Date of Award

Summer 2020

Access Type

Dissertation - Open Access

Degree Name

Doctor of Philosophy in Human Factors

Department

Human Factors and Behavioral Neurobiology

Committee Chair

Elizabeth H. Lazzara

First Committee Member

Joseph R. Keebler

Second Committee Member

Barbara S. Chaparro

Third Committee Member

Beatrice Podtschaske

Fourth Committee Member

Elizabeth Phillips

Abstract

The practice of delivering surgical care has evolved to be less invasive to the patients undergoing surgery. Minimally-invasive surgery can be practiced through traditional laparoscopic methods as well as with robotic technology that displaces the surgeon from the operating table. Robotic surgery has been cited to be safer and more effective than traditional laparoscopic surgery; however, little research has endeavored to investigate the role of surgical modality upon aspects of teamwork. This dissertation contributes to the human factors and teamwork literature by evaluating how surgical modality may influence communication, shared leadership, and team outcomes. Multiple methods were employed to study robotic and non-robotic (i.e., open and laparoscopic) surgical teams. Teams were evaluated through video analysis of surgical procedures as well as questionnaire methods. The results of this research revealed very few modality-specific differences which may represent the adaptive nature of teams and individuals. Robotic surgical team members did not perceive a statistically significant difference in communication quality which may indicate that the impact of the closed console design may be relatively benign in this regard. While there were no statistically significant differences between the degree to which robotic and non-robotic teams shared or perceived shared leadership, there were interesting role and leadership behavior type differences. For instance, the assists conducted significantly more leadership in robotic surgery than in laparoscopic surgery. In the video data, sharing leadership to a greater extent led to shorter operative durations. In the survey data, higher perceptions of communication quality and communication behavior significantly predicted higher perceptions of team effectiveness, indicating a strong positive relationship between perceived communication and perceived effectiveness. As robotic surgical systems and practices continue to inevitably advance in the coming years, developers should be keenly aware of the interdependencies between all aspects of the sociotechnical system including the providers and recipients of care, the environment and organization, and the tools and technologies.

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