How do emergency care teams create knowledge ?

We all have some idea of how interaction in the hospital happens. The doctor gives commands to nurses who report back vital signs and the medical history of the patient. The doctor thinks, gives orders, and finally shouts out the diagnoses. Or maybe you envision the doctor to be young and inexperienced and a nurse taking the lead, guiding the doctor, and giving a helping hand with the assessment of the patient’s health? In any case, throughout the assessment decisions have to be made to keep the patient in a stable condition, and at the end a decision has to be made regarding his or her treatment. And that is what I’m presenting at the INGroup conference 2015 in Pittsburgh (PA).

We had two questions in mind when researching the interaction:

What interaction network leads to the quickest creation of knowledge ? 

How can it be created ?

Using an analysis to look at the likelihood of an interaction occurring (relational event analysis; Marcum & Butts, 2015) we reached the following conclusions:

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If this is all too much, just remember this take-away from the research:ingroupv2.019-001

To come full circle and answer our questions, knowledge is most likely created by a sequence of interaction that begin with a question being asked, following by a reply and a series of information allocation events. Once this is over, the team has enough information to summarize and think out loud, and finally make a decision about what to do with the patient. This network is best created by allowing for a call-and-response structure and giving the main nurse room (and responsibility and rewards) to lead the exchange of information (However, this last conclusion may change once the model is accounting better for the different roles in the team).


Bohle Carbonell, K., Könings, K., Marcum, C., Segers, M. & van Merriënboer J. (2015). How do emergence care teams create knowledge. Paper presented at the 10th Annual INGRoup conference, July 23rd - 25th, Pittsburgh (PA)
Marcum, C. & Butts, C (2015). Constructing and Modifying Sequence Statistics for relevent using informR in R. Journal of Statistical Software, 64 (5),

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