Bias in the trauma bay: A multicenter qualitative study on team communication.

BACKGROUND: Team communication and bias in and out of the operating room have been shown to impact patient outcomes. Limited data exist regarding the impact of communication bias during trauma resuscitation and multidisciplinary team performance on patient outcomes. We sought to characterize bias in communication among health care clinicians during trauma resuscitations. METHODS: Participation from multidisciplinary trauma team members (emergency medicine and surgery faculty, residents, nurses, medical students, emergency medical services personnel) was solicited from verified level 1 trauma centers. Comprehensive semistructured interviews were conducted and recorded for analysis; sample size was determined by saturation. Interviews were led by a team of doctorate communications experts. Central themes regarding bias were identified using Leximancer analytic software (Leximancer Pty Ltd., Brisbane, Australia). RESULTS: Interviews with 40 team members (54% female, 82% White) from 5 geographically diverse Level 1 trauma centers were conducted. More than 14,000 words were analyzed. Statements regarding bias were analyzed and revealed a consensus that multiple forms of communication bias are present in the trauma bay. The presence of bias is primarily related to sex but was also influenced by race, experience, and occasionally the leader's age, weight, and height. The most commonly described targets of bias were females and non-White providers unfamiliar to the rest of the trauma team. Most common sources of bias were White male surgeons, female nurses, and nonhospital staff. Participants perceived bias being unconscious but affecting patient care. CONCLUSION: Bias in the trauma bay is a barrier to effective team communication. Identification of common targets and sources of biases may lead to more effective communication and workflow in the trauma bay. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.

Effective message design targeting college students for the prevention of binge-drinking: basing design on rebellious risk-taking tendency.

This study examined the responses of college students who were exposed to different types of episodic stories related to drinking (gender-consistent vs. gender-inconsistent condition) and their intention to modify risky behavior (binge drinking) based on their rebellious risk-taking tendency. Self-report measures such as intention to modify drinking behavior and reaction to the message were measured. Eighty-two college students between the ages of 19 and 23 years participated in a posttest-only group design experiment. Results suggested that rebellious participants were less afraid of the dangers of binge drinking than those who were low in rebelliousness for the gender-consistent condition. Regardless of the level of rebelliousness, the participants who were in the gender-consistent (increased relevance) condition produced higher recognition scores than those who were in the gender-inconsistent condition. However, the rebellious participants who were in the gender-inconsistent condition exhibited a higher level of intention to change their drinking behavior than did those in the gender-consistent condition.