Transactive memory in trauma resuscitation

ABSTRACT

This paper describes an ethnographic study conducted to explore the possibilities for future design and development of technological support for trauma teams. We videotaped 10 trauma resuscitations and transcribed each event. Using a framework that we developed, we coded each transcript to allow qualitative and quantitative analysis of the trauma teams' collaborative processes. We analyzed teams' tasks, interactions, and communication patterns that support information acquisition and sharing. Our results showed the importance of team transactive memory, but also pointed to inefficiencies in communication processes, which enable the functioning of this collective memory system. Based on quantitative and qualitative observations of trauma teamwork, we present opportunities for technological solutions that may reduce the cognitive effort needed for maintaining the working memory of trauma teams.

REFERENCES

• 1: American College of Surgeons. Advanced Trauma Life Support® (ATLS®), 7th Edition, Chicago, IL, 2005.
• 2: Jakob E. Bardram, Temporal Coordination –On Time and Coordination of CollaborativeActivities at a Surgical Department, Computer Supported Cooperative Work, v.9 n.2, p.157-187, May 2000 [doi>10.1023/A:1008748724225]
• 3: Bergs, E. A. G., Rutten, F. L. P. A., Tadros, T., Krijnen, P., and Schipper, I.B. Communication during trauma resuscitation: Do we know what is happening? Injury 36, 8 (2005), 905--911.
• 4: Clarke, J. R., Hayward, C. Z., Santora, T. A., Wagner, D. K., and Webber, B. L. Computer-generated trauma management plans: Comparisons with actual care. World Journal of Surgery 26, 5 (2002), 536--538.
• 5: Entin, E. E., and Serfaty, D. Adaptive team coordination. Human Factors 41, 2 (1999), 312--325.
• 6: Samer Faraj , Yan Xiao, Coordination in Fast-Response Organizations, Management Science, v.52 n.8, p.1155-1169, August 2006 [doi>10.1287/mnsc.1060.0526]
• 7: Garg, A. X., Adhikari, N. K. J., McDonald, H., Rosas-Arellano, M. P., Devereaux, P. J., et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: A systematic review. JAMA 293, 10, (2005), 1223--1238.
• 8: Abigail S. Gertner , Bonnie L. Webber, TraumaTIQ: Online Decision Support for Trauma Management, IEEE Intelligent Systems, v.13 n.1, p.32-39, January 1998 [doi>10.1109/5254.653222]
• 9: Gruen, R. L., Jurkovich, G. J., McIntyre, L. K., Foy, H. M., and Maier, R. V. Patterns of errors contributing to trauma mortality: Lessons learned from 2594 deaths. Annals of Surgery 244, 3 (2006), 371--380.
• 10: Heath, C., Knoblauch, H., and Luff, P. Technology and social interaction: the emergence of 'workplace studies.' British Journal of Sociology 51, 2, (2000), 299--320.
• 11: Heath, C., and Luff, P. Collaboration and control: Crisis management and multimedia technology in London underground line control rooms. Computer Supported Cooperative Work 11, 1-2 (1992), 69--95.
• 12: Hindmarsh, J., and Pilnick, A. The tacit order to teamwork: Collaboration and embodied conduct in anesthesia. Sociological Quart. 43, 2, (2002), 139--164.
• 13: James Hollan , Edwin Hutchins , David Kirsh, Distributed cognition: toward a new foundation for human-computer interaction research, ACM Transactions on Computer-Human Interaction (TOCHI), v.7 n.2, p.174-196, June 2000 [doi>10.1145/353485.353487]
• 14: Jordan, B., and Henderson, A. Interaction analysis: Foundations and practice. The Journal of Learning Sciences 4, 1 (1995), 39--103.
• 15: Klein, K., Ziegert, J., Knight, A., and Xiao, Y. Dynamic delegation: Shared, hierarchical, deindividualized leadership in extreme action teams. Administrative Science Quarterly 51, 4 (2006), 590--621.
• 16: Moreira, T. Coordination and embodiment in the operating room. Body & Soc. 10, 1 (2004), 109--129.
• 17: Moreland, R. L. Transactive memory and job performance: Helping workers learn who knows what. In J. Levine, L. Thompson, and D. Messick (Eds.), Shared Cognition in Organizations. Mahwah, NJ: Lawrence Erlbaum Assoc. (1996), 3--32.
• 18: Moreland, R. L., and Argote, L. Transactive memory in dynamic organizations. In R. S. Peterson & E. A. Mannix, Leading and Managing People in the Dynamic Organization. Mahwah, NJ: Lawrence Erlbaum Associates (2003), 135--162.
• 19: Madhu Reddy , Paul Dourish, A finger on the pulse: temporal rhythms and information seeking in medical work, Proceedings of the 2002 ACM conference on Computer supported cooperative work, November 16-20, 2002, New Orleans, Louisiana, USA [doi>10.1145/587078.587126]
• 20: Madhu C. Reddy , Patricia Ruma Spence, Collaborative information seeking: A field study of a multidisciplinary patient care team, Information Processing and Management: an International Journal, v.44 n.1, p.242-255, January, 2008 [doi>10.1016/j.ipm.2006.12.003]
• 21: Stewart, R. M., Myers, J. G., Dent, D. L., Ermis, P., Gray, G. A., et al. Seven hundred fifty-three consecutive deaths in a level I trauma center: The argument for injury prevention. J. Trauma 54, 1 (2003), 66--71.
• 22: Svensson, M. S., Heath, C., and Luff, P. Instrumental action: The timely exchange of implements during surgical operations. Proc. ECSCW '07, (2007), 41--60.
• 23: Kim J. Vicente, Cognitive Work Analysis: Towards Safe, Productive, and Healthy Computer-Based Work, L. Erlbaum Associates Inc., Hillsdale, NJ, 1999
• 24: Wegner, D. M. Transactive memory: A contemporary analysis of the group mind. In B. Mullen & G. R. Goethals (Eds.), Theories of Group Behavior, New York: Springer-Verlag (1987), 185--208.
• 25: Xiao, Y., Moss, J. A., Mackenzie, C. F., Seagull, F. J., and Faraj, S. Transactive responsibility systems and high reliability teams: A tentative formulation. Proc. Human Factors & Ergonomics Soc. Conf. 46, (2002), 1428--32.

INDEX TERMS

Primary Classification:
  H. Information Systems
  H.5 INFORMATION INTERFACES AND PRESENTATION (I.7)
      H.5.3 Group and Organization Interfaces
          Subjects: Computer-supported cooperative work

Additional Classification:
  H. Information Systems
  H.1 MODELS AND PRINCIPLES
      H.1.2 User/Machine Systems
          Subjects: Human information processing

General Terms:
Design, Human Factors

Keywords:
cognitive work analysis, communication, distributed cognition, healthcare, teamwork, transactive memory, trauma