Team communication patterns during real and simulated trauma resuscitation - a social network analysis.

In trauma teams, coordination can be established through a centralised leader. The team can also use a decentralised strategy.In this descriptive study of video-recorded trauma resuscitations, using quantification of qualitative data, Social Network analysis of all real-time communications of eight in-real-life (IRL) and simulated trauma teams explained team social structure.The communication network structures in the simulated scenarios were more centralised using individually directed speech and had a high proportion of communication to up-date all team members. Such a structure might be the result of work performed in a complexity-stripped simulation environment where simplified task-executions required less interactions, or from work revolving around a deteriorating patient, imposing high demands on rapid decision-making and taskwork. Communication IRL was mostly decentralised, with more variability between cases, possibly due to unpredictability of the IRL case. The flexibility to act in a decentralised manner potentiates adaptability and seems beneficial in rapidly changing situations.