It鈥檚 estimated that a round trip to Mars will take at least two years. That鈥檚 why is investing millions of dollars trying to figure out the right recipe for creating highly effective, collaborative teams that can troubleshoot themselves out of any problem. The space agency is investigating the role leadership plays in such dynamic groups, as well.

For the past several years several experts on teamwork have been helping NASA with that question. This month, several University of Central experts earned more than $1.2 million to continue their work as NASA looks to prepare its workforce of the future.

鈥淲e are looking for ways to identify key social and task-oriented roles on long-duration missions,鈥� said Eduardo Salas, a psychologist and the lead investigator for the NASA Human Research Program grant. 鈥淕enerally, we know you want people on a team who are emotionally stable, extroverts, catalysts. But by the end of this three-year study we hope to have a taxonomy to allow NASA to select or compose teams according to desirable social roles.鈥�

Seems like common sense, but difficult to deliver. Everyone who has co-workers knows how a disagreement or clash of personalities can create a nightmare work environment that is depressing and demoralizing if not handled correctly. From a business point of view, that kind of conflict can lead to distractions that take away from productivity and cost the company money.

And unlike most office environments, a clash between astronauts could result in dire consequences for the entire crew. And unlike missions to the moon or the International Space Station, where astronauts can call Houston to help solve a problem, that won鈥檛 be so easy on long missions when the communication lag is expected to be 20 minutes each way to and from Earth.

鈥淭here鈥檚 not a lot of hard science yet with respect to team dynamics in long-duration exploration missions,鈥� Salas said. 鈥淭here are several groups working on it. We鈥檝e been doing it for a while with other teams as well. But we hope to have a good foundation by the time we finish our study.鈥�

Salas is a trustee chair and Pegasus professor of psychology at 麻豆原创. He also holds an appointment as program director for the Human Systems Integration Research Department at the university鈥檚 (IST). His co-investigators on this grant are Stephen Fiore, director of the Cognitive Sciences Laboratory at IST and an associate professor of cognitive sciences in the philosophy department, and James Driskell, a social psychologist with Florida Maxima Corp. in Winter Park.

To compliment Salas鈥� work, NASA awarded a $100,000 grant to associate professor of research Shawn Burke so she can look at the role leadership plays in dynamic and stressful environments. Burke works next door to Salas at IST and is also a co-investigator on Salas鈥� new grant.

鈥淐omplex environments, especially like those seen in long-duration exploration mission, will require more autonomous teams,鈥� Burke said. 鈥淪o we need to identify the challenges to leadership in such environments and the most effective forms of leadership to combat the challenges. That鈥檚 what I鈥檓 looking at.鈥�

Burke will review behavioral data from NASA experiments conducted in remote environments that are designed with many of the same characteristics expected as long duration space flight.聽 Archival documentation from other teams that work in isolated and extreme environments (oil rigs, Antarctic exploration, firefighting, military) will be examined to look for clues.聽 Interviews with astronauts and key NASA personnel will also be conducted in an effort to gain their perspective and learn from their experience.

Burke earned her Masters and Doctorate degrees in Industrial/Organizational psychology from George Mason University. Her areas of expertise are team dynamics and leadership roles. She鈥檚 been at IST since 2000 and was a research fellow at the U.S. Army Research Institute before that. She鈥檚 published more than 80 journal articles and book chapters related to teams and leadership and has presented at more than 100 conferences.

Burke鈥檚 co-investigators on this project are Salas and Marissa Shuffler, an assistant professor of industrial/organization psychology at Clemson University and a 麻豆原创 alumnae.

Salas and Burke will also likely bump into each other in Houston when they travel to Houston as part of their grants to visit NASA鈥檚 research facility that focuses on behavioral health and performance. The facility mimics some of the isolated and harsh conditions astronauts are likely to encounter, which should aid researchers.

The conclusion of 麻豆原创 studies will not only help NASA, but may also help companies and organizations that work in extreme environments on earth, such as oilrigs and the military.

The 麻豆原创 teams were selected from 123 proposals. NASA awarded $17 million in grants to 26 projects from 16 institutions in eight states.

麻豆原创 has a long history working with NASA, from helping it develop hardware to take accurate color pictures of the Mars surface to groundbreaking work on teamwork conducted by Salas and psychologist Kimberly Smith-Jentsch.

Eduardo Salas, Pegasus and Trustee Chair professor of psychology and scientist with the Institute for Simulation and Training, will lead the research that supports NASA鈥檚 objectives to ensure the health of space flight crews, especially as they venture beyond the Earth鈥檚 orbit for extended periods of time.

NASA and the National Space Biomedical Research Institute announced a total of 23 awards valued at approximately $17 million. Salas is the only researcher to receive two awards in the peer-reviewed competition and only two other universities received more than one award.

Salas is an internationally recognized expert on teams and training. His projects will help NASA safely and efficiently divide tasks between humans and automation, and assess the cognitive and emotional states of individuals and teams, both of which are priorities of the space agency.

The first project will focus on methods to detect and mitigate cognitive performance deficits, stress, fatigue, anxiety and depression for the operational setting of spaceflight from ongoing team member communications, either spoken or written.

Using software and analytic tools the researchers will quantify word choice and patterns in real-time, which may be used to alert them to any changes or potential risk factors.

The effort is critical to keeping teams in space for months and perhaps years, Salas said.

鈥淒uring long-term spaceflight team members will talk a lot, both during mission critical operations and their down time.聽By analyzing spontaneous verbal output in real-time communication, we can develop tools to predict problems before they arise,鈥� he said.

The second project will develop a framework for measuring the safety and efficiency of interactions between human team members and the automation required to sustain long-term flight.

The awards come less than two weeks after 麻豆原创 became the first Florida university selected to lead a NASA project.聽Physicist Richard Eastes, from the Florida Space Institute, is leading that $55 million project to develop an imaging instrument to study Earth鈥檚 upper atmosphere.

鈥淣ASA is one of our earliest research partners and we are pleased, in our 50th anniversary year, to be granted these awards, in complimentary disciplines, which highlight the increasing breadth of our research strength,鈥� said MJ Soileau, vice president for research & commercialization at 麻豆原创.

Trustees approved spending about $35.6 million of Capital Improvement Trust Fund fees on the two projects, which were recommended by a committee that includes students. The per-credit-hour fee funds student-related projects on campus.

Before any construction can begin, the state Board of Governors, which oversees all Florida public universities, must authorize spending the fee on the two projects. The state Legislature also must vote to release the money to 麻豆原创 next year.

The library expansion would accommodate a four-story Automated Retrieval Center that would hold up to 1.5 million volumes, freeing up much of the main library to add individual and group study spaces.

The new addition also would enable 麻豆原创 to keep a portion of the library open 24 hours a day, seven days a week. The 24-hour space is something many students want to see at the library, said Cortez Whatley, president of the Student Government Association

The most frequently used materials would remain in the main library, while materials that are rarely used would be moved to the expansion. An automated retrieval system would fetch those materials when needed, and the system would save the university money as well as space.

The Lake Claire enhancements would include a student services building with space for boats and other outdoor equipment. Usage of the recreational area has nearly tripled during the past three years as a result of prior improvements such as sand volleyball courts.

In other action, the Board of Trustees:

Recognized several faculty members who earned at least $1 million in external research funding during the past year. A total of 35 faculty members achieved Millionaires Club status in 2011-12.

Heard an update on a 麻豆原创 initiative that involves the collection and interpretation of data examining topics such as which students are at risk for dropping out of a course or not completing a program. That data then would be used to help identify barriers to student success and to help students overcome those barriers. The goals of the initiative include increasing student retention and graduation rates.

Learned that 麻豆原创 will host the 2014 Science Olympiad National Tournament, which will be the 30th anniversary of the competition. The invitation was a result of 麻豆原创鈥檚 success with hosting the Science Olympiad earlier this year. The tournament includes about 2,500 of the nation鈥檚 best science, technology, engineering and math students.

Congratulated the 麻豆原创 women鈥檚 soccer team on winning the Conference USA tournament and earning an automatic bid to the NCAA tournament. The Knights defeated Miami on Saturday in the first round and will play at Florida on Friday in the second round.

Lauded Eric Van Stryland, professor of optics in CREOL, The College of Optics and Photonics, for earning the R.W. Wood Prize of the Optical Society of America for his work that revolutionized the measurement of nonlinear properties of materials.

Congratulated Eduardo Salas, of Psychology and the Institute for Simulation聽& Training, for winning the Michael R. Losey Award presented by the Society for Human Research Management.

Met briefly with newly elected State Rep. Joe Saunders, a 2005 麻豆原创 graduate whose district will include the university. Saunders earned a bachelor鈥檚 degree in Political Science with minors in Women鈥檚 Studies and Legal Studies.

The award, recognizing human resource academics or experts whose research significantly advances the field of human resource management, was presented at SHRM鈥檚 Strategy Conference in Palm Springs.

鈥淒r. Salas鈥� research on workplace teams and training provides the HR community with important insight during a time when related issues, like STEM skills gap training and managing virtual teams, impact HR professionals on a daily basis,鈥� said Henry G. (Hank) Jackson, the president and CEO of SHRM. 鈥淭he Losey Award recognizes the important work Dr. Salas has already accomplished and the future work we look for from him.鈥�

Salas won the Losey Award for his prolific research on effectiveness, productivity and training of workplace teams. During his 30-year career, he produced more than 400 publications that have helped bridge scientific understanding of HR management, teams, and training to best practices businesses and HR professionals can implement in everyday use.

鈥淚 am honored and humbled by this award鈥攊t is, indeed, an incredible feeling,鈥� said Dr. Salas. 鈥淭here is nothing more satisfying in some ones career than the recognition that you have made an impact in the field鈥攖o those who manage individuals and teams in organizations.鈥�

The award, established in 2000, is named in honor of former SHRM President and CEO Michael R. Losey, SPHR. Given by the boards of SHRM, the HR Certification Institute, and the SHRM Foundation, the award acknowledges major research accomplishments and helps fund future individual contributions to the field.

Salas is the Pegasus and Trustee Chair Professor of the psychology department at the 麻豆原创 in Orlando and the program director of the school鈥檚 Institute for Simulation & Training. He is the president-elect of the Human Factors and Ergonomics Society, past-president of the Society for Industrial and Organizational Psychology and a fellow with the Human Factors and Ergonomics Society, the American Psychological Association, and the Association for Psychological Science.

Previously, Salas was a senior research psychologist and head of the training technology development branch of the Naval Air Warfare Center鈥檚 Training Systems Division. He held academic appointments at Aberdeen University, Rollins College, the University of South Florida, and Old Dominion University.

As a management consultant, his clients include British Petroleum, UBS, The World Bank and numerous healthcare providers and military agencies. Salas is the author and editor of numerous articles and books, such as Guiding Learning from Experience and Team Processes, Performance and Training in Organizations.

Salas holds a doctorate degree in industrial and organizational psychology from Old Dominion University, a master鈥檚 degree in industrial psychology from the 麻豆原创, and a bachelor鈥檚 degree in general psychology from Florida International University.

The latest tool in this process is a new book about medical teamwork edited by Eduardo Salas, a 麻豆原创 psychology professor, and Karen Frush, chief patient safety officer and associate professor of pediatrics at Duke University School of Medicine.

鈥淚mproving Patient Safety Through Teamwork and Team Training,鈥� which is scheduled for release later this month, provides a look at the science of improving team performance in the delivery of clinical care.

鈥淧atient care is a team sport,鈥� said Salas. 鈥淚f you鈥檝e ever been to a hospital or had surgery, you know that not just one person is taking care of you.鈥�

The Institute of Medicine report largely blamed the failures of communication and cooperation for the hospital deaths.

鈥淲e need to better understand teamwork, how to keep it, and how to train for these things,鈥� said Salas, a Pegasus Professor and Trustee Chair Professor who holds an appointment as program director for the Human Systems Integration Research Department at 麻豆原创鈥檚 Institute for Simulation & Training.

Salas said he was approached by several health care publishers to write the book because 麻豆原创 has become recognized as a world leader in teamwork, training and patient safety.聽

He approached Frush and other editors and writers in the field to create the 288-page paperback. He and Frush also both wrote several of the chapters.

鈥淲e launched this project about 18 months ago, and we were able to recruit the best thinkers, practitioners and scientists across the country and around the world that were doing something with patient teamwork and training,鈥� Salas said. 鈥淭his really puts 麻豆原创 at the forefront.鈥�

Chapters of the book offer guidelines and lessons on topics such as how to measure success, different needs of various clinical situations, and how to monitor training.

Frush, who has worked both as a nurse and physician, said in her experiences she has seen the critical importance of teamwork.聽

鈥淢any clinicians and leaders in health care speak of the importance of teamwork using anecdotes and stories,鈥� she said. 鈥淭his book provides evidence and examples that will be very helpful in convincing those health care leaders and clinicians who鈥檝e not yet realized the power and importance of teamwork.鈥�

She also said that as health care continues to become more complex, it is even more clear that treatments cannot be delivered by one individual.聽

鈥淭here is not one 鈥榚xpert鈥� that can do it all,鈥� Frush said. 鈥淭he complexity requires an expert team, and we鈥檙e finally聽beginning to include training in teamwork knowledge and skills.鈥�

In the book’s preface, Salas stressed that team training can produce significant results in clinical outcomes.

鈥淚t is safe to say a science of teamwork and team training is emerging,鈥� he wrote. 鈥淭his volume is motivated by that goal鈥攌eeping the science moving.鈥�

Other 麻豆原创 contributors to the book published by Oxford University Press are: Tripp Driskell, a graduate research assistant; Jennifer Feitosa, a psychology doctoral student; Elizabeth H. Lazzara, a doctoral candidate and graduate research assistant; Sallie J. Weaver of the Department of Psychology and Institute for Simulation & Training; and Salvatore Silvestri, clinical associate professor of emergency medicine at 麻豆原创, program director at Orlando Regional Medical Center, and associate EMS medical director of the Orange County EMS System.

This is Salas’ 24th book, most of which have covered team performance or training. His nationally recognized expertise includes helping organizations foster teamwork, designing and implementing team-training strategies, facilitating training effectiveness, managing decision-making under stress, developing performance measurement tools and designing learning environments. He is working on designing tools and techniques to minimize human errors in aviation, law enforcement and medical environments.

He also has served as a consultant to a variety of manufacturing, industrial and governmental organizations and pharmaceutical laboratories. He received his doctorate in industrial and organizational psychology from Old Dominion University.

鈥淚 consider myself a scientist practitioner 鈥� that is, I use science to solve organizational problems,” Salas said about the honor. 鈥淭he award also recognizes that 麻豆原创 is a leading expert in team performance, because not only do we understand the science of team performance but we understand the practical side because we engage in team training as well.鈥�

Salas, a former president of SIOP and a SIOP Fellow, has been a professor at the 麻豆原创 for 12 years. 聽Previously he was a senior research psychologist and head of the Training Technology Development Branch of the U.S. Naval Air Systems Command in Orlando for 15 years.

鈥淢y research has focused on teamwork 鈥� how a team in a high-stakes environment functions in industries like aviation, military, healthcare, oil and the like,鈥� he said. 聽He also has worked with airlines through a longstanding grant 麻豆原创 has with the Federal Aviation Administration and has worked in healthcare with Florida Hospital and Orlando Health, Ryder Trauma Center and Jackson Memorial in Miami along with schools of medicine across the country.

He is currently involved in a project with NASA involving team cohesion in astronauts for a projected trip to Mars. He is also researching the effects that different cultures have on collaboration and working with Florida Hospital on developing efficient rapid response teams.

Salas has co-authored more than 300 journal articles and co-edited more than 20 books. He is also a fellow of the Human Factors and Ergonomics Society and has served on numerous editorial boards for psychology-related journals.

Dr. Eduardo Salas: Well, I thought I would find that health care and medicine in general understand the science of team training and simulation. Much to my surprise, I spent the first few years essentially educating health care professionals on what we know about teamwork, team training, and the like. The lack of awareness about this very robust science that could help them with their problems surprised me.

RW: As you reflected on that surprise, did you have any theories why this was such a foreign science to health care back then?

ES: It’s like any other science. We are so invested in our own journals, societies, and conferences that we don’t look to other disciplines that might be studying this. Fortunately, I think in the last 10 years, most fields have become more multidisciplinary. There’s a little more cross-fertilization. But, I found over the years that disciplines are so insular and in their own box that they forget to reach out. So, I spent a lot of my time writing and giving talks in schools of medicine and hospitals about this science and what it could do for them.

RW: Did you discover that part of the reason also was that people in medicine didn’t recognize that teamwork was an important part of what they were doing for a living?

ES: That came second. Even today, there’s pushback in some sectors, and some physicians still reject this notion despite all of the evidence we have that this seems to work. I found there was (not to be disrespectful) some arrogance that said, “I’m not so sure this is relevant to us, and if it is can you just give me a book to read, then we’ll figure it out.” That was the usual response I received when I first started this. Now, it’s a little different; but back then there was a lot more resistance, a lot more pushback, a lot more thinking that this is just a very fuzzy concept and that we don’t need it.

RW: What did you come to believe were the reasons for that?

ES: The first thing is how physicians are trained and educated. I read recently about the cowboy mentality: “I know everything; therefore, I’m the one that has all the solutions.” Some of the resistance stems from the nature of the training and the education physicians are receiving. The second thing is that organizations or health care providers are not organized around teams and do not send any signals that teamwork is what is needed. The third thing is the difference in status, which was very prevalent in the military 20 years ago. That has changed, but you have this hierarchy鈥攖here’s the nurse, the technician, and so forth鈥攁nd everybody seems to think the best way to communicate is among themselves and not across each other. There’s also the lack of recognition that health care is a team sport. Every patient is receives care from a lot of people, no matter what condition they come in, and there’s lack of recognition of that. I found leadership in hospitals or in schools of medicine didn’t know what to do with this concept at that time. “What does this mean? Do I need to select people differently now?” Obviously you need to train them differently. “How do I reinforce what they do?” The way health care pays clinical care providers is also a problem. A whole host of these little things were, in a sense, barriers to adopting the concept that teams do help with patient safety and that teams do many things that individuals by themselves cannot do.

RW: As you entered health care, what concepts or lessons did you find worked perfectly well in health care, and which did you find weren’t a perfect fit because health care is so different?

ES: I get asked that a lot. I think that just about 80% of what we learned in the military about team performance and teamwork transfers to health care in America and in many other places for that matter. Every discipline has that mentality: “We are different.” Cardiologists think they’re different than pediatrics鈥攁s a hypothetical example鈥攂ut I found a similar mentality in the military. “The A14 is different than the F18; therefore, we do things differently.” I learned that what is different is equipment or the setting, but the behaviors, conditions, and attitudes needed in order to function were the same. There was this pushback in health care at the beginning; everybody wanted to look at things through the eyes of their own discipline. It took me many years to convince the Pentagon that teams matter. The way we convinced them was with data. We went out and collected data with real military teams doing real things in the real world. We found differences between the effective teams and the ineffective teams. The same thing has happened in health care. I decided that the best way to convince CEOs, CFOs, deans, or whomever is with data, and the data has come in: Teams who are trained on teamwork principles do better than those who were not trained on them.

RW: Sometimes people bring up the idea that, for example, a cockpit really only has two or three people at fairly similar levels of the organization and hierarchy that have to be able to speak up to each other. But in health care a team might have 20 or 30 people, very fluid, and it might be a clerk who has to speak up to the Chief of Neurosurgery鈥攈uge differences in training, language, and status.

ES: Of course, there are differences. But at the end of the day, what is your mission and what is it you need to be prepared for? In health care, some professionals reject the teamwork notion from aviation because they think pilots go from A to B and that’s it. Therefore, sometimes I use an analogy to respond to that thinking. That response is like saying, “Well here comes a patient, I’ll give him a pill, then he’ll just go away and come back if he feels bad again.” It’s not simplistic like that. Pilots go from A to B, but a lot of things can happen in between: unexpected events, crises that they have to deal with or be prepared for. It’s the same thing in health care, so I frankly don’t buy the argument that one is so different than the other one. Are there differences? Of course there are. But at the end, we’re talking about task interdependence. So, if a pilot and co-pilot are as task interdependent as a surgeon and nurse, they will need the same knowledge, skills, and attitudes to function effectively.

RW: What is the state of the evidence that better teamwork is associated with better outcomes and safety than worse teamwork, versus the state of the evidence that teamwork can be improved and that makes a difference in outcomes?

ES: There have been a number of studies in team training. In 2008, I published a of team training in the journal, Human Factors. Essentially, we found a very robust effect that team training accounts for 20% of the team performance variance. That’s good news and bad news. Team training does have an effect. It gives you better outcomes across safety, fewer errors, and those kinds of things. But this also says that 80% is left to other interventions, other things you need to do in order to account for performance. That’s where I think organization and leadership come into play, with all the other things. The Journal of the American Medical Association just published a from the VA on team training and found that those who were trained in teamwork had better clinical outcomes. The study is not perfect, but the data are certainly encouraging. There is a lot of medical team training evaluation going on, and I’ve been reviewing some of them. They all show that those who know about teamwork do better. They feel better, they know the concepts, they see the behaviors on the job, and there are better outcomes. Again, the outcomes are not perfect and it’s very difficult to get access to clinical outcomes, but I think that the data is very encouraging. I think we’re getting to a point where we can say that team training does work. Now the question is: What do you do with the other 80% of the variance that is remaining? And that’s what I’ve been writing lately. In the military, we also did the same thing with real experts doing real Navy tasks. For example, we found that those who were trained on a simple strategy of self-correction and team correction outperformed the teams that did not. They had better communication, decision-making, accuracy, and so forth. There is now mounting evidence that teamwork does matter and that team performance can be improved by simple interventions.

RW: What does a great team training program look like?

ES: Even before I recommend a team training program or a team training system, I usually tell a leader, “The first thing you need to do is know your own organization. Where are the problems?” Most organizations will tell you, “We have good communication in our organization.” Communication is a big bucket, so you need to peel the onion. What are the team problems you are having? Tell me where your needs are. Tell me where the gaps are. Where are the issues or concerns? The second thing is you need to do an organization readiness assessment. Is the organization ready to deliver the team training? Because if it doesn’t have the resources, if it doesn’t have the leadership aligned, then at the end of training people have all these great skills but they go back to the organization and the organization has not changed, it has not done anything to support the new skills, and of course with time, people revert back to old methods and don’t apply the newly learned skills. Those two things are critical to understand before you implement any team training. What are your needs? Where are your gaps? Peel back the onion of communication so that you can match the training to the skills you need, and secondly, make sure you have the resources and incentive, as much as you can, to facilitate these behaviors on the job, as well as a culture that will support all of this.

Then you select a team approach. Any training has four components at the end of the day: information, demonstration, practice, and feedback. I’m not married to any team training program, as there are a few out there that are well-designed. But, I tell them that the science of learning tells us that people learn more when they practice and get feedback on the skills that they’ve been trained on, and not from a lot of information and demonstration. So, if you can afford simulation, if you can afford some sort of practice, then get a program that allows you to do these four things: information, demonstration, practice, and feedback and spend more on the practice and feedback. Most team training programs spend a lot of time on information and demonstration. These are 4- to 6-hour workshops where there might be a little role play but not a lot. They spend a lot of time talking about skills; they show videos of good and bad performance, but allow very little time for practice and feedback. So I always recommend practice鈥攖hat’s how you get this ingrained in your peoples’ minds.

RW: Let’s say I’ve done that and I feel like I’ve gotten a pretty good team training program and I’ve addressed that 20%, and I still have that 80% black box. I call you into my organization and ask you to help me. What do you tell us?

ES: I would ask, “How are you reinforcing that the trainees can now apply the skills on the job? What are your policies? What are your procedures? What types of signals is top leadership sending? Is the CEO sending memos or speeches to say, ‘this matters, and this is why it matters’?” The rest of the 80% will come from leadership within the organization, at least as we know it now. If I just went through the best team training program in the world, and am now trained, and then I go to work and my boss tells me, “That training you just went to, I think it’s useless,” that 3-second interaction just killed my motivation to apply the new skills. So you must have supervisory support. In my view, at the end of the day organizations get the behaviors that they measure and reinforce. If you want teamwork, you’d better measure it and you’d better reinforce it. But a lot of hospitals call me for what you just asked me. They say, “We just invested in this team training program, and we’re not getting the behaviors that we want.” I respond by saying, “Let’s look at what you are doing as an organization. What are the policies and the procedures, etc.?” And that’s where they say, “Oh, we didn’t know. Oh, we needed to do this?” So in the end, it’s the culture that sustains the training. It is what the organization values and what they do in order to preserve those values. The good organizations do that; they create the climate for implementing newly trained skills. Some of it is very subtle and some very obvious, but you have to work at both.

RW: Let me shift gears slightly away from teamwork and more toward individual cognition. You’ve written quite a bit about situation awareness and how people can be aware of their environment and perhaps catch themselves before they make errors. What do we know about that and how do you teach people to think differently?

ES: We know that there are limits to how people process information. Essentially, every experience that an individual has, builds a repertoire in their head and it becomes a template鈥攁 template for how to act, how to think, and so forth. The way to train this is through simulation. Simulation accelerates expertise by providing experiences through scenarios that help to connect and then create a template that an individual puts in his or her head. At the same time, in order for individuals to monitor their own thinking and behavior, we teach them what you might call self-regulation. It is kind of like stepping out of where you are and saying, “Am I following the right path? Do I have all the information I need? Have I received all the communications that I need to have in order to execute?” There are opportunities where the simulation can be stopped (even though it changes the dynamic of the task a little; but this is for training purposes, so you have license to do that), and questions can be addressed. You continually tell the trainee that he or she needs to take a different path because there’s a crystal ball which says that you’re going to crash. These types of experiences create self-regulation. Always thinking about what you’re thinking. Again, in the military we did that with simulations. I’m not talking about high-fidelity simulation necessarily; we can also do this with low fidelity.

RW: It sounds like it begins with thinking about your own thinking. But you can’t do that constantly or your brain hurts鈥攕o you must have to learn to read your own internal thermostat and recognize this is a situation where I might make an error because there’s so much stuff going on that I need to stop and think about it. How do you get people to recognize that moment, because paradoxically that’s the moment maybe when you’re least likely to do that?

ES: It comes with experience. I’d say it’s expertise. That’s why experts, while they do make errors, make fewer errors than novices. The reason experts make fewer errors is that they build this template in their head that creates a set of patterns鈥攑attern recognition is critical to all of it. Usually what happens is the experts say, “I’ve been here before and this is the thing I need to do.” Or they say, “I don’t think I’ve been here; I haven’t been in this situation before, but I think if I go this way I’ll be successful.” Now all of this happens in seconds in their head, but the ability to be able for a moment to step back and say, “What is this? Have I been here before or not?” is crucial to anticipating when a mistake might be made. With experience employing the strategy I just explained, I think people do evolve a mindset where they can self-regulate. Experts are good at self-regulation but the other thing experts do is imagine probable outcomes. Every individual engages in this type of mental simulation. You project very quickly what’s going to happen after you make that mistake鈥攚hen golfers kneel down and look at the ball in relation to the hole, they’re doing a mental simulation of where and how the ball might go. Basketball players do it, and I’m sure surgeons do it as well. It’s a way for us to process information and that’s how we can check ourselves.

RW: I hadn’t really thought about this notion that the signal for me to think carefully about this and hit the pause button really is that this violates a pattern that I’ve either learned about or done many, many times before.

ES: Chess players do it all the time and most of the studies on pattern recognition come from master chess players. They project the game鈥攖he way they move their pieces鈥攚ay, way ahead.

RW: As you bring up pattern recognition and chess players, earlier this year a computer beat the Jeopardy!champions. What does the future hold as we begin to distribute some of our intelligence through information technology systems rather than confine it to the human brain?

ES: One area that I’m following more and more is neuroscience. I think we’re finding a lot more about the brain and how firing A will lead to B. To me the future is uncovering more about how the brain works. I think we have technology to do that. Other things that are happening鈥擨 think we’re going to use more and more technology no matter what. We have to start thinking about human鈥搒ystem integration. When the computer, your iPad, your tablet, or whatever is your teammate, and is giving you information鈥攈ow do we create mental models with that? How do we create a trust in these technologies? Those are the issues that I think are confronting us now. Technology is going to evolve, and the technology is doing more and more of the thinking for us. So the question is: How do we use technologies as teammates? How do we process that information? How do we trust that information? This whole human鈥搒ystem integration, I think, is the future. How do we integrate the social/technical system such that you reduce errors?

Simulations are also evolving. We can now simulate just about everything and mimic the real world with tremendous realism. But I still believe that it’s not the realism that matters, but what you do with it. The instructional features you’re training and so forth. We cannot get in people’s heads, but how do we get proxies that have a sense of how much individuals and teams are processing, what knowledge they have, and what knowledge they’re missing. Current research is trying to capture in real time and diagnose in real time what teams and individuals are thinking. Hopefully in 10 years we’ll know more. Those are different buckets that I see evolving and maturing and helping us.

RW: Anything else that you wanted to talk about?

ES: Just how we started; there is a science of teams and team training. There’s a lot of information out there that is useful, practical, and can be applied. I think in 5 years we’re going to stop talking about team training. And it’s all about the culture of the organization, what leadership does. What the CEOs, CFOs, what they value and reinforce. Hopefully the next generation of health care providers will think differently. As you know, the way you were trained makes a difference in how you perform in your job. Similar to the way the culture of the aviation industry has evolved, which has taken 20 years to change, changing the culture of the health care industry will require a new generation of doctors that are used to collaborating, that are used to communicating a lot, and other things. We have a new School of Medicine here at 麻豆原创. The way we’re teaching is very different than what I’ve seen in other schools. The next generation will embrace a lot more teamwork and collaboration, which will accelerate the future of the health care industry.