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Using epistemic network analysis to identify targets for educational interventions in trauma team communication
Sarah Sullivan1, Charles Warner-Hillard1, Brendan Eagan2
1Department of Surgery, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
Surgery
|February 4, 2018
Summary
Epistemic Network Analysis (ENA) reveals how communication patterns in trauma teams impact performance. Higher-performing teams exhibit stronger connections between information sharing and confirmation, unlike lower-performing teams whose question patterns suggest uncertainty.
Area of Science:
- Medical Education
- Team Communication Analysis
- Simulation-Based Training
Background:
- Epistemic Network Analysis (ENA) models connections within coded data.
- Hypothesized that team discourse structures analyzed by ENA predict trauma team performance quality.
Purpose of the Study:
- To investigate the relationship between team communication patterns and performance quality in trauma resuscitation simulations.
- To determine if ENA can differentiate between high- and low-performing trauma teams based on discourse structure.
Main Methods:
- Utilized the Modified Non-technical Skills Scale for Trauma (T-NOTECHS) to assess performance.
- Coded dialogue from 16 trauma team simulations using Verbal Response Modes (VRM).
- Applied ENA to model connections between VRM codes and compared models of high- and low-scoring teams.
Main Results:
- Significant differences in VRM code connection patterns were observed between high- and low-performing teams (P=.046).
- Higher-scoring teams showed stronger links between stating information and providing acknowledgments/confirmation.
- Lower-scoring teams displayed a stronger connection between asking questions and stating information, indicative of uncertainty.
Conclusions:
- ENA is a valid method for assessing communication in trauma teams.
- Team communication differences, particularly in question usage, distinguish performance levels.
- ENA identifies specific communication targets, like question and information-sharing strategies, for performance improvement.
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