title: The collective construction of safety: a trade-off between "understanding" and "doing" in managing dynamic situations.
abstract: This exploratory research aims to understand how teams organize themselves and collectively manage risky dynamic situations. The objective is to assess the plausibility of a model of a collective trade-off between "understanding" and "doing". The empirical study, conducted in the pediatric anesthesia service of a French university hospital, was supported by a "high fidelity" simulation with six teams. Data on the teams' behavior and on the verbal communications were collected through video recordings. The results highlight three modes for management of dynamic situations (determined management, cautious management, and overwhelmed management). These modes are related to the way in which teams manage their cognitive resources. More precisely, they are related to the teams' ability to collectively elaborate a trade-off between "understanding" and "doing". These results question existing perspectives on safety and suggest improvements in the design of crisis management training (concerning for example the recommendation of "calling for help").
authors.affiliation: Laboratoire Paragraphe, Equipe C3U, Université Paris 8, 2 rue de la Liberté, 93526 Saint-Denis Cedex, France. Electronic address: lucie.cuvelier@univ-paris8.fr.
authors.forename: L
authors.initials: L
authors.lastname: Cuvelier
authors.affiliation: Center for Research on Work and Development (CRTD), Cnam, 41 rue Gay Lussac, 75005 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Falzon
mesh_terms: D000776:Anesthesiology; D003142:Communication; D032882:Comprehension; D003198:Computer Simulation; D003299:Cooperative Behavior; D003657:Decision Making; D004630:Emergencies; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008348:Manikins; D008962:Models, Theoretical; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D013598:Systems Theory
keywords: Adaptation; Safety; Teamwork