Skip to main content
SpringerLink
Log in
Book cover

Advancing Surgical Education pp 279–288Cite as

Developing Surgical Teams: Theory

  • Chapter
  • First Online:

Part of the book series: Innovation and Change in Professional Education ((ICPE,volume 17))

Overview

Although excellence in the care of a surgical patient depends in part on the medical knowledge and technical skill of the surgeon, such attributes are not necessarily sufficient. In addition, the expert functioning of the teams working with the surgeon in the perioperative setting is critical to a successful outcome. Developing highly reliable surgical teams, therefore, is essential for safe, effective patient care. Unfortunately, more often than not, surgical teamwork falls short of this ideal. For the surgical educator, the challenge thus becomes overcoming ingrained patterns of detrimental behavior among practicing clinicians and inculcating students in team-based competencies that will improve the quality of care. (S)he can meet such a challenge by adopting human factors (HF) principles when teaching and training inter-professional teams. The next two chapters will discuss how to develop such an approach by first addressing the theoretical underpinnings of HF concepts in the present chapter, then by demonstrating applications of these concepts to promote highly reliable team function in general and using a specific example. In doing so, they will combine to address the following objectives: (1) discussing the role of HF in promoting safe surgical care, (2) applying HF concepts to develop highly reliable surgical teams, and (3) illustrating such an application through a discussion of the development of simulation-based team training in surgery at LSU Health New Orleans Health Sciences Center.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Densen, P. (2011). Challenges and opportunities facing medical education. Transactions of the American Clinical and Climatological Association, 122, 48–58.

    Google Scholar 

  2. Greiner, A. C., & Knebel, E. (Eds.). (2003). Health professions education: A bridge to quality. Washington, DC: Institute of Medicine, National Academies Press.

    Google Scholar 

  3. IOM (Institute of Medicine). (2010). Redesigning continuing education in the health professions. Washington, DC: The National Academies Press.

    Google Scholar 

  4. Anonymous. What is human factors and ergonomics? Benchmark Research & Safety, Inc. http://www.benchmarkrs.com/main/human-factors/what.aspx. Accessed 20 Jan 2017.

  5. Adams, D. (2006). A layman’s introduction to human factors in aircraft accident and incident investigation. Australian Transport Safety Bureau (ATSB) Safety Information Paper. B2006/0094. Canberra City, ACT.

    Google Scholar 

  6. Christensen, J. M., Topmiller, D. A., & Gill, R. T. (1988). Human factors definitions revisited. Human Factors Society Bulletin, 31, 7.

    Google Scholar 

  7. Reason, J. (2005). Safety in the operating theatre – part 2: Human error and organisational failure. Quality & Safety in Health Care, 14, 56–60.

    Article  Google Scholar 

  8. Cafazzo, J. A., & St-Cyr, O. (2012). From discovery to design: The evolution of human factors in healthcare. Healthcare Quarterly, 15, 24–29.

    Article  Google Scholar 

  9. Fackler, M.. Nuclear disaster in Japan was avoidable, critics contend. New York Times, 3/9/2012. http://www.nytimes.com/2012/03/10/world/asia/critics-say-japan-ignored-warnings-of-nuclear-disaster.html?_r=0. Accessed 3 Feb 2017.

  10. US Chemical Safety and Hazard Investigation Board. (2014). Investigation report: Explosion and fire at the Macondo well 1 and 2 (Report No. 2010-10-I-OS). Washington, DC.

    Google Scholar 

  11. Associated Press. Third wrong-sided brain surgery at R.I. hospital. http://www.msnbc.msn.com/id/21981965. Accessed 28 Nov 2016.

  12. Gawron, V. J., Drury, C. G., Fairbanks, R. J., & Berger, R. C. (2006). Medical error and human factors engineering: Where are we now? American Journal of Medical Quality, 21, 57–67.

    Article  Google Scholar 

  13. Weinger, M. B., & Gaba, D. M. (2014). Human factors engineering in patient safety. Anesthesiology, 120(4), 801–806.

    Article  Google Scholar 

  14. The Eras Society. http://www.erassociety.org/. Accessed 28 Nov 2016.

  15. Haynes, A. B., Weiser, T. G., Berry, W. R., Lipsitz, S. R., Breizat, A. H., Dellinger, E. P., Herbosa, T., Joseph, S., Kibatala, P. L., Lapitan, M. C., Merry, A. F., Moorthy, K., Reznick, R. K., Taylor, B., Gawande, A. A., & Safe Surgery Saves Lives Study Group. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. The New England Journal of Medicine, 360, 491–499.

    Article  Google Scholar 

  16. Joint Commission. The universal protocol for preventing wrong site, wrong procedure, wrong person surgeryTM. The Joint Commission. http://www.jointcommission.org/assets/1/18/UP_Poster.pdf. Accessed 20 Jan 2017.

  17. Nolan, T. W. (2000). System changes to improve patient safety. BMJ, 320, 771–773.

    Article  Google Scholar 

  18. Weick, K. E., & Sutcliffe, K. M. (2001). Managing the unexpected: Assuring high performance in the age of complexity. San Francisco: Jossey-Bass.

    Google Scholar 

  19. Westrum, R. (2004). A typology of organisational cultures. Quality & Safety in Health Care, 13(Suppl 2), ii22–ii27.

    Google Scholar 

  20. Cheremisinoff, N. P., & Davletshin, A. (2010). Emergency response Management of Offshore oil Spills: Guidelines for emergency responders. Hoboken: Wiley.

    Book  Google Scholar 

  21. 2014 User Comparative Database Report. Content last reviewed March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/hospital/2014/index.html.

  22. Runciman, B., & Walton, M. (2007). Safety and ethics in healthcare: A guide to getting it right. Aldershot: Ashgate.

    Google Scholar 

  23. Kotter, J. P. (1996). Leading change. Boston: Harvard Business School Press.

    Google Scholar 

  24. Mohr, J. J., & Batalden, P. B. (2002). Improving safety on the front lines: The role of clinical microsystems. Quality & Safety in Health Care, 11, 45–50.

    Article  Google Scholar 

  25. Sanchez, J. A., & Barach, P. R. (2012). High reliability organizations and surgical microsystems: Re-engineering surgical care. Surgical Clinics of North America, 92, 1–14.

    Article  Google Scholar 

  26. Salas, E., Sims, D. E., & Burke, C. S. (2005). Is there a big five in teamwork? Small Group Research, 36, 555–599.

    Article  Google Scholar 

  27. Agency for Healthcare Research and Quality. Team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS)TM. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/index.html. Accessed 3 Feb 2017.

  28. Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149–154.

    Article  Google Scholar 

  29. Bleakley, A. (2006). You are who I say you are: The rhetorical construction of identity in the operating theatre. Journal of Workplace Learning, 18(7–8), 414–425.

    Article  Google Scholar 

  30. Bleakley, A., Boyden, J., Hobbs, A., Walsh, L., & Allard, J. (2006). Improving teamwork climate in operating theatres: The shift from multiprofessionalism to interprofessionalism. Journal of Interprofessional Care, 20(5), 461–470.

    Article  Google Scholar 

  31. Burke, C. S., Salas, E., Wilson-Donnelly, K., et al. (2004). How to turn a team of experts into an expert medical team: Guidance from the aviation and military communities. Quality & Safety in Health Care, 13(Suppl 1), i96–i104.

    Article  Google Scholar 

  32. Helmrich, R. L., & Davies, J. M. (1994). Team performance in the operating room. In M. S. Bogner (Ed.), Human error in medicine (pp. 225–253). Hillside: Erlbaum.

    Google Scholar 

  33. Nakarada-Kordic, I., Weller, J. M., Webster, C. S., Cumin, D., Frampton, C., Boyd, M., & Merry, A. F. (2016). Assessing the similarity of mental models of operating room team members and implications for patient safety: A prospective, replicated study. BMC Medical Education, 16(1), 229.

    Article  Google Scholar 

  34. Makary, M. A., Sexton, J. B., Freischlag, J. A., et al. (2006). Operating room teamwork among physicians and nurses: Teamwork in the eye of the beholder. Journal of the American College of Surgeons, 202, 746–752.

    Article  Google Scholar 

  35. Nestel, D., & Kidd, J. M. (2006). Nurses’ perceptions and experiences of communication in the operating theatre: A focus group interview. BMC Nursing, 5, 1.

    Article  Google Scholar 

  36. Lingard, L., Garwood, S., & Poenaru, D. (2004). Tensions influencing operating room team function: Does institutional context make a difference? Medical Education, 38, 691–699.

    Article  Google Scholar 

  37. Schlitzkus, L. L., Agle, S. C., McNally, M. M., et al. (2009). What do surgical nurses know about surgical residents? Journal of Surgical Education, 66(6), 383–391.

    Article  Google Scholar 

  38. Nagpal, K., Vats, A., Lamb, B., Ashrafian, H., Sevdalis, N., Vincent, C., & Moorthy, K. (2010). Information transfer and communication in surgery: A systematic review. Annals of Surgery, 252(2), 225–239.

    Article  Google Scholar 

  39. Yule, S., & Paterson-Brown, S. (2012). Surgeons’ non-technical skills. The Surgical Clinics of North America, 92(1), 37–50.

    Article  Google Scholar 

  40. ElBardissi, A. W., Regenbogen, S. E., Greenberg, C. C., et al. (2009). Communication practices on 4 Harvard surgical services: A surgical safety collaborative. Annals of Surgery, 250(6), 861–865.

    Article  Google Scholar 

  41. Antoniadis, S., Passauer-Baierl, S., Baschnegger, H., & Weigl, M. (2014). Identification and interference of intraoperative distractions and interruptions in operating rooms. The Journal of Surgical Research, 188(1), 21–29.

    Article  Google Scholar 

  42. Wheelock, A., Suliman, A., Wharton, R., Babu, E. D., Hull, L., Vincent, C., Sevdalis, N., & Arora, S. (2015). The impact of operating room distractions on stress, workload, and teamwork. Annals of Surgery, 261(6), 1079–1084.

    Article  Google Scholar 

  43. Weigl, M., Antoniadis, S., Chiapponi, C., Bruns, C., & Sevdalis, N. (2015). The impact of intra-operative interruptions on surgeons’ perceived workload: An observational study in elective general and orthopedic surgery. Surgical Endoscopy, 29(1), 145–153.

    Article  Google Scholar 

  44. Weigl, M., Stefan, P., Abhari, K., Wucherer, P., Fallavollita, P., Lazarovici, M., Weidert, S., Euler, E., & Catchpole, K. (2016). Intra-operative disruptions, surgeon’s mental workload, and technical performance in a full-scale simulated procedure. Surgical Endoscopy, 30(2), 559–566.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA, USA

    John T. Paige

Authors
  1. John T. Paige
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John T. Paige .

Editor information

Editors and Affiliations

  1. Faculty of Medicine, Nursing & Health Sciences, Monash Institute for Health and Clinical Education, Monash University, Clayton, VIC, Australia, Faculty of Medicine Dentistry & Health Sciences, Department of Surgery, Melbourne Medical School, University of Melbourne, Parkville, Australia

    Debra Nestel

  2. Faculty of Medicine, Imperial College London, London, UK

    Kirsten Dalrymple

  3. Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA, USA

    John T. Paige

  4. Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA, Jefferson Strategic Ventures, Jefferson Health, Philadelphia, PA, USA

    Rajesh Aggarwal

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Paige, J.T. (2019). Developing Surgical Teams: Theory. In: Nestel, D., Dalrymple, K., Paige, J., Aggarwal, R. (eds) Advancing Surgical Education. Innovation and Change in Professional Education, vol 17. Springer, Singapore. https://doi.org/10.1007/978-981-13-3128-2_25

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-3128-2_25

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-3127-5

  • Online ISBN: 978-981-13-3128-2

  • eBook Packages: EducationEducation (R0)

Publish with us

Policies and ethics

Search

Navigation