Medians and mean scores are presented. Mean scores are used with the aim of more accurately highlighting subtle, yet significant differences in performance. For instance, a mean score of 0.67 is closer to 1, than the median of 0.000, indicating that a task, was performed to a certain degree (0.67), as opposed to “not at all” that a median of 0 would indicate. The mean score for the decision-making indicators ranged from 0.67 to 2.0 while mean scores for staff procedure indicators ranged from 1.08 to 2.0. The sum of the mean scores for all six simulations concerning decision-making was 17.16 (table 1) while the sum of the mean scores for staff procedure skills was 19.66 (table 2).
Table 1
Scores, Median and Mean for decision-making skills
|
Performance Indicator (standard within x minutes)
|
Simulations
|
Median
|
Mean
|
|
|
A
|
B
|
C
|
D
|
E
|
F
|
|
|
1
|
Decision concerning hospital level of preparedness (3)
|
1
|
2
|
2
|
2
|
2
|
2
|
2
|
1,83
|
2
|
Initial guidelines for hospital response formulated (15)
|
2
|
2
|
2
|
1
|
2
|
2
|
2
|
1,67
|
3
|
First information to media (15)
|
1
|
1
|
2
|
2
|
2
|
0
|
1.5
|
1,5
|
4
|
Information concerning resources reported to the strategic level of management (25)
|
1
|
2
|
2
|
2
|
2
|
2
|
2
|
1,83
|
5
|
Medical offices appointed at emergency and surgical departments (30)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
6*
|
Needs of ICU capacity estimated (45)
|
1
|
2
|
1
|
1
|
2
|
2
|
1.5
|
1,5
|
7
|
First information to hospital staff (60)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
8*
|
Endurance of staff estimated (90)
|
1
|
1
|
1
|
1
|
2
|
2
|
1
|
1,3
|
9*
|
Shortage of own capacity estimated and reported (120)
|
2
|
1
|
1
|
1
|
2
|
2
|
1.5
|
1,5
|
10*
|
Influence on daily hospital activities estimated (120)
|
0
|
2
|
2
|
1
|
1
|
2
|
1.5
|
1,3
|
11*
|
Plan for patients with postponed appointments and operations formulated (180)
|
0
|
2
|
0
|
0
|
0
|
2
|
0.00
|
0,67
|
Total score
|
|
13
|
19
|
17
|
15
|
19
|
20
|
|
17.16
|
Indicator related to proactive decision-making indicated with (*).
Table 2
Scores, Median and Mean staff procedure skills
Performance indicator (standard within x minutes)
|
Simulation
|
Median
|
Mean
|
|
A
|
B
|
C
|
D
|
E
|
F
|
|
|
12
|
Functions to staff members assigned(direct)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
13
|
Positioning in room in accordance to above (direct)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
14
|
Designated telephone numbers (direct)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
15
|
Arriving staff members introduced (1min)
|
1
|
2
|
2
|
0
|
2
|
2
|
2
|
1,5
|
16
|
Equipment utilize (only if equipment is available)
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
17
|
Staff briefing (max 8 min in length)
|
2
|
2
|
1
|
2
|
1
|
2
|
1.5
|
1,5
|
18*
|
Content of staff briefing
|
1.75
|
2
|
2
|
1.75
|
2
|
2
|
2
|
1,92
|
19
|
Telephone discipline
|
0
|
1
|
1
|
0
|
1
|
2
|
1.25
|
1,08
|
20
|
Content of staff schedule
|
2
|
1
|
1
|
2
|
2
|
0.5
|
2
|
1,67
|
21
|
Summary: oral briefing
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
2
|
22
|
Summary: written
|
2
|
2
|
0
|
2
|
2
|
2
|
2
|
2
|
Total
|
|
18.75
|
19
|
17
|
15
|
19
|
20.5
|
|
19,7
|
* consists of sub indicators as described (6).
Association of indicators
A one-way analysis of variance indicated a statistically significant differences between the decision-making skills and staff procedure (p= 0.036, d=0.386) (Table 3).
Table 3 Post Hoc Comparisons – Decision-making and staff procedure means
|
|
Mean Difference
|
SE
|
t
|
Cohen's d
|
p tukey
|
|
1
|
|
2
|
|
-0.227
|
0.103
|
-2.215
|
-0.386
|
0.028
|
|
Kruskal-Wallis Test
|
|
Factor
|
Statistic
|
df
|
p
|
|
Role
|
4.398
|
1
|
0.036
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The correlation between decision-making skills and staff procedure skills was r=0.809, ρ = 0.51 (figure 1, table 4).
Reactive skills had statistically significant higher means (1.5- 2.0) than proactive skills which had lower means (0,80- 1.60) (p=.046) (table 5). While Spearman’s rho indicated no significant correlation between reactive indicators and staff procedure (r=0,09 and p= .86) there was significant positive correlation between proactive indicators and staff procedure skills (r=0,947 p= .014) (figure 2, Table 4).
Table 4 Spearman’s rho correlation of decision-making and staff procedure skills
|
Staff procedure skills
|
ρ
|
Decision-making
|
|
.809
|
.051
|
Proactive decision-making
|
|
.947
|
.014
|
Reactive decision-making
|
|
.090
|
.86
|
*. Correlation is significant at the 0.05 level (2-tailed).
Table 5. Reactive and proactive indicator means
|
N
|
Minimum
|
Maximum
|
Mean
|
ρ
|
Reactive
|
6
|
1,66
|
2,00
|
1,83
|
.046
|
Proactive
|
5
|
,80
|
1,60
|
1,07
|
Figure 1. Correlation Decision-making and staff procedural skills r=0.809, p = 0.051
Figure 2. Correlation proactive decision-making and staff procedure r=0,947 p= .014