2003 IMTA Proceedings - International Military Testing Association

Numerous lessons learned have come out of the TADMUS research for example (e.g., team selfcorrection
training, cross-training) that could directly transition and should yield improved team
performance on the part of aircrews at significantly reduced costs.
Healthcare
Current Practice. It is only within the last few years that the healthcare industry has
placed a significant emphasis on the relationship between teamwork and patient safety. This
new focus was caused by the publication of To Err is Human, a detailed treatise on the
unacceptable levels of system failures within healthcare (Kohn, Corrigan, & Donaldson, 1999).
Since the publication of To Err is Human, several team training interventions have been
introduced. For example, MedTeams TM (Morey, Simon, Jay, Wears, et al., 2002) – a lecture and
discussion-based curriculum – and Anesthesia Crisis Resource Management (ACRM; Gaba,
Howard, Fish, Smith, & Sowb, 2001) – a simulator based curriculum – have been implemented
in a number of private, public, and military hospitals.
Possible Transitions. We believe, relative to aviation, that there are significantly more
opportunities to transition military findings to healthcare, because of the early stage of
development of medical team training. However, and quite interesting from the standpoint of the
discussion here, the healthcare domain has not developed their existing approaches in a vacuum
but rather looked to aviation and not the military for guidance. Although this has led to some
important transitions from aviation, we believe that the more relevant and most useful
information resides in accomplishments made by the military. Specifically, we believe that
healthcare could benefit greatly by examining the work of Cannon-Bowers et al. (1995) on how
team knowledge, skill, and attitude requirements vary by task and team characteristics. Such
research should be used as a basis when identifying medical team competency requirements and
how competency requirements might vary by medical specialty. Second, we believe that many
of the training strategies developed under the TADMUS program could be directly transitioned
to healthcare. Particularly, team self-correction training because of its reliance on team members
to observe, assess, and debrief their own performance. This strategy seems like it would be of
great benefit in medicine where time and cost constraints require practical approaches to
addressing teamwork.
IMPEDIMENTS AND RECOMMENDATIONS
With the continuous reduction in Federal funding for basic and applied research, we
believe that now more than ever it is important for multiple industries to coordinate their efforts
to understand important human performance problems like error, safety, and team performance.
Typically, the impediments for joint efforts are the unique contextual factors that are
characteristic of the teams under investigation; military teams differ from aircrews and medical
teams. However, we believe that teams in high-risk environments likely have more
characteristics in common than not. For example, in all cases the consequences of error are great
and time pressure and high workload are likely.
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45 th Annual Conference of the International Military Testing Association
Pensacola, Florida, 3-6 November 2003