Robot-Assisted Surgeries: Technology Changing Team Dynamics

By: Pooja Juvekar & Keaton Fletcher

The introduction of new technology to the workplace can influence the way employees complete their tasks, including how they coordinate with one another. A case study published in the International Journal of Social Robotics (Cunningham, et al., 2013) observed four surgical procedures using the da Vinci surgical system (a robot designed to minimize the invasiveness of surgeries). In these surgeries, the surgeon in physically removed from the patient, operating the robot from a separate console in a different part of the room, or potentially in a different room altogether. By taking one of the leaders of the team and physically removing them from the work environment, and by introducing a technology that necessitates a new set of skills and behaviors from all remaining members, the use of effective communication and coordination becomes increasingly important for teams.

Cunningham and colleagues coded all communications between team members and analyzed it for patterns. Communication could be categorized into three categories: equipment-related, procedure-related, and other communications (e.g., unrelated conversation). Certainly, in non-robot-assisted surgery these same categories may emerge, but the amount/type of equipment-related communication likely differs (e.g., discussing uncertainty with use of the equipment/teaching how to use it). The authors argue that the teams that were more familiar with the da Vinci robot spent a greater percentage of their communications discussing the procedure (roughly 53%), while those who were less familiar with the robot spent a greater percentage discussing the equipment (roughly 55%), specifically uncertainty in use of the equipment (roughly 25%).

Further, because of the central importance of the da Vinci robot in the surgeries, the authors were able define the workflow the surgery, not in terms of the surgery itself, but in terms of interaction with the robot. The authors proposed a five phase procedure: preparation, port placement, docking, console (the phase in which the surgery actually occurs), undocking. Teams did spend a bulk of their time in the console phase, completing the surgery itself, but they also spent a significant portion of time in the preparation phase. The authors found that the less experienced teams spent nearly twice the amount of time in the preparation phase than did the more experienced teams, similarly these teams spent a significant portion of time (25-60 minutes) in the port placement phase, while experienced teams spent less than 10 minutes in this phase.

Although the conclusions one can draw from this study are limited given that it is a case study, it does provide initial evidence that the introduction of new technologies, particularly technologies that radically alter the nature of team interactions and task completion, can fundamentally alter how team members communicate and what they discuss. The data also support a dynamic nature of these communication patterns, such that less experienced teams communicate differently than more expert teams, and take longer in general (given a portion of the procedure time is focused on learning the new technology). For practitioners looking to implement new technology, this suggests that during periods of introduction, teams should be given extra time to complete their tasks, and that interventions to help teams improve communications, maximize learning, and manage their errors effectively may be particularly important. For researchers, this suggests that our models of team dynamics and learning may need to become more complex in order to capture the interplay between learning and team communication that evolves over multiple performance episodes.

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