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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychol. | doi: 10.3389/fpsyg.2019.01660

Advancing our understandings of healthcare team dynamics from the simulation room to the operating room

 Ronald Stevens1*, Trysha Galloway2 and Ann Willemsen-Dunlap3
  • 1UCLA David Geffen School of Medicine, United States
  • 2Team Neurodynamics (United States), United States
  • 3Jump Simulation and Education Center, United States

The initial models of team and team member dynamics using biometric data in healthcare will likely come from simulations. But how confident are we that the simulation-derived high resolution dynamics will reflect those of teams working with live patients?
We have developed neurodynamic models of a neurosurgery team while they performed a peroneal nerve decompression surgery on a patient to approach this question. The models were constructed from EEG-derived measures that provided second by second estimates of the neurodynamic responses of the team and team members to task uncertainty.
The anesthesiologist, and two neurosurgeons developed peaks, often coordinated, of elevated neurodynamic organization during the patient preparation and surgery which were similar to those seen during simulation training, and which occurred near important episodes of the patient preparation and surgery.
As the analyses moved down the neurodynamic hierarchy, and the simulation and live patient neurodynamics occurring during the intubation procedure were compared at progressively smaller time scales, differences emerged across scalp locations and EEG frequencies. The most significant was the pronounced suppression of gamma rhythms detected by the frontal scalp sensors during the live patient intubation which was absent in simulation trials of the intubation procedure.
These results indicate that while profiles of the second-by-second neurodynamics of teams were similar in both the simulation and live patient environments, a deeper analysis revealed differences in the EEG frequencies and scalp locations of the signals responsible for those team dynamics.
As measures of individual and team performance become more micro-scale and dynamic, and simulations become extended into virtual environments, these results argue for the need for parallel studies in live environments to validate the dynamic of cognition being observed.

Keywords: healthcare, EEG, team neurodynamics, Intubation, Gamma suppression, Information Theory, simulation

Received: 31 Oct 2018; Accepted: 01 Jul 2019.

Edited by:

Michael Rosen, Johns Hopkins Medicine, United States

Reviewed by:

M. Teresa Anguera, University of Barcelona, Spain
Sadaf Kazi, Johns Hopkins University, United States  

Copyright: © 2019 Stevens, Galloway and Willemsen-Dunlap. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Ronald Stevens, UCLA David Geffen School of Medicine, Los Angeles, 90095, California, United States, immexr@gmail.com