Effective coordination in medical emergency teams: The moderating role of task type

Coordination in health care action teams is an important factor in clinical performance and patient safety. Implementing a high-fidelity in situ simulation study, we investigated the performance-relevant effects of task distribution, provide information without request (PIWR) and closed-loop communication (CLC) in 68 medical emergency teams (METs) composed of fully qualified clinicians. We differentiated between two task types: algorithm-driven and knowledge-driven tasks. We assigned two different emergency tasks to each task type. We proposed not only a direct relationship between the three coordination behaviours and clinical performance, but also a moderating role for the type of task. Only CLC was related to performance and also moderated by task type. There was no relationship between the coordination behaviours task distribution and PIWR and performance. We discuss the differential effects of the three coordination behaviours on performance and emphasize the importance of the task in team research. In particular, we highlight theoretical and practical implications.     

Testing extrinsic and intrinsic motivation as explanatory variables for the safety climate–safety performance relationship among long-haul truck drivers

The paper tests the proposition that the organizational climate-behavior relationship is based primarily on extrinsic motivation induced by climate perceptions. Using safety climate as exemplar, the effect of climate-induced extrinsic motivation was compared with that of engagement-induced intrinsic motivation on safety behavior and subsequent injury outcomes. Using a sample of long-haul truck drivers representing lone employees, (individual-level) safety climate perceptions and employee engagement predicted safety behavior, which mediated their effect on subsequently measured road injury outcomes. Consistent with meta-analytic evidence suggesting a non-symmetric compensatory relationship between extrinsic and intrinsic motivation, high safety climate undermined the effect of engagement on safety behavior with the reverse being true under low safety climate. This resulted in a moderation effect of engagement on the strength of relationship between climate perceptions and safety behavior. Theoretical and practical implications for climate, engagement, and lone work research are discussed.     

Frequency and impact of hands-free telephoning while driving – Results from naturalistic driving data

The frequency and impact of hands-free telephoning while driving was analyzed based on naturalistic driving data from 106 drivers. The results from naturalistic driving data were compared with the results from experimental approaches. The implication of the overall results and the differences across drivers are discussed. Continuous information on the usage of the hands-free phone equipment was available which made it possible to include the entire database (∼1 000 000 km) in a completely automatized analysis. Results show that drivers talked on a hands-free phone about 11% of driving time. There were large differences across drivers in the frequency and usage of a hands-free phone. While telephoning, an adaptation of driving behavior could be found. Drivers slowed down and increased their distance to the lead vehicle. Furthermore, during telephoning, an overall reduction of potentially critical driving situations was found. Overall, the results indicate that compensation for telephoning was carried out with a long-term change of driving behavior, rather than with a short term adaption to the situation.     

The estimation of vehicle speed and stopping distance by pedestrians crossing streets in a naturalistic traffic environment

The ability to estimate vehicle speed and stopping distance accurately is important for pedestrians to make safe road crossing decisions. In this study, a field experiment in a naturalistic traffic environment was conducted to measure pedestrians’ estimation of vehicle speed and stopping distance when they are crossing streets. Forty-four participants (18–45 years old) reported their estimation on 1043 vehicles, and the corresponding actual vehicle speed and stopping distance were recorded. In the speed estimation task, pedestrians’ performances change in different actual speed levels and different weather conditions. In sunny conditions, pedestrians tended to underestimate actual vehicle speeds that were higher than 40 km/h but were able to accurately estimate speeds that were lower than 40 km/h. In rainy conditions, pedestrians tended to underestimate actual vehicle speeds that were higher than 45 km/h but were able to accurately estimate speeds ranging from 35 km/h to 45 km/h. In stopping distance estimation task, the accurate estimation interval ranged from 60 km/h to 65 km/h, and pedestrians generally underestimated the stopping distance when vehicles were travelling over 65 km/h. The results show that pedestrians have accurate estimation intervals that vary by weather conditions. When the speed of the oncoming vehicle exceeded the upper bound of the accurate interval, pedestrians were more likely to underestimate the vehicle speed, increasing their risk of incorrectly deciding to cross when it is not safe to do so.     

A matter of style? Driver attributional ‘style’ in accounting for the driving of others as protective or as predisposing drivers towards retaliatory aggressive driving

Driver cognitions about aggressive driving of others are potentially important to the development of evidence-based interventions. Previous research has suggested that perceptions that other drivers are intentionally aggressive may influence recipient driver anger and subsequent aggressive responses. Accordingly, recent research on aggressive driving has attempted to distinguish between intentional and unintentional motives in relation to problem driving behaviours. This study assessed driver cognitive responses to common potentially provocative hypothetical driving scenarios to explore the role of attributions in driver aggression. A convenience sample of 315 general drivers 16–64 yrs (M = 34) completed a survey measuring trait aggression (Aggression Questionnaire AQ), driving anger (Driving Anger Scale, DAS), and a proxy measure of aggressive driving behaviour (Australian Propensity for Angry Driving AusPADS). Purpose designed items asked for drivers’ ‘most likely’ thought in response to AusPADS scenarios. Response options were equivalent to causal attributions about the other driver. Patterns in endorsements of attribution responses to the scenarios suggested that drivers tended to adopt a particular perception of the driving of others regardless of the depicted circumstances: a driving attributional style. No gender or age differences were found for attributional style. Significant differences were detected between attributional styles for driving anger and endorsement of aggressive responses to driving situations. Drivers who attributed the on-road event to the other being an incompetent or dangerous driver had significantly higher driving anger scores and endorsed significantly more aggressive driving responses than those drivers who attributed other driver’s behaviour to mistakes. In contrast, drivers who gave others the ‘benefit of the doubt’ endorsed significantly less aggressive driving responses than either of these other two groups, suggesting that this style is protective.     

Safety–critical events in everyday cycling – Interviews with bicyclists and video annotation of safety–critical events in a naturalistic cycling study

Research in cycling safety seeks to better understand bicycle-related crashes and injuries. The present naturalistic cycling study contributes to this research by collecting data about bicyclists’ behavior and impressions of safety–critical situations, information unavailable in traditional data sources (e.g., accident databases, observational studies). Naturalistic data were collected from 16 bicyclists (8 female; M = 39.1 years, SD = 11.4 years) who rode instrumented bicycles for two weeks. Bicyclists were instructed to report all episodes in which they felt uncomfortable while riding (subjective risk perception), even if they didn’t fall. After data collection, the bicyclists were interviewed in detail regarding their self-reported safety–critical events. Environmental conditions were also recorded via video (e.g., road surface, weather). In total, 63 safety–critical events (56 non-crashes, 7 crashes) were reported by the bicyclists, mainly due to interactions with other road users – but also due to poorly maintained infrastructure. In low-visibility conditions, vehicle-bicycle and bicycle-bicycle events were the most uncomfortable for the bicyclists. Self-reported pedestrian–bicycle events primarily consisted of pedestrians starting to cross the bicycle path without looking. With one exception, all crashes found in the study belonged to poorly maintained road and infrastructure. In particular, construction work or obstacles in the bicycle path were reported as uncomfortable and annoying by the bicyclists. This study shows how naturalistic data and bicyclists’ interviews together can provide a more informative picture of safety–critical situations experienced by the bicyclist than traditional data sources can.     

The CS-Preexposure Effect in Conditioned Taste-Aversion Learning in Golden Hamsters

In Experiment 1, golden hamsters were injected with either 0.9% saline or the nausea-inducing agent, lithium chloride (LiCL), immediately after consuming a flavored diet that was either novel or familiar. The LiCl-induced aversion was strong in hamsters for which the flavored diet was novel, but no significant aversion was observed in hamsters that were familiar with the flavored diet. In Experiment 2, the strength of the LiCl-induced aversion was related inversely to the amount of conditioned-stimulus (CS) preexposure and directly to the duration of the preexposure-conditioning interval. Thus, although some previous researchers have suggested that hamsters may not demonstrate the CS-preexposure effect in a conditioned taste-aversion paradigm, they clearly did so under the conditions of the present experiments, and moreover, the characteristics of the CS-preexposure effect in hamsters were generally similar to those observed in rats.     

Age-Related Changes in Grip Force and Dynamics of Hand Movement

The authors investigated whether older adults (n = 16; mean age = 65 years) increased grip force to compensate for load force fluctuations during up and down movements more than young adults did (n = 16; mean age = 24 years) and whether older and young adults exhibited similar adaptation of grip force to alterations in friction associated with changes in object surface texture. As previously reported, older adults used a higher level of grip force than young adults during static holding. Increased grip force was observed in the older group during movement. The increase was appropriate to the lower coefficient of friction estimated for the older group. In both groups, grip force was greater with a smooth than with a rough surface (the latter having the higher coefficient of friction) during static holding and during movement. Moreover, grip force modulation was equally well synchronized with load force fluctuation during movement in the two groups. The authors concluded that changes in organization of grip force with age are well adapted to change in hand-object interface properties. Elevated grip force in older adults does not necessarily signify a fundamental change in synchronizing grip force modulation with load force fluctuation.     

The Force/Force-Variability Relationship Under Controlled Temporal Conditions

Previously, an inverted U relationship between force and force variability was demonstrated in both static and dynamic responses. Recent research suggests that the inverted U function may be due to a lack of control of the temporal aspects of the response. To investigate this hypothesis, we examined the relationship between force and force variability in rapid movements under controlled temporal conditions. Subjects (N = 4) made rapid reversal responses with a horizontal lever (using elbow flexion and extension) such that the time to reversal (160 ms) and the distance to reversal (45°) were held constant in each of six load conditions (either 0, .260, .520, .780,1.040, or 1.560 kg added to the lever). When time to reversal and time to peak acceleration were held constant, a curvilinear relationship between force and force variability resulted, suggesting that the inverted U function is related to control of the temporal aspects of the response.     

Preference for Sex of Child Among Primiparous Women

Primiparous American women (N = 140) were questioned during their third trimester concerning their choice of sex of offspring and their willingness to use sex preselection techniques (if available). Eighty-two women expressed no preference for sex of offspring; of the remaining 58, 33 chose girls and 25 chose boys. Of the 26 women who indicated they would have used preselection technology, 13 chose boys and 13 chose girls. Fifty-three percent of the sample indicated they would not have used preselection techniques; 29% were undecided. These results were at variance with earlier studies that indicated a consistent choice of male firstborns, especially in nonpregnant samples. The discrepancy is discussed in terms of a move from boy preference to no preference and a gradual weakening of societal bias against women.