Teamwork is crucial in every industry. But there are a handful of industries where lives are held in the hands of teams. That’s especially the case in healthcare. Surgical and emergency department interdisciplinary teams, among others, are routinely called on to work effortlessly together to save lives. That in itself has many moving parts, but procedures don’t always go as planned and some complications are beyond the clinicians’ control.
What if there’s a power outage? What if a piece of medical equipment stops working? What if a patient reacts negatively to a medication? A more experienced team is able to respond quickly to the disturbance and recover accordingly. A more novice team might take a while to figure out what’s happening, wasting precious time as they re-group.
Jump hosts a number of educational, hands-on simulations to advance the skills of new medical professionals. Our goal is to go a step further and design education and simulation curriculum to develop the best interprofessional teams medicine has to offer. This is being done through a research project called Team Neurodynamics.
Team Neurodynamics is the brainchild of Dr. Ron Stevens and Trysha Galloway of The Learning Chameleon. The project aims to quantitatively model how teams cognitively organize in response to environmental and task changes. This work is achieved by studying the brainwaves of diverse sets of teams as they work through a simulated scenario. Much of the research is taking place right here at Jump.
Our collaborative work has identified what we believe are the physiologic neurodynamic markers of teamwork in new and expert surgical teams going through simulation. These markers could point out when a team is working well together and when they are falling apart. We are now making progress to validate the data against other types of teamwork analysis.
Neurodynamic Vs. Other Assessment Tools
We first compared our neurodynamic markers against language models developed by Georgia Institute of Technology and found there was a strong correlation between how both analyzed teamwork. The next task was determining whether our models matched a qualitative assessment of teamwork using a TeamSTEPPS teamwork evaluation tool.
TeamSTEPPS was developed by the U.S. Department of Defense and the Agency for Healthcare Research and Quality. The program aims to optimize performance among teams of healthcare professionals. It includes the Team Evaluation and Performance Observation Tool (TPOT): a mechanism to evaluate how well a team is communicating, synchronizing, and accomplishing a particular task. Teams are rated on a scale of 1 to 5 on various team performance questions, with 1 being very poor and 5 being excellent. We mapped our neurodynamic markers against this analytic tool for two reasons. The first is to validate our research with EEG data, and the second is to offer our quantitative measures as scientific backing for the tool. As of now, there is no real objective evidence showing that TPOT is statistically accurate in measuring teamwork and synchronization.
We found that our neurodynamic markers matched the scores given in TPOT for novice and experienced teams. Surgical teams with more practice in the operating room communicated well to solve a simulated problem. Newer teams intensely talked, but weren’t communicating in a productive manner. It’s our intent to further analyze TPOT sub-scores to ensure the team performance questions being asked are valuable.
Next Step in Team Neurodynamics
So far a lot of interesting information has resulted from our efforts to study the brainwaves of surgical teams during simulation. Our next round of work includes collecting the brainwave data of novice teams throughout the pre-briefing, simulation, and debriefing process.
Simulation hinges, to some degree, on pre-briefing, so we’ll be interested in the data that comes out of that. It’s our belief that more hands-on and interactive learning takes place during an actual simulation. The debrief phase is where participants synthesize what they have learned and plan how they will improve their actions. We think the neurodynamic markers of the team during pre-brief and debrief will look much different from those mapped in simulation.
The research will include collecting the brainwave data of the educators/debriefers to determine what neurodynamic effect they have on team learning. This information was not gathered in previous simulations. Our hope is to discover patterns of data from the debriefers that we can use to enhance facilitator training and maximize the effectiveness of the debriefing process.
Our ultimate goal with this research is to better inform the way we structure medical education and simulation for learners. This could lead to creating more effective medical teams for all of OSF HealthCare.