In the early nineties, the Air Force achieved a 60% drop in accidents after implementing a program called Crew Resource Management (CRM)training – which emphasizes the “human factor” skills of communication,situational awareness, decision-making and team performance. The pre-CRM cockpit featured a “a traditionally rigid hierarchy with an autocratic captain and subservient flight crew. The cabin crew was not even considered part of the flying team. This tradition closely mirrored the maritime industry’s concept of the captain being “master of the ship.” Since adopting CRM, U.S. air disasters (not related to terrorism) have fallen from approximately 20 per year to one to two per year” ("Sustaining and Advancing Performance Improvements Achieved by CRM" Dynamics Research Corporation). Since that time, aviation professionals reached out to the medical/surgical field where CRM is gaining ground
Medical, surgical and aviation teams operate in high-stakes situations with lives on the line that demand technical precision with little margin for error. Specialists in group dynamics will not be surprised to learn that when mistakes are made within teams – sometimes with catastrophic results - the majority are due to problems in communication within the team and interpersonal issues. A few examples:
- “Communication Failures: An Insidious Contributor to Medical Mishaps” published in the journal Academic Medicine states that “Communication failures are complex and relate to hierarchical differences, concerns with upward influence, conflicting roles and role ambiguity, and interpersonal power and conflict.”
- A study published in The Journal of the American College of Surgery found that “communication in the OR was perceived to be poor by the anesthesiologists, adequate by the OR nurses, and good by the surgeons” revealing a true disconnect among members of the same team.
- Communication skills trainings significantly improved the communication between oncologists and patients that is critical to effective care, and more resources should be allocated to this work, according to a study reported in Lancet.
Read a Crew Resource Management Manual
|Nicholas Wolff, LCSW, BCD, TEP runs a weekly training group|
in Experiential/Action Methods at Lifestage, Inc.