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A thematic analysis of communication patterns of interprofessional teams during simulated pediatric traumas
Lia Cruz1, Megan Stuhlman2, Crystal Bencken2
1Department of Emergency Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC; Wake Forest School of Medicine, Department of Emergency Medicine, Atrium Health, Carolinas Medical Center, Charlotte, NC.
Insights
Effective communication in pediatric trauma care is crucial for team success. This study identified key communication patterns in simulated trauma events, offering insights to improve team collaboration and patient outcomes.
Area of Science:
- Medical Simulation
- Teamwork and Communication Studies
- Pediatric Emergency Medicine
Background:
- Pediatric trauma care necessitates seamless coordination among ad hoc interprofessional teams.
- Human interactions and institutional culture significantly influence team dynamics but are challenging to quantify.
- Simulated pediatric trauma events provide a controlled environment to study team communication and its impact on patient outcomes.
Purpose of the Study:
- To explore and categorize patterns of interprofessional team communication during simulated pediatric trauma activations.
- To identify communication strategies that enhance or hinder effective teamwork in high-stakes pediatric trauma scenarios.
- To inform future research on improving team communication in critical care settings.
Main Methods:
- An ethnographic qualitative study was conducted, observing 12 simulated pediatric trauma activations.
- Data were collected through observational field notes, structured debriefings, focus groups, and semistructured interviews.
- Recursive thematic analysis was employed to categorize communication patterns and their effectiveness.
Main Results:
- Three primary themes of communication patterns were identified, each with 10 subthemes.
- These themes encompassed communication approaches and mechanisms that either facilitated or impeded team effectiveness.
- Observed communication patterns were consistent across all simulated trauma scenarios.
Conclusions:
- Findings from this ethnography offer a foundation for systematically assessing communication practices in pediatric trauma care.
- Results can guide future simulation studies aimed at improving interprofessional team communication and patient care.
- Implications include integrating communication strategies with existing workflows, training, and fostering psychological safety within teams.
Background:
Pediatric trauma care requires complex coordination and rapid, accurate actions in high-stakes situations by ad hoc interprofessional teams. This teamwork is driven by human interactions and institutional culture, which are difficult constructs to measure. Simulated pediatric traumas offer opportunities to observe team communication practices, understand the landscape of team communications, and explore impacts to simulated patient endpoints.
Methods:
We used an ethnographic approach to conduct a qualitative study of interprofessional team communications. We observed 12 pediatric trauma activations in a simulated environment and used observational field notes, structured debriefings, participant focus groups and semistructured interviews as data sources to allow us to identify and categorize patterns of interprofessional team communications. We used recursive thematic analysis to analyze this qualitative data by transformation of qualitative findings into frequency counts of effective and ineffective examples of team communications across the 12 sessions.
Results:
Three primary themes were identified. Each theme was further defined by 10 subthemes demonstrating observed communication patterns. All identified themes represented approaches to communications or their mechanisms that may have enabled success or presented obstacles to working effectively as a team. The 3 primary themes were observed in all scenarios.
Conclusion:
Results from this ethnography provide the background context to inform systematic assessment of communication practices and drive future translational simulation studies toward impacting interprofessional team communications on patient care. Findings carry implications for linking communications of ad hoc teams to existing workflows, training practices, and psychological safety.
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