title: Utilizing Telemedicine in the Trauma Intensive Care Unit: Does It Impact Teamwork?
abstract: BACKGROUND
  The aim of this study was to examine the impact of a telemedical robot on trauma intensive care unit (TICU) clinician teamwork (i.e., team attitudes, behaviors, and cognitions) during patient rounds.
  
  
  METHODS
  Thirty-two healthcare providers who conduct rounds volunteered to take surveys assessing teamwork attitudes and cognitions at three time periods: (1) the onset of the study, (2) the end of the 30-day control period, and (3) the end of the 30-day experimental period, which immediately followed the control period. Rounds were recorded throughout the 30-day control period and 30-day experimental period to observe provider behaviors. For the initial 30 days, there was no access to telemedicine. For the final 30 days, the rounding healthcare providers had access to the RP-7 robot (Intouch Health Inc., Santa Barbara, CA), a telemedical tool that can facilitate patient rounds conducted away from bedside.
  
  
  RESULTS
  Using a one-tailed, one-way repeated-measures analysis of variance (ANOVA) to compare trust at Times 1, 2, and 3, there was no significant effect on trust: F(2, 14)=1.20, p=0.16. When a one-tailed, one-way repeated-measures ANOVA to compare transactive memory systems (TMS) at Times 1, 2, and 3 was conducted, there was no significant effect on TMS: F(2, 15)=1.33, p=0.15. We conducted a one-tailed, one-way repeated-measures ANOVA to compare team psychological safety at Times 1, 2, and 3, and there was no significant effect on team psychological safety: F(2,15)=1.53, p=0.12. There was a significant difference in communication between rounds with and without telemedicine [t(25)=-1.76, p<0.05], such that there was more task-based communication during telerounds. Telemedicine increased task-based communication and did not negatively impact team trust, psychological safety, or TMS during rounds.
  
  
  CONCLUSIONS
  Telemedicine may offer advantages for some teamwork competencies without sacrificing the efficacy of others and may be adopted by intact rounding teams without hindering teamwork.
authors.affiliation: 1 Department of Human Factors, Embry Riddle Aeronautical University , Datona Beach, Florida.
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Lazzara
authors.affiliation: 2 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine , Armstrong Institute for Patient Safety and Quality, Baltimore, Maryland.|3 Department of Psychology and Institute for Simulation and Training, University of Central Florida , Orlando, Florida.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Benishek
authors.affiliation: 4 Department of Psychology, Wichita State University , Wichita, Kansas.
authors.forename: Brady
authors.initials: B
authors.lastname: Patzer
authors.affiliation: 3 Department of Psychology and Institute for Simulation and Training, University of Central Florida , Orlando, Florida.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Gregory
authors.affiliation: 3 Department of Psychology and Institute for Simulation and Training, University of Central Florida , Orlando, Florida.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Hughes
authors.affiliation: 3 Department of Psychology and Institute for Simulation and Training, University of Central Florida , Orlando, Florida.
authors.forename: Kyle
authors.initials: K
authors.lastname: Heyne
authors.affiliation: 5 Department of Psychology, Rice University , Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Salas
authors.affiliation: 6 William Lehman Injury Research Center, DeWitt Daughtry Family Department of Surgery, Division of Trauma and Surgical Care, University of Miami Miller School of Medicine , Miami, Florida.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Kuchkarian
authors.affiliation: 6 William Lehman Injury Research Center, DeWitt Daughtry Family Department of Surgery, Division of Trauma and Surgical Care, University of Miami Miller School of Medicine , Miami, Florida.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marttos
authors.affiliation: 6 William Lehman Injury Research Center, DeWitt Daughtry Family Department of Surgery, Division of Trauma and Surgical Care, University of Miami Miller School of Medicine , Miami, Florida.
authors.forename: Carl
authors.initials: C
authors.lastname: Schulman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012371:Robotics / Q000295:instrumentation*; D056164:Teaching Rounds / Q000458:organization & administration*; D017216:Telemedicine / Q000706:statistics & numerical data*; D035502:Trust
keywords: emergency medicine/teletrauma; telecommunications; telehealth; telemedicine