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.     

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.     

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.     

混沌理论对优化临床管理模式的启示——以孕产妇管理为例

围绕混沌理论与妊娠及分娩之间的联系,结合实践,提出可行的优化孕产妇管理工作的建议。强调医务人员应应用线上及线下多种方式,于孕前、孕期、产时、产后各阶段,针对孕产妇身心各方面,对其实施系统化的管理;应重点把握与孕妇首次接触的时机,建立信任关系以保证其良好的遵医行为;管理过程中应尊重孕产妇的个体差异,为其提供个性化的指导,同时应重视其支持系统的建立,医疗机构、社区、家庭应为孕产妇提供切实的支持。旨在为孕产期保健工作提供新思路,从而更好地为广大孕产妇服务。     

直觉思维在麻醉临床决策中的应用

围手术期麻醉医师面临问题的复杂性、动态性和模糊性,要求其在具备良好逻辑思维能力的同时,还要学会应用直觉思维来进行麻醉危机管理。通过决策判断的双加工理论模型探讨说明直觉思维在临床麻醉决策中的可应用性,并给出麻醉医师直觉思维的培养途径,提高麻醉医师的思考能力,增加应急处理课程和临床训练,重视临床经验的学习,营造良好的教学氛围。为了在围手术期更好地保证患者的安全,麻醉医师应重视直觉思维在临床麻醉决策中的应用。     

人才伦理学刍议

人才伦理是使人才之所以成为人才的各种伦理要素的总和;人才伦理既是人力资源管理理论的重要内容,也是伦理学特别是人才伦理学的研究对象。人才伦理学的内容主要包括以下五个方面：德与才的关系、人才的道德素质、人才的道德标准、人才的道德环境、人才的道德作用。德与才的关系是人才伦理学所要处理的基本关系,“德才兼备”是人才伦理学的核心范畴。提高人才的道德素质,是人才伦理学所确立的最高目标。人才伦理研究要揭示各类人才在道德要求和道德素质上的共同性和特殊性,为新世纪新阶段我国人才培养工作确立新的人才伦理原则和道德标准。     

中学生时间管理自我监控量表的研究

时间管理自我监控是一个多层次多维度的心理结构,按其抽象程度的不同,可分为整体监控和具体监控两个层次,整体监控系统分为主动性、开放性和有效性三个维度,具体监控系统分为目标设置、时间规划、灵活性、自制力和检查评估五个维度。通过对832名中学生的测试结果进行分析,编制了具有较高信度和效度的中学生时间管理自我监控量表。     

Safer driver responses at intersections with green signal countdown timers

Traffic signal countdown timers (TSCTs) are innovative, practical, and cost effective technologies with the potential to improve safety at signalized intersections. The purpose of these devices is to assist motorists in decision-making at signalized intersections by providing them with real-time signal duration information. This study examines US driver responses in the presence of a green signal countdown timer (GSCT) and the implications those responses have on intersection safety. A driving simulator study was conducted to record driver responses to virtual GSCTs. Fifty-five participants (32 male and 23 female) responded to 1100 simulated traffic signals, half of which had GSCTs. A predictive model was developed and validated to estimate the change in driver’s probability to stop at different distances from the stop line in the presence of a GSCT. The presence of a GSCT increased average driver stopping probability in the dilemma zone by 13.10%, while decreasing average driver deceleration rates by 1.50 ft/s². These results suggest that GSCTs may contribute to improved intersection safety in the US.     

Fat talk and self-presentation of body image: Is there a social norm for women to self-degrade?

The current investigations build upon previous ethnographic research, which identified a social norm for adolescent females to engage in “fat talk” (informal dialogue during which individuals express body dissatisfaction). In Study 1, participants were shown a vignette involving women engaging in fat talk dialogue and were subsequently asked to chose one of three self-presentational responses for a target female: (1) self-accepting of her body, (2) providing no information, or (3) self-degrading about her body. Male and female participants believed the target would be most likely to self-degrade, and that this would lead women to like her, while the self-accepting response would lead men to like her most. Study 2 used the same vignette but participants were asked to respond in an open-ended fashion. Participants again expected the target female to self-degrade. The present findings suggest college students perceive fat talk self-degradation of body image as normative.