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Beyond “Communication Skills”: Research in Team Communication and Implications for Surgical Education

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Part of the book series: Advances in Medical Education ((AMEDUC,volume 2))

Abstract

Communication is not only descriptive but also constructive of our realities. In social settings such as the surgical team, communication shapes attitudes toward the team’s work, relations among team members, and the complex, coordinated actions that constitute a surgical procedure. Research in the past decade has mapped recurrent patterns of surgical team communication, with critical implications for surgical education in terms of our concept of “the expert surgeon,” our training objectives, and our curriculum design. This chapter presents research that takes a rhetorical perspective on team communication, emphasizing what communication does, the way it shapes understanding and action in social settings. It reviews the research underpinning four key claims about communication, and considers how these claims might inform future efforts in surgical education.

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References

  • Allard, J., Bleakley, A., Hobbs, A., & Vinnell, T. (2007). “Who’s on the team today?” The status of briefing amongst operating theatre practitioners in one UK hospital. Journal of Interprofessional Care, 21(2), 189–206.

    Article  Google Scholar 

  • Altpeter, T., Luckhardt, K., Lewis, J. N., Harken, A. H., & Polk, H. C. (2007). Expanded surgical time out: a key to real-time data collection and quality improvement. Journal of the American College of Surgeons, 204(4), 527–532.

    Article  Google Scholar 

  • Awad, S. S., Fagan, S. P., Bellows, C., Albo, D., Green-Rashad, B., De La Garza, M., et al. (2005). Bridging the communication gap in the operating room with medical team training. American Journal of Surgery, 190(5), 770–774.

    Article  Google Scholar 

  • Backster, A., Teo, A., Swift, M., Polk, H., & Harken, A. (2007). Transforming the surgical “time-out” into a comprehensive “preparatory pause”. Journal of Cardiac Surgery, 22(5), 410–416.

    Article  Google Scholar 

  • Bradbury-Jones, C., Sambrook, S., & Irvine, F. (2007). Power and empowerment in nursing: a fourth theoretical approach. Journal of Advanced Nursing, 62(2), 258–266.

    Article  Google Scholar 

  • Brown, W. (2005). Freedom’s silences. In Edgework: critical essays on knowledge and politics (pp. 83–98). Princeton: Princeton University Press.

    Google Scholar 

  • Burke, K. (1966). Language as symbolic action: essays on life, literature and method. Berkeley: University of California Press.

    Google Scholar 

  • Burke, K. (1969). A rhetoric of motives. Berkeley: University of California Press. (Original work published 1950).

    Google Scholar 

  • Colletti, L., Gruppen, L., Barclay, M., & Stern, D. (2001). Teaching students to break bad news. American Journal of Surgery, 182(1), 20–23.

    Article  Google Scholar 

  • Dayton, E., & Henriksen, K. (2007). Communication failure: basic components, contributing factors, and the call for structure. Joint Commission Journal on Quality and Patient Safety, 33(1), 34–47.

    Google Scholar 

  • Dias, P., & Pare, A. (Eds.) (2000). Transitions: writing in academic and workplace settings. Cresskill: Hampton Press.

    Google Scholar 

  • Espin, S., & Lingard, L. (2001). Time as a catalyst for tension in nurse-surgeon communication. AORN Journal, 74(5), 672–682.

    Article  Google Scholar 

  • Flin, R., Yule, S., McKenzie, L., Paterson-Brown, S., & Maran, N. (2006). Attitudes to teamwork and safety in the operating theatre. Surgeon Journal of the Royal Colleges of Surgeons of Edinburgh & Ireland, 4(3), 145–151.

    Article  Google Scholar 

  • France, D. J., Leming-Lee, S., Jackson, T., Feistritzer, N. R., & Higgins, M. S. (2008). An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training. American Journal of Surgery, 195(4), 546–553.

    Article  Google Scholar 

  • Gardezi, F., Lingard, L., Espin, S., Whyte, S., Orser, B., & Baker, G. R. (2009). Silence, power and communication in the operating room. Journal of Advanced Nursing, 65(7), 1390–1399.

    Article  Google Scholar 

  • Gettman, M. T., Pereira, C. W., Lipsky, K., Wilson, T., Arnold, J. J., Leibovich, B. C., et al. (2009). Use of high fidelity operating room simulation to assess and teach communication, teamwork and laparoscopic skills: initial experience. The Journal of Urology, 181(3), 1289–1296.

    Article  Google Scholar 

  • Gillespie, B. M., Wallis, M., & Chaboyer, W. (2007). Operating theater culture: implications for nurse retention. Western Journal of Nursing Research, 30(2), 259–277.

    Article  Google Scholar 

  • Glenn, C. (2004). Unspoken: a rhetoric of silence. Carbondale: Southern Illinois University Press.

    Google Scholar 

  • Haynes, A. B., Weiser, T. G., Berry, W. R., Libsitz, S. R., Breizat, A.-H. S., Dellinger, E. P., et al. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. The New England Journal of Medicine, 360(5), 491–499.

    Article  Google Scholar 

  • Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (2004). Universal protocol for preventing wrong site, wrong procedure, wrong person surgery. www.jointcommission.org/PatientSafety/UniversalProtocol/. Accessed 26 Sept 2008.

  • Katz, P. (1999). Scalpel’s edge: the culture of surgeons. Boston: Allyn and Bacon.

    Google Scholar 

  • Kennedy, T. J. T., Regehr, G., Baker, G. R., & Lingard, L. (2008). Point-of-care assessment of medical trainee competence for independent clinical work. Academic Medicine, 83(10), S89–S92.

    Article  Google Scholar 

  • Lave, J., & Wenger, E. (1991). Situated learning: legitimate peripheral participation. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality & Safety in Health Care, 13(Suppl 1), i85–i90.

    Article  Google Scholar 

  • Linde, C. (2009). Noisy silences. Stories not told. In C. Linde (Ed.), Working the past: narrative and institutional memory. New York: Oxford University Press.

    Chapter  Google Scholar 

  • Lingard, L. (2007). The rhetorical ‘turn’ in medical education: what have we learned and where are we going? Advances in Health Sciences Education, 12(2), 121–133.

    Article  Google Scholar 

  • Lingard, L., & Haber, R. J. (1999). Teaching and learning communication in medicine: a rhetorical approach. Academic Medicine, 74(5), 507–510.

    Article  Google Scholar 

  • Lingard, L., Reznick, R., DeVito, I., & Espin, S. (2002). Forming professional identities on the healthcare team: discursive constructions of the ‘other’ in the operating room. Medical Education, 36(8), 728–734.

    Article  Google Scholar 

  • Lingard, L., Reznick, R., Espin, S., DeVito, I., & Regehr, G. (2002). Team communication in the operating room: talk patterns, sites of tension, and implications for novices. Academic Medicine, 77(3), 232–237.

    Article  Google Scholar 

  • Lingard, L., Garwood, S., & Poenaru, D. (2004). Tensions influencing operating room team function: does institutional context make a difference? Medical Education, 38(7), 691–699.

    Article  Google Scholar 

  • Lingard, L., Espin, S., Whyte, S., Regehr, G., Baker, R., Orser, B., et al. (2004). Communication failures in the operating room: an observational classification of recurrent types and outcomes. Quality and Safety in Healthcare, 13(5), 330–334.

    Article  Google Scholar 

  • Lingard, L., Regehr, G., Espin, S., DeVito, I., Whyte, S., Buller, D., et al. (2005). Perceptions of operating room tension across professions: building generalizable evidence and educational resources. Academic Medicine, 80(10 Suppl), S75–S79.

    Article  Google Scholar 

  • Lingard, L., Regehr, G., Orser, B., Reznick, R., Baker, G. R., Doran, D., et al. (2008). Evaluation of a preoperative checklist and team briefing among surgeons, nurses, and anesthesiologists to reduce failures in communication. Archives of Surgery, 143(1), 12–17.

    Article  Google Scholar 

  • Lingard, L., Whyte, S., Regehr, G., & Gardezi, F. (2009). Counting silence: complexities in the evaluation of team communication. In R. Flin & L. Mitchell (Eds.), Safer surgery: analysing behaviour in the operating theatre. Aldershot: Ashgate.

    Google Scholar 

  • Lingard, L., Regehr, G., Cartmill, C., Orser, B., Espin, S., Bohnen, J., et al. (2011). Evaluation of a preoperative team briefing: a new communication routine results in improved clinical practice. BMJ Quality and Safety, 20(6), 475–482.

    Google Scholar 

  • Makary, M. A., Sexton, J. B., Freischlag, J. A., Holzmueller, C. G., Millman, E. A., Rowen, L., 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(5), 746–752.

    Article  Google Scholar 

  • Manias, E., & Street, A. (2001). Nurse-doctor interactions during critical care ward rounds. Journal of Clinical Nursing, 10(4), 442–450.

    Article  Google Scholar 

  • Marshall, D. A., & Manus, D. A. (2007). A team training program using human factors to enhance patient safety. AORN Journal, 86(6), 994–1011.

    Article  Google Scholar 

  • Mazzocco, K., Petitti, D. B., Fong, K. T., Bonacum, D., Brookey, J., Graham, S., et al. (2009). Surgical team behaviors and patient outcomes. American Journal of Surgery, 197(5), 678–685.

    Article  Google Scholar 

  • Moulton, C. A., Regehr, G., Lingard, L., & McRae, H. (2010). Operating from the other side of the table: control dynamics and the surgeon educator. Journal of the American College of Surgeons, 210, 79–86.

    Article  Google Scholar 

  • Paige, J. T., Kozmenko, V., Yang, T., Gururaja, R., Hilton, C. W., Cohn, I., et al. (2009). High-fidelity, simulation-based interdisciplinary operating room team training at the point of care. Surgery, 145(2), 138–146.

    Article  Google Scholar 

  • Riley, R., & Manias, E. (2005). Rethinking theatre in modern operating rooms. Nursing Inquiry, 12(1), 2–9.

    Article  Google Scholar 

  • Rivers, R. M., Swain, D., & Nixon, W. R. (2003). Using aviation safety measures to enhance patient outcomes. AORN Journal, 77(1), 158–162.

    Article  Google Scholar 

  • Rosenbaum, M. E., Ferguson, K. J., & Lobas, J. G. (2004). Teaching medical students and residents skills for delivering bad news: a review of strategies. Academic Medicine, 79(2), 107–117.

    Article  Google Scholar 

  • Rosenberg, A. D., Wambold, D., Kraemer, L., Begley-Keyes, M., Zuckerman, S. L., Singh, N., et al. (2008). Ensuring appropriate timing of antimicrobial prophylaxis. The Journal of Bone and Joint Surgery, 90(2), 226–232.

    Article  Google Scholar 

  • Saville-Troike, M. (1985). The place of silence in an integrated theory of communication. In D. Tannen & M. Saville-Troike (Eds.), Perspectives on silence (pp. 3–21). Norwood: Ablex Publishing Corporation.

    Google Scholar 

  • Saville-Troike, M. (2003). The ethnography of communication: an introduction (3rd ed.). Malden: Blackwell Publishing.

    Book  Google Scholar 

  • Schryer, C. F. (1993). Records as genre. Written Communication, 10(2), 200–243.

    Article  Google Scholar 

  • Schryer, C. F., Lingard, L., & Spafford, M. M. (2005). ‘Techne’ or artful science and the genre of case presentations in healthcare settings. Communication Monographs, 72(2), 234–260.

    Article  Google Scholar 

  • Sexton, J. B., & Helmreich, R. L. (2000). Analyzing cockpit communications: the links between language, performance, error, and workload. Journal of Human Performance in Extreme Environments, 5(1), 63–68.

    Google Scholar 

  • Whyte, S., Lingard, L., Reznick, R., Doran, D., Orser, B., Cartmill, C., et al. (2009). Uptake of a team briefing in the operating theatre: a burkean dramatistic analysis. Social Science & Medicine, 69(12), 1757–1766.

    Article  Google Scholar 

  • World Health Organization. (2008). Implementation manual: surgical safety checklist. www.who.int/patientsafety/safesurgery/ss_checklist/en/index.html. Accessed 25 Sept 2008.

  • Yule, S., Flin, R., Maran, N., Rowley, D., Youngson, G., & Paterson-Brown, S. (2008). Surgeons’ non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system. World Journal of Surgery, 32(4), 548–556.

    Article  Google Scholar 

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Correspondence to Lorelei Lingard .

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Lingard, L. (2011). Beyond “Communication Skills”: Research in Team Communication and Implications for Surgical Education. In: Fry, H., Kneebone, R. (eds) Surgical Education. Advances in Medical Education, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-1682-7_12

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  • DOI: https://doi.org/10.1007/978-94-007-1682-7_12

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