- To evaluate workload levels among team leaders and members during a simulated pediatric sepsis scenario.
- To test the hypothesis that both leaders and members experience moderate to high workloads.
- To compare workload experienced by team leaders versus team members.
Main Methods:
- A multicenter observational study was conducted across nine pediatric simulation centers in the US, Canada, and UK.
- 127 teams participated in a 12-minute simulated pediatric sepsis scenario.
- The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) was administered to 127 team leaders and 253 team members to quantify workload.
Main Results:
- Team leaders reported significantly higher overall workload (51 ± 11) compared to team members (44 ± 13; p < 0.01).
- High workload scores for leaders were concentrated in mental demand (73 ± 13) and effort (66 ± 16).
- Team members experienced moderate workload levels across most domains, with higher physical demand scores than leaders.
Conclusions:
- Both team leaders and members operate under moderate workloads during pediatric sepsis simulations.
- Team leaders experience high mental demand and effort workloads, exceeding the high workload threshold (>60).
- Revising team leader responsibilities may enhance workload distribution and improve overall team performance during pediatric emergencies.
Objectives:
Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members.
Design:
Multicenter observational study.
Setting:
Nine pediatric simulation centers (five United States, three Canada, and one United Kingdom).
Patients:
Team leaders and team members during a 12-minute pediatric sepsis scenario.
Interventions:
National Aeronautics and Space Administration-Task Load Index.
Measurements And Main Results:
One hundred twenty-seven teams were recruited from nine sites. One hundred twenty-seven team leaders and 253 team members completed the National Aeronautics and Space Administration-Task Load Index. Team leader had significantly higher overall workload than team member (51 ± 11 vs 44 ± 13; p < 0.01). Team leader had higher workloads in all subcategories except in performance where the values were equal and in physical demand where team members were higher than team leaders (29 ± 22 vs 18 ± 16; p < 0.01). The highest category for each group was mental 73 ± 13 for team leader and 60 ± 20 for team member. For team leader, two categories, mental (73 ± 17) and effort (66 ± 16), were high workload, most domains for team member were moderate workload levels.
Conclusions:
Team leader and team member are under moderate workloads during a pediatric sepsis scenario with team leader under high workloads (> 60) in the mental demand and effort subscales. Team leader average significantly higher workloads. Consideration of decreasing team leader responsibilities may improve team workload distribution.
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