Abstract
Field observation studies can be an important tool during the discovery phase of the scientific process. They enable observers to identify and document patterns of interaction among practitioners, complications that arise and adaptive strategies developed in response to the exigencies of the work environment. We conducted an observational study that examined operating room (OR) team performance during ten lengthy and complex surgical procedures. The study allowed us to identify latent factors that complicate the cognitive and collaborative performance of OR teams and can contribute to adverse events, and the strategies that medical practitioners have developed to coordinate performance and to minimis e the potential for adverse events. The paper describes the methodology employed, presents illustrative results and discusses issues unique to the design and analysis of observational studies. While video recordings were not used in this study, the data analysis method and results are illustrative of exploratory data analysis approaches that lend themselves to video analysis.
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Acknowledgements
This study was funded by the directors of the Risk Management Foundation, Harvard Medical Institutions Controlled Risk Insurance Company (CRICO), professional liability insurance provider to Harvard Medical institutions and physicians. The authors owe thanks to Jack McCarthy, President of the Risk Management Foundation, who supported this work. We also wish to thank the departments of surgery, anesthesia, and nursing and all of the OR personnel who participated in the study, without whose cooperation this research would not have been possible. We also wish to thank Jane Carthey for generously sharing her experiences and insights in conducting observational studies in the OR.
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Roth, E.M., Christian, C.K., Gustafson, M. et al. Using field observations as a tool for discovery: analys ing cognitive and collaborative demands in the operating room. Cogn Tech Work 6, 148–157 (2004). https://doi.org/10.1007/s10111-004-0156-0
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DOI: https://doi.org/10.1007/s10111-004-0156-0