Jo Angouri

Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross‐sectional study

Please cite this paper as: Siassakos D, Bristowe K, Draycott T, Angouri J, Hambly H, Winter C, Crofts J, Hunt L, Fox R. Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross‐sectional study. BJOG 2011;118:596–607.

Corporate meetings as genre: a study of the role of the chair in corporate meeting talk

Abstract Meetings are the backbone of organizational life and as such constitute an important component of workplace discourse. We expand here upon earlier work which suggests that a meeting constitutes a distinct genre, taking informal rather than formal meeting talk as our focus. To further explore the genre theory perspective, the analysis draws on theoretical and analytical tools deriving from work on “activity types” (Levinson, Activity types and language, Cambridge University Press, 1992 [1979]) by concentrating on the role of the meeting chair which is characterized as a structural device for managing these interactions. Acts that index “chairing” are analyzed as discourse types (Sarangi, ATs, DTs and interactional hybridity: The case of genetic counselling, Harlow, 2000) enacted in the context of the corporate (informal) meeting activity type. We analyze data from two comparable data sets, one recorded in Europe and one in New Zealand. Despite the effect of local context on the instantiation of the meeting event, there seem to be generalizable features (e.g., the chairs function in openings and closings and the agenda) which make meetings recognizable to participants. The findings indicate striking similarities across the organizations, lending support to the existence of a meeting genre, and emphasizing the significance of the chair role which shapes and is shaped within the context of the genre. We close the paper by discussing how the activity- and discourse-type approach can contribute to the study of spoken business genres.

From Grexit to Grecovery: Euro/crisis discourses

The ongoing financial turbulence, especially in the Eurozone, has been prominent in the media since the late 2000s. More recently, however, a number of countries of the European South – Portugal, Spain, Italy, Greece and Cyprus – as well as Ireland, were put in the spotlight when sovereign debt was reported to threaten the stability of the euro and the ideal of the monetary union. This triggered an array of constructions and representations of a financial/socio-political crisis in the European Union and global politics, media and everyday talk. Unsurprisingly, a range of possible solutions and potential culprits emerged in relevant debates, negotiations and media reports, both nationally and transnationally. Greece in particular is a case in point. The country turned to emergency loans to avert default and has occupied international and national headlines for several years, starting in 2008/2009. Discourses portraying Greece as the ‘perpetrator’ or the ‘victim’ have now become commonplace and neologisms, such as those constituting the title of this issue, spread from the media to politics and politicians and to the everyday domain. Greece has been continuously constructed as the weakest link of the EU ‘family’ and the starting point of a potentially ‘contagious’ Eurozone crisis: two of the metaphors excessively used to position Self and Other in various contexts and explain the changes in the socioeconomic sphere. Some political actors – political parties and governments – opted to support Greece; others called for an exclusion of Greece from the single currency. Some

'They became big in the shadow of the crisis' : the Greek success story and the rise of the far right

Greece has been in ‘crisis’ for six consecutive years now and during this time living standards have dropped considerably for the majority of the population, strict austerity measures have been implemented and unemployment has reached a record figure of 27.8% (with a Eurozone average of 12%). At the same time, a ‘success story’ is prominent in dominant discourses where Greece is portrayed to have achieved a primary budget surplus and according to which the ‘worst has passed’. The dire consequences of austerity, the political polarisation of Greek society and the rise of the far-right party Golden Dawn (GD), however, indicate a much less positive picture. In this context, the article aims to problematise the complex nexus of relationships between the financial crisis and the re-emergence of the extreme right-wing party, GD. The discussion draws on an analysis of 1497 postings from the online website of the British newspaper, The Guardian. We focus on discourse strategies for attributing/resisting blame emerging from the analysis of the postings, but also as negotiated in two popular threads on the online discussion board. The article takes a critical stance and combines the discourse-historical approach with a micro analysis of the interaction. This allows us to pay special attention to the multiple layers of context and to combine the macro and the micro in the constructions of blame and sense making of the crisis. Analysis of the data shows that a range of actors is held responsible for the current situation, while the rise of GD is constructed both as a ‘product of’ and ‘movement against’ the crisis. We close the article with the implications of our study and areas for further research.

What makes maternity teams effective and safe?: Lessons from a series of research on teamwork, leadership and team training

We describe lessons for safety from a synthesis of seven studies of teamwork, leadership and team training across a healthcare region. Two studies identified successes and challenges in a unit with embedded team training: a staff survey demonstrated a positive culture but a perceived need for greater senior presence; training improved actual emergency care, but wide variation in team performance remained. Analysis of multicenter simulation records showed that variation in patient safety and team efficiency correlated with their teamwork but not individual knowledge, skills or attitudes. Safe teams tended to declare the emergency earlier, hand over in a more structured way, and use closed‐loop communication. Focused and directed communication was also associated with better patient‐actor perception of care. Focus groups corroborated these findings, proposed that the capability and experience of the leader is more important than seniority, and identified teamwork and leadership issues that require further research.

Teamwork for Clinical Emergencies Interprofessional Focus Group Analysis and Triangulation With Simulation

Our purpose was to investigate health care professionals’ beliefs about effective teamwork in medical emergencies based on their experiences. We used framework analysis of interprofessional focus groups in four secondary and tertiary maternity units. The participants were randomly selected senior and junior doctors, senior and junior midwives, and health care assistants, in five groups of 5 to 7 participants each. We found that optimal teamwork was perceived to be dependent on good leadership and availability of experienced staff. The participants described a good leader as one who verbally declares being the leader, communicates clear objectives, and allocates critical tasks, including communication with patients or their family, to suitable individual members. We triangulated the results with evidence from simulation to identify convergent findings and issues requiring further research. The findings will inform the development of teaching programs for medical teams who manage emergencies to improve patient safety and experience.

Team communication with patient actors: findings from a multisite simulation study.

Introduction: Patient satisfaction is an important healthcare outcome and communication with clinical staff is an important determinant. Simulation could identify problems and inform corrective action to improve patient experience. Methods: One hundred eight randomly selected maternity professionals in 18 teams were videoed managing a patient-actor with a simulated emergency. The trained patient-actor assessed the quality of staff-patient interaction. Clinicians scored teams for their teamwork skills and behaviors. Results: There was significant variation in staff-patient interaction, with some teams not having exchanged a single word and others striving to interact with the patient-actor in the heat of the emergency. There was significant correlation between patient-actor perceptions of communication, respect, and safety and individual and team behaviors: number, duration, and content of communication episodes, as well as generic teamwork skills and teamwork behaviors. The patient-actor perception of safety was better when the content of the communication episodes with them included certain items of information, but most teams failed to communicate these to the patient-actor. Conclusion: Some aspects of staff-patient interaction and teamwork during management of a simulated emergency varied significantly and were often inadequate in this study, indicating a need for better training of individuals and teams.

‘So what problems bother you and you are not speeding up your work?’ Problem solving talk at work

Problem solving (PbS) can be readily described as one of the key activities regularly performed by professionals in any workplace setting. Despite its importance, however, there is relatively little (socio)linguistic research which looks at the complex ways in which problems are constructed in discourse. This article sees the enactment of a ‘problem’ as a discursive phenomenon with fluid boundaries. It draws on business meeting data recorded in multinational companies in Europe and focuses on excerpts identified by the participants as having a PbS function. The data show that problem solving processes and practice are anchored to the structure of the organizations, the local history and employees’ shared perceptions of professional practices and hierarchies in their workplace. The analysis also shows two focal points in the PbS talk of the participants in this study, namely identification of a problem (what the problem is) and its ownership (whose problem it is). These, however, are not predetermined starting points but rather locally constructed in relation to the status, expertise and shared/past history of the interactants.

“I'm a Greek Kiwi”: Constructing Greekness in Discourse

The article reports on the preliminary findings of a project on the constructions of Greekness in modern diasporas. The discussion draws on data from the self-identified Greek community of Wellington, New Zealand. Interview data, ethnographic diaries, and everyday real-life spoken interactions were collected. The analysis of the data shows that the interactants move away from a “teleology of return” (Clifford, 1997) and reconceptualise the host/minority dimension, highlighting the dynamics and complexities of Greek identity. Special attention is paid in the analysis to the role of institutions, particularly the Greek Orthodox community, in constructing a Greek identity in this context. The standpoint taken considers identity not to be a stable, predefined entity but an ongoing dynamic process that is constantly negotiated and co-constructed between the interactants (De Fina, Schiffrin, & Bamberg, 2006). Identity is not something interactants are or have but rather something they actively do in discourse. The article closes by arguing that diasporas are not static “definable” communities, but dynamic systems shaping and being shaped in the discourse of their self-affiliated members.

‘OK one last thing for today then’: Constructing Identities in Corporate Meeting Talk

Meetings play a central role in the life and growth of corporate companies, especially for problem solving and decision making, and their pervasiveness means they necessarily warrant attention within workplace communication research. The meeting is an interactional site in which many aspects of workplace communication are instantiated or ‘performed’. Whether it is evidence of power asymmetries or complex socio-professional relationships, meeting participants are constantly engaged in the ongoing negotiation and co-construction of relevant norms and practices. In this context participants demonstrate their group membership, their role within the team and beyond, their expertise and status in the company; in short, meetings provide an opportunity for participants to perform and construct any one of their roles and their professional identity. To explore the dynamic construction of corporate identity (as one of many identities constructed within workplace talk),1 we describe the ways in which the meeting chair discursively performs and negotiates their identity in the privileged role of meeting controller.