Forming professional identities on the health care team: discursive constructions of the ‘other’ in the operating room

作者：Lorelei Lingard, Richard K. Reznick, Isabella Devito, Sherry Espin · 发表于：Medical Education · 年份：2002 · DOI：10.1046/j.1365-2923.2002.01271.x · 被引用次数：274 · 研究领域：Interprofessional Education and Collaboration、Patient Safety and Medication Errors、Hospital Admissions and Outcomes

BACKGROUND: Inter-professional health care teams represent the nucleus of both patient care and the clinical education of novices. Both activities depend upon the'talk' that team members use to interact with one another. This study explored team members' interpretations of tense team communications in the operating room (OR). METHODS: The study was conducted using 52 team members divided into 14 focus groups. Team members comprised 13 surgeons, 19 nurses, nine anaesthetists and 11 trainees. Both uni-disciplinary (n = 11) and multi-disciplinary (n = 3) formats were employed. All groups discussed three communication scenarios, derived from prior ethnographic research. Discussions were audio-recorded and transcribed. Using a grounded theory approach, three researchers individually analysed sample transcripts, after which group discussions were held to resolve discrepancies and confirm a coding structure. Using the confirmed code, the complete data set was coded using the 'NVivo' qualitative data analysis software program. RESULTS: There were substantial differences in surgeons', nurses', anaesthetists', and trainees' interpretations of the communication scenarios. Interpretations were accompanied by subjects' depictions of disciplinary roles on the team. Subjects' constructions of other professions' roles, values and motivations were often dissonant with those professions' constructions of themselves. CONCLUSIONS: Team members, particularly novices, tend to simplify and distort ...