This study aims to understand the interaction within cabin crew members and study the teaching methods regarding communication to the cabin crew. For exploring this matter, interviews with two cabin crew instructors were conducted. These interviews have been analysed by using socio-cultural theory on learning, along with relevant theoretic terms to comprehend how interaction and communication between cabin crew members are taught. The interviews with the instructors have been analyzed from a socio-cultural perspective with concepts relevant to the study; language as a tool, crew resource management as a communicative method and mediation, which can be explained as how something is conveyed. By analyzing the interviews and interpreting them from the socio-cultural perspective, three categories were established. These were: teaching environment, crew resource management and safe teaching environment and finally social interaction. The results of the study indicate that one of the most critical factors for teaching communicative skills and the understanding thereof is the numerous years of working experience of the cabin crew instructors. Another crucial result from this study demonstrates that in order to teach communication skills to cabin crew effectively, it may be necessary to re-evaluate the methods in which the subject is instructed to cabin crew as the training program for cabin crew is based mainly on pilot manuals. Onward research in the field may also regard the use of virtual-reality methods through VR-goggles, which is something the respondents briefly explained as an exciting breakthrough in cabin crew teaching methods. / Studiens syfte är att undersöka instruktörers erfarenheter och upplevelser om undervisningen av säkerhetsbärande kommunikation till kabinpersonal i ett flygbolag. För att studera detta har två djupgående intervjuer genomförts med två instruktörer eftersom det är instruktörerna som är ansvariga för att undervisa om kommunikationen som kabinpersonalen senare använder i den dagliga verksamheten. Intervjuerna med instruktörerna genomfördes genom video och/eller telefonsamtal och har därefter analyserats utifrån ett sociokulturellt perspektiv med för studien relevanta begrepp; språket som redskap, crew resource management som kommunikativ metod samt mediering, vilket kan förklaras som hur någonting förmedlas. Med hjälp av att analysera intervjuerna och tolka dem utifrån det sociokulturella perspektivet kunde tre kategorier uppmärksammas: undervisningsmiljö, CRM och trygg undervisningsmiljö samt social interaktion. Studiens resultat visar att en av de viktigaste faktorerna i undervisningen och i synnerhet kommunikation, är instruktörens egen yrkeserfarenhet vilken visat sig viktig för undervisningen om kommunikation. Ett annat viktigt resultat från undersökningen är att den belyser instruktörernas erfarenheter av hur teori och praktik samspelar i undervisningen. Med resultat från denna studie uppmuntras till fortsatta studier om undervisningen för kabinpersonal i syfte att belysa och effektivisera den kommunikation som kabinpersonalen arbetar med dagligen. Ett intressant ämne som framfördes genom intervjuerna med respondenterna är möjligheten att arbeta med VR-glasögon, alltså glasögon som genom en virtuell värld kan återge undervisningsmiljö som annars kan vara svåråtkomlig.

Fel och misstag relaterade till bristande kommunikation och brister i teamarbete sker inom sjukvården, vilket medför ett hot mot patientsäkerheten, framför allt i akuta situationer där snabba beslut måste tas och där liv står på spel. Forskningen visar att det är den mänskliga faktorn som är en bidragande orsak till dessa fel och misstag. Standardiserade arbetssätt, effektivt teamarbete och tydlig kommunikation i teamet krävs för att säkerställa patientsäkerheten. Syfte med föreliggande studie var att beskriva specialistsjuksköterskans upplevelser av interprofessionell teamträning samt hur det påverkar kommunikation och teamarbetet i det kliniska arbetet. Metoden utgjordes av semistrukturerade intervjuer som genomfördes med åtta specialistsjuksköterskor som genomgått interprofessionell medicinsk simulering. Materialet analyserades med hjälp av kvalitativ innehållsanalys med induktiv ansats. Resultatet utmynnade i två teman utifrån studiens tvådelade syfte. Det första temat var upplevelser av simuleringsövningen där följande tre kategorier framkom: lärandemiljö, samverkan i team samt kommunikation. Det andra temat var effekter i det kliniska arbetet där följande tre kategorier framträdde: samverkan i team, kommunikation samt patientsäkerhet. Resultatet visar att specialistsjuksköterskans upplevelser den interprofessionella teamträningen som mycket positiv. Nyttan av att träna och att använda sig av loopkommunikation tillsammans med de andra i teamet belystes. Likaså belystes betydelsen av att ha en tydlig ledare i teamet i det akuta omhändertagande, vilket skapar känslan av delaktighet. Teamledarens uppgift är att skapa en tydlig struktur och ett bra teamarbete runt patienten, vilket ökar patientsäkerheten. Slutsatsen av studien visar att interprofessionell medicinsk simuleringsövning ger en ökad medvetenhet kring vikten av ett välfungerande team med en effektiv kommunikation i det akuta omhändertagandet. Vidare visade det sig att alla specialistsjuksköterskor fått flera verktyg som var användbara i det kliniska arbetet.

During childbirth, multiple providers deliver care at the bedside that requires optimal teamwork and communication to prevent patient harm. The complexity of caring for obstetrical patient demands a well-coordinated team to relay information and respond to conditions that can change quickly during childbirth. A patient safety strategy to prevent perinatal harm is Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) training. TeamSTEPPS is an evidence-based program based on crew resource management (CRM) principles developed in the aviation and military industries. This process improvement project used the Plan-Do-Study-Act framework and Kotter's change theory to implement TeamSTEPPS training after an increase in patient safety events from 2014 to 2016. A convenience sample of 200 physicians, nurses, respiratory therapists, scrub techs, and patient care techs from perinatal units completed the training in a community hospital setting. The Teamwork Perceptions Questionnaire administered pre- and posttraining show a statistical improvement in teamwork, communication, and situational awareness among nursing staff that correlated with a decrease in safety events. Project limitations include lack of a control group for comparison and lack of physician involvement with training. The positive social impact of TeamSTEPPS training is the decrease in maternal and newborn adverse events surrounding childbirth due to perinatal teams using CRM principles. Over the long term, TeamSTEPPs training may become the standard team training method to improve birth outcomes and support the establishment of a patient safety culture, which may be replicated in perinatal centers around the world.

Nästan var tionde patient i den svenska somatiska sjukhusvården drabbas av en vårdskada och som följd har patientsäkerhetsfrågor aktualiserats. Orsaker till brister i patientsäkerheten kan ofta hittas i organisationen eller arbetsplatsens rutiner där bl.a. bristfälliga rutiner för samverkan och kommunikation är vanliga orsaker. Teamarbete är en vanligt förekommande samarbetsform inom vården och byggstenarna i dessa team utgörs av de teammedlemmar som ingår och som för tillfället arbetar tillsammans. Individernas prestationsförmåga styrs av mänskliga psykologiska och fysiologiska begränsningar vilket leder till att misstag och fel är oundvikliga. Ett system som förebygger, fångar upp och mildrar effekten av dessa fel är Crew Resource Management (CRM). Säkerhetskonceptet, med ursprung inom flygindustrin, har under de senaste decennierna börjat etablerats inom hälso- och sjukvården som ett led i arbetet för att öka patientsäkerheten. Avsikten med CRM är att skapa en säkerhetskultur inom organisationen där det finns en medvetenhet om att fel inträffar och att träna hälso- och sjukvårdspersonal i att hantera dessa. CRM-träning fokuserar på att skapa förutsättningar för ett säkert teamarbetet där bl.a. kommunikation, ledarskap, situationsmedvetenhet och problemlösning är viktiga komponenter. Denna träning i kombination med säkerhetsverktyg, som t.ex. checklistor och kommunikationsstrukturer, används i vardagen för att förstärka samarbetet och bidra till att förebygga och fånga upp fel innan någon kommer till skada. Syftet var att belysa effekten av teamträning i Crew Resource Management. Den metod som valdes var forskningsöversikt med avsikt att kartlägga området och att införskaffa kunskap och träning i att på ett strukturerat sätt sammanställa resultaten från publicerade empiriska studier. Forskningsöversikten redovisar forskningsresultat som publicerats mellan åren 2006-2011. Författarna till forskningsöversikten fann att CRM-interventioner påverkade patientsäkerhetskulturen i positiv riktning även om signifikanta förbättringar inte alltid kunde påvisas. Även patientsäkerheten ökade då flera studier kunde påvisa ett förbättrat utfall för patienterna både när det gällde behandlingsprogram och resultat men även minskad mortalitet efter infört CRM-program. Teamträningen hade dessutom påvisbar positiv effekt avseende medvetenheten och benägenheten att rapportera fel samt minskade antalet rapporterade händelser som kunde kopplas till teamarbete och kommunikation. Teamträning i CRM-principer kan på sikt ha en betydande positiv effekt på patientsäkerheten. Att förändra en säkerhetskultur tar tid och för att uppnå full effekt krävs att upprepad utbildning och teamträning är etablerade delar i CRM-initiativet. Dessutom krävs ett stort engagemang från ledningen där erkännande, stöd och uppmuntran är viktiga komponenter för att uppnå önskad förändring.

The accuracy and similarity of team members' perceptions regarding the interdependencies of their task as well as the criticality of teamwork behaviors is essential to team performance. Unfortunately, these perceptions are not always accurate or similar, which has led to calls for research evaluating the effectiveness of interventions aimed at improving these perceptions. The present study evaluated the accuracy and similarity of crew members' perceptions of task interdependence and teamwork in the U.S. railroad industry. Specifically, this study assessed (1) the effect of Crew Resource Management (CRM) training on the accuracy and similarity of locomotive and maintenance of way (MOW) crew members' perceptions and (2), the extent to which the accuracy and similarity of those perceptions are retained 2-years after training. The overall results of the present study suggests that CRM training is effective in increasing the accuracy and similarity of crew members' perceptions of team-relatedness (amount of task interdependence) and perceptions regarding the importance of teamwork. However, the effectiveness is often dependent on the metric used (i.e., accuracy vs. similarity), and the specific characteristics of the crew members (i.e., locomotive vs. MOW, higher vs. lower interpositional experience). Furthermore, the results suggest that training did not increase the accuracy or similarity of crew members' perceptions of team workflow pattern (form of task interdependence). Lastly, a small sample size and low power precluded the running of quantitative statistical analysis assessing the long-term retention of the accuracy and similarity of participants' perceptions of task interdependence or teamwork. However, for the sake of completeness, the means, standard deviations, and effect sizes are presented in the Appendix.

Ambulanssjukvården blir allt viktigare i den moderna akutsjukvården då avancerad akutsjukvård kan utföras i prehospital miljö. World Health Organization menar att bristande kommunikation är orsaken till upp emot 70 procent av alla händelseavvikelser. Kommunikation i teamet har stor betydelse för samarbetet kring den skadade/sjuka patienten. Syftet var att undersöka kommunikation hos ambulansteamet vid simulerade prehospitala patientfall under utbildning i Crew Resource Management (CRM). Urvalet bestod av tolv deltagare där samtliga arbetade inom ambulanssjukvård. Datainsamlingen skedde i samband med ett utbildningsprojekt i ett ambulansdistrikt i södra Sverige och bestod av 12 stycken filmer. Dessa analyserades med hjälp av kvalitativ innehållsanalys med deduktiv ansats. I resultatet framkom tre kategorier utifrån befintliga nyckelord i CRM, adressering, readback och teamsummering. Analysen visar att de flesta fallen blir strukturerade genom kroppsspråk, ögonkontakt, att tala högt, även vid ickeadressering, icke-readback eller icke-teamsummering. Icke-verbal kommunikation såsom kroppsspråk spelar stor roll vid kommunikation i teamet. Ytterligare forskning behövs inom området för att förstå vilka effekter kommunikationen har kopplat till patientsäkerhet i det akuta prehospitala patientomhändertagandet. / Ambulance services are becoming more important in modern emergency medical care as advanced emergency medical care can be carried out in the prehospital environment. According to World Health Organization poor communication causes as much as 70% of all healthcare errors. Communication in the team is of great importance for the teamwork when working with an injured/ill patient. The aim was to study communication in the ambulance team at simulated prehospital cases during an education in Crew Resource Management (CRM). The data selection consisted of twelve participants, all of whom worked in ambulance care. The data collection took place in connection with a training project in an ambulance district in southern Sweden and consisted of 12 films. These were analyzed by means of qualitative content analysis with deductive approach. The results presented three main categories based on existing keywords in CRM, addressing, readback, and team summary. The analysis show that most cases are structured through body language, eye contact, talking loudly, even at non-addressing, non-readback or non-teamsummering. Non-verbal communication like body language plays an important role in communication with the team. Further research is needed in this area to understand what effects the communication is linked to patient safety in the emergency pre-hospital patient care.

With the development and evolution of technology and aviation safety management, the aviation accident rate of the world has been reducing year by year, and the aviation safety situation appears to be improving. Nevertheless, in the analysis of the causes of aviation accidents of local and foreign civil aircrafts happened in recent years, the proportion of the cause being human factors of pilot is as high as 90%. And the two major accidents happened to the Navy in the past 10 years were also related to the human error of pilot. In other words, human factors are is the greatest threats to aviation safety, and should be taken as the core work of aviation safety management in aviation field. The study refers to the literature about the related human factors of the local and foreign civil aircraft and naval aircraft accidents, and takes the SHELL model as the classification criterion of the course structure. As a result, the study has screened and summarized 7 constructs, including ¡§brief introduction of human factors of aviation accidents,¡¨ ¡§aviation physiology of pilot,¡¨ ¡§aviation psychology of pilot,¡¨ ¡§interaction between pilot and other people,¡¨ ¡§relationship between pilot and equipment,¡¨ ¡§relationship between pilot and software,¡¨ and ¡§relationship betweel pilot and environment.¡¨ Under these 7 constructs, the paper designs 60 training subjects. The research approach of the paper adopts two-stage questionnaire survey. In the first stage, aviation experts screened out 7 constructs with 50 more important subjects. After that, survey is made on the helicopter pilots of the Navy and National Airborne Service Corps. Verbal evaluation function is adopted to analyze different constructs as well as the relative weights and sequence of different courses in these constructs. Furthermore, the study develops for the Navy three courses, namely initial training, specialized training and recurrent training, which are applicable to different training targets. Finally, the study refers to the related literature about human factors of civil aviation, and proposes some improvement strategies for the human factors management of naval pilot in order to ensure success of the training of the study. The study sets a 35-hour initial training course, a 26-hour specialized training course, and a 15-hour recurrent training course. Recurrent training course has to be taken regularly every half year. The skill practices of both specialized training and recurrent training can be implemented by the Line Oriented flight training or by the way of role playing so as to let pilots experience their practice in crew resource management. In addition, the study proposes to the Navy some improvement strategies in the aspects of human factors operation doctrine, organization, training and supervision. These improvement strategies and the training courses of the study can be provided to the Navy as a reference for future use in achieving the goal of great improvement on aviation safety.

High-risk industries are operating in an increasingly complex and dynamic environment; this leads to new perspectives on the role of the human operator in the safety management system, encouraging organizations to exploit the uniquely human capabilities of operator teams in order to maintain safe operations. Crew resource management is a popular framework for training operator teams, but has not yet been adapted to accommodate this theoretical development in any major way. Through an action research project within N-USOC, a control room supporting science missions at the International Space Station, a prototypical CRM course is developed for a distributed team working in a complex-dynamic environment, guided by theoretical analysis of safety literature and by the specific needs of the N-USOC context. Adaptive decision making strategies and skills are identified as important success factors for the human operator, along with developing team processes to increase the team capacity for managing safety margins. For N-USOC operators, building this desired adaptive expertise while learning how to manage workload and utilize domain expertise in time-critical situations is especially important. While the development of CRM training for N-USOC is not complete, the study represents a foundation to build upon for the organization, and a theoretical contribution to safety research.

Dissertação (mestrado)—Universidade de Brasília, Instituto de Psicologia, 2017. / Submitted by Albânia Cézar de Melo (albania@bce.unb.br) on 2017-06-28T13:09:12Z No. of bitstreams: 1 2017_SimoneKelliCassiano.pdf: 1551878 bytes, checksum: 068a43020418acad7befc2df3b725d51 (MD5) / Approved for entry into archive by Raquel Viana (raquelviana@bce.unb.br) on 2017-07-28T20:35:03Z (GMT) No. of bitstreams: 1 2017_SimoneKelliCassiano.pdf: 1551878 bytes, checksum: 068a43020418acad7befc2df3b725d51 (MD5) / Made available in DSpace on 2017-07-28T20:35:03Z (GMT). No. of bitstreams: 1 2017_SimoneKelliCassiano.pdf: 1551878 bytes, checksum: 068a43020418acad7befc2df3b725d51 (MD5) Previous issue date: 2017-07-28 / No contexto dinâmico e complexo da aviação, reconhecer os efeitos de treinamentos em Crew Resource Management (CRM) permite aprimorar práticas organizacionais que fortaleçam a segurança operacional. Atendendo a essa demanda, foram conduzidos dois estudos, com os objetivos de: a) revisar a produção na área de avaliação de treinamento, desenvolvimento e educação (TD&E) com ênfase nas questões metodológicas das pesquisas brasileiras; e b) testar um modelo de avaliação de efetividade de treinamento, considerando efeitos diretos e indiretos nas relações entre lócus de controle, estratégias para transferir o adquirido e impacto do treinamento no trabalho. A revisão de literatura apresentou um caráter seletivo e enfocou apenas publicações dos periódicos com expressiva produção em comportamento organizacional que obtiveram classificações superiores a B2 no Sistema Qualis da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Os avanços possíveis que podem ser obtidos principalmente por meio do rigor metodológico no delineamento das pesquisas foram destacados. Os resultados obtidos por meio das análises de regressão lineares usadas na testagem do modelo indicaram que a) indivíduos com níveis mais altos de internalidade reportaram maior percepção do impacto do treinamento no trabalho; e b) efeitos negativos poderão ser anulados se o indivíduo com níveis mais altos de externalidade utilizar estratégias para transferir o adquirido. Assim, tais estratégias exercem um efeito mediador que poderá blindar a influência negativa gerada pelas crenças pessoais relacionadas ao lócus de controle externo. Resultados no contexto da aviação militar poderão ser aprimorados se organizações interessadas em ampliar o impacto do CRM fomentarem o uso de estratégias de aplicação do aprendido. / In the dynamic and complex context of aviation, to recognize effects of Crew Resource Management (CRM) training allows to improve organizational practices that strengthen safety. Meeting that demand, two studies were conducted, aiming to: a) review the literature about evaluation of training, development, and education (TD&E) with emphasis on the methodological questions of Brazilian researches; and b) test a training effectiveness evaluation model, considering direct and indirect effects on the relationship among locus of control, applied learning strategies of training at work and training impact at work. The literature review showed a selective characteristic and focused only articles from journals with an expressive production on organizational behaviour, which obtained better classification than B2 in the evaluation of the Sistema Qualis from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Possible advances that can be obtained through methodological rigor in research designs were highlighted. Results from linear regression analysis used in the test of the proposed model indicated that a) people with higher level of internality reported higher perception of work training impact; and b) negative effects can be nullified if people, with higher levels of externality, use applied learning strategies of training at work. Hence, such strategies have a mediator effect that suggests that their application may block possible negative influence generated by personal beliefs related to external locus of control. Outcomes in military aviation context may be improved if organizations encourage the use of applied learning strategies of training at work, in order to increase the CRM impact.

abstract: ABSTRACT This study sought to inform the curriculum of crew resource management (CRM) for multi-pilot flight deck operations. The CRM curriculum requires continued reexamination to ensure safe flight in the changing demographic of flight decks in the US. The study calls attention to the CRM curriculum’s insufficient inclusion of robust training components to address intercultural communication skills and conflict management strategies. Utilizing a phenomenological approach, the study examined the communicative experiences of African American female military and airline transport pilots on the flight deck and within the aviation industry. Co-cultural theory was used as a theoretical framework to investigate these co-researcher’s (pilots) experiences. A parallel goal of the investigation was to better understand raced and gendered communication as they occur in this specific context—the flight deck of US airlines and military aircraft. The researcher conducted in-depth semi-structured interviews and shadowed two co-researchers (pilots) for a period of days and built a relationship with them over the course of one year. Eight years of preparation working in the airline industry situated the researcher for this study. The researcher collected stories and interviews during this time immersed in industry. The data collected offers initial insights into the experiences of non-dominant group members in this unique organizational environment. The study’s findings are reported in the form of a creative/narrative nonfiction essay. This effort was twofold: (1) the narrative served to generate a record of experiences for continued examination and future research and (2) created useful data and information sets accessible to expert and non-expert audiences alike. The data supports rationalization as a co-cultural communication strategy, a recent expansion of the theory. Data also suggests that another strategy—strategic alliance building—may be useful in expanding the scope of co-cultural theory. The proposed assertive assimilation orientation identifies the intentional construct of alliances and warrants further investigation. / Dissertation/Thesis / Doctoral Dissertation Communication 2015