Instructional Science

, Volume 40, Issue 5, pp 829–847 | Cite as

Computer-based 3D simulation: a study of communication practices in a trauma team performing patient examination and diagnostic work

  • Ingeborg Krange
  • Anne Moen
  • Sten Ludvigsen


Diagnostic work in trauma teams is critical for the patient’s condition and for the possibility of survival. It is a difficult situation to train due to the inherently unpredictable and time-critical practice when an injured patient presents in the Emergency Room (ER). Different types of simulations have been developed for specialized training of specific skills and on contribution to teamwork, but there are hardly any studies reporting on opportunities to train realistic, multidisciplinary collaboration and communicative skills in such time-critical settings. In this article we report on a collaboration-oriented simulation where a trauma team performs diagnostic work: examining a patient in an ER at a hospital. The setting studied is arranged as a design experiment and video data constitute the basis for our interaction analysis. Our main finding is that highly-specialized simulations are useful as an arena for communication training among trauma team members. Doctors and nurses manage to make the simulated representations relevant in their talk, share medical observations and examinations, and consecutively include these findings into their collaborative diagnostic trajectory.


Virtual world 3D simulation Trauma team Teamwork Collaborative problem solving Communication Diagnostic trajectory Sociocultural theories Design experiment Interaction analysis 



We acknowledge the contributions by the participating medical students and professionals at Norrland University Hospital in Umeå, Sweden, and Oslo University Hospital—Rikshopsitalet, Oslo, Norway, in developing the design experiments, and the important contributions by colleagues at Oslo University Hospital—Ullevål in securing disciplinary content for the simulator scenario. In addition, we wish to thank Dr. Hans Rystedt, University of Gothenburg, Sweden, for initial analytical comments on the data material, and the sociocultural research group at InterMedia, University of Oslo for valuable comments on the transcripts and early drafts of the article. The study received funding from Nordunet2, financed by the Nordic council of Ministers and by the Nordic Governments, and Telenor, and we would also like to thank Telenor and Octaga for their contributions to the MATADOR system development.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.InterMediaUniversity of OsloBlindernNorway
  2. 2.InterMedia and Institute of Health and SocietyUniversity of OsloBlindernNorway

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