Team dynamics in emergency surgery teams: results from a first international survey
Authors: Cobianchi Lorenzo , Dal Mas Francesca , Massaro Maurizio , Fugazzola Paola , Coccolini Federico , Kluger Yoram , Leppäniemi Ari , Moore Ernest E. , Sartelli Massimo , Angelos Peter , Catena Fausto , Ansaloni Luca ,   the Team Dynamics Study Group, Abdelmalik Abubaker , Abebe Nebyou Seyoum , Abu-Zidan Fikri M. , Adam Yousif Abdallah Yousif , Adamou Harissou , Agrusa Antonino , Akin Emrah , Alexandrino Henrique , Ali Syed Muhammad , Almeida Pedro Miguel , Amico Francesco , Ammendola Michele , Andreuccetti Jacopo , Aparicio-Sánchez Daniel , Ardito Antonella , Argenio Giulio , Askevold Ingolf Harald , Atanasov Boyko Tchavdarov , Augustin Goran , Awad Selmy Sabry , Bagnoli Carlo , Bains Lovenish , Balalis Dimitrios , Baldini Edoardo , Baraket Oussama , Barone Mirko , Barreras Jorge Arturo , Bellanova Giovanni , Biancuzzi Helena , Bignell Mark Brian , Bini Roberto , Bissacco Daniele , Boati Paoll , Bottari Andrea , Bouliaris Konstantinos , Brillantino Antonio , Buonomo Luis Antonio , Buscemi Salvatore , Calu Valentin , Campo Dall’Orto Riccardo , Carvas Joao Miguel , Casoni Pattacini Gianmaria , Celentano Valerio , Ceresoli Marco , Chirica Mircea , Cianci Pasquale , Cillara Nicola , Cimbanassi Stefania , Cioffi Stefano Piero Bernardo , Colak Elif , Conti Luigi , Dantas Costa Silvia , D’acapito Fabrizio , Damaskos Dimitrios , Das Koray , Davies Richard Justin , De Beaux Andrew Charles , De Simone Belinda , Demetrashvili Zaza , Demetriades Andreas Kyriacou , Denicolai Stefano , Di Buono Giuseppe , Di Carlo Isidoro , Di Saverio Salomone , Diaconescu Bogdan , Dibra Rigers , Dios-Barbeito Sandra , Dogjani Agron , Domanin Maurizio , D’Oria Mario , Duran Munoz-Cruzado Virginia , East Barbora , Ekwen Gerald Takem , Elbaih Adel Hamed , Escalera-Antezana Juan Pablo , Esposito Giuseppe , Farre Roser , Ferrario di Tor Vajana Antonjacopo , Cordeiro Fonseca Vinicius , Forfori Francesco , Fortuna Laura , Fradelos Evangelos , Fraga Gustavo P. , Fransvea Pietro , Gachabayov Mahir , Garcia Vazquez Alain , Ghannam Wagih Mommtaz , Gioco Rossella , Giraudo Giorgio , Giuffrida Mario , Giulii Capponi Michela , Gomes Carlos Augusto , Teixeira Gonsaga Ricardo Alessandro , Gonullu Emre , Goosen Jacques , Goranovic Tatjana , Griffiths Ewen Alexander , Haidar Muad Gamil , Hamid Hytham K. S. , Harddastle Timothy Craig , Hecker Matthias , Hernandez Garcia Edgar Fernando , Cancio Huaman Eduardo , Hutan Martin , Ioannidis Orestis , Isik Arda , Ismail Azzain Mahadi Hamid , Ismail Nizar , Jang Ji Young , Kalipershad Sujala Niatarika Rajsain , Kaplan Lewis J. , Kara Yasin , Karamagioli Evika , Karamarkovia Aleksandar , Kavalakat Alfie J. , Kechagias Aristotelis , Kenig Jakub , Khan Jim S. , Khokha Vladimir , Klappenbach Roberto Felix , Klappenbach Roberto , Kobe Yoshiro , Kong Victor , Korkolis Dimitrios , Kurihara Hayato , Kuriyama Akira , Landaluce-Olavarria Aitor , Licari Leo , Litvin Andrey , Lohsiriwat Varut , Lopes Moreira Claudia Cristina , Lostoridis Eftychios , Tovar Luna Agustín , Luppi Davide , Machain Gustavo Miguel , Maegele Marc , Maggiore Daniele , Maier Ronald V. , Manangi Mallikarjuna , Manetti Andrea , Mantoglu Baris , Mariani Federico , Marinis Athanasios , Sbalcheiro Mariot Evandro Antonio , Martines Gennaro , Martinez Perez Aleix , Mascagni Pietro , Massalou Damien , Bessa Melo Renato , Miceli Luca , Mingoli Andrea , Mishra Tushar S. , Mohamedahmed Ali Yasen Y. , Mohan Rajashekar , Morales-Garcia Dieter , Mustafa Sami Mohamed Siddig , Naimzada Mukhammad David , Negoi Ionut , Nidaw Melkamu Kibret , Nigri Giuseppe , Ogundipe Habeeb Damilola , Oliveri Cristina , Olmi Stefano , Pagani Leonardo , Palomba Giuseppe , Pantalone Desire , Panyko Arpad , Paolillo Ciro , Papis Davide , Pararas Nikolaos , Pata Francesco , Pavone Giovanna , Pecchini Francesca , Pellino Gianluca , Pelloni Maria , Peloso Andrea , Perea Del Pozo Eduardo , Goncalves Pereira Rita , Monteiro Pereira Bruno , Lizarazu Perez Aintzane , Perrone Gennaro , Pesce Antonio , Petracca Giovanni , Piccoli Micaela , Picetti Edoardo , Pikoulis Emmanouil , Pintar Tadeja , Pirozzolo Giovanni , Podda Mauro , Previtali Pietro , Privitera Francesca , Punzo Clelia , Quiodettis Martha Alexa , Qvist Niels , Rahim Razrim , Reinisch-Liese Alexander , Rodriguez-Luna Maria Rita , Roizblatt Daniel , Roscio Francesco Pietro Maria , Rossi Stefano , Sakakushev Boris Evgeniev , Salamea Juan Carlos , Sall Ibrahima , Sammartano Fabrizio , Sanchez Arteaga Alejandro , Sanchez-Cordero Sergio , Sasia Diego , Sawyer Robert G. , Seretis Charalampos , Serradilla-Martin Mario , Shelat Vishal G. , Shlyapnikov Sergei , Lages Simoes Romeo , Siribumrungwong Boonying , Slavchev Mihail , Solaini Leonardo , Soldini Gabriele , Soreide Kjetil , Sydorchuk Larysa , Sydorchuk Ruslan , Syed Ali Muhammad , Tallon-Aguilar Luis , Tan Jih Huei , Tarasconi Antonio , Tartaglia Dario , Tartaglia Nicola , Taylor John , Tebala Giovanni Domenico , Teixeira Gonsaga Ricardo Alessandro , Teuben Michel , Tolonen Matti , Tomasicchio Giovanni , Triantafyllou Tania , Trigiante Giuseppe , Turrado-Rodriguez Victor , Tutino Roberta , Uccelli Matteo , Ugarte-Sierra Bakarne , Ukkonen Mika , Vassiliu Panteleimon G. , Verde Juan Manuel , Veroux Massimiliano , Vilallonga Ramon , Visconti Diego , Waledziak Maciej , Wannatoop Tongporn , Widmer Lukas Werner , Wilson Michael Samuel James , Wong Ting Hway , Xenaki Sofia , Yu Byungchul , Zakaria Andee Dzulkarnaen , Zambrano Diego A. , Zese Monica 
Published: September 2021

Abstract
Background
Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes.

Methods
An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).

Results
Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients’ and stakeholders’ engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego.

Discussion
Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey’s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.