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Differences in talking-to-the-room behaviour between novice and expert teams during simulated paediatric resuscitation: a quasi-experimental study
  1. Michael J Burtscher1,
  2. Eva-Maria Jordi Ritz2,
  3. Michaela Kolbe3
  1. 1 Department of Psychology, University of Zurich, Zurich, Switzerland
  2. 2 Department of Anaesthesiology, University Children’s Hospital Basel, Basel, Switzerland
  3. 3 Simulation Center, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Dr Michael J Burtscher, Department of Psychology - Social and Business Psychology, University of Zurich, Zurich 8050, Switzerland; m.burtscher{at}


Background Team coordination represents an important factor for clinical performance. Research in this area suggests that not only behaviour frequencies but also patterns of team coordination constitute a central aspect of teamwork. However, little is known about potential differences in coordination patterns between novice teams (ie, teams of inexperienced members) and expert teams (ie, teams of experienced members). The current study addresses this gap by investigating the use of talking-to-the-room—an important implicit coordination behaviour—in novice teams versus expert teams.

Aim To illustrate differences in coordination behaviour between novice and expert teams. This will provide important knowledge for simulation-based training.

Methods The study was conducted in the context of two resuscitation training courses (introductory course and refresher course) for staff members at a children’s hospital. Volunteers from both courses participated in the study. They were randomly assigned to 16 teams each consisting of one physician and two nurses. The study used a quasi-experimental design with two conditions (novice vs expert). Participants of the introductory course were assigned to the novice condition (eight teams), and participants of the refresher course were assigned to the expert condition (eight teams). All teams completed the same standardised paediatric resuscitation scenario. They were videotaped during the simulation, and team coordination behaviour was coded using Co-ACT.

Results Lag-sequential analysis of 1902 distinct coordination acts revealed that novice teams and expert teams differed significantly in their coordination behaviour. Expert teams were characterised by patterns in which implicit coordination behaviour (ie, talking to the room) was followed by further implicit coordination behaviour and not followed by explicit coordination behaviour (ie, instructions), whereas the reverse was found for novice teams.

Conclusion The current study highlights role of coordination patterns for understanding teamwork in healthcare and provides important insights for team training.

  • teamwork
  • coordination
  • behavioural observation
  • talking-to-the-room
  • team training

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  • Contributors MJB and E-MJR were involved in the planning of this study and prepared the study protocol. MJB analysed the data and drafted the article. E-MJR collected the data and revised the final article. MK helped with the data analyses and the writing of the article, and coded part of the video data.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval "Ethikkommission beider Basel" (now: "EK Nordwest- und Zentralschweiz"), reference number: 68/13.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Original data are not available due to confidentiality issues.

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