ABSTRACT

Objective: Current evidence-based guidelines to mitigate fatigue and protect against adverse events in the emergency medical service industry are minimally effective. Since flight medicine is a team event, the performance-cohesion relationship is examined as a potential countermeasure against fatigue-related errors in aeromedicine.

Background: Fatigue has been implicated in decision-making errors, suggesting that it impacts cognitive abilities and clinical performance. Although the impact of fatigue on medical performance in aeromedicine has yet to be examined, it is intuitive flight providers are also susceptible to fatigue-induced errors. Given the additional fatiguing effects of flight, research is needed to elucidate protective factors that can reduce the likelihood of fatigue-induced errors in flight medicine.

Method: A comprehensive review of literature was conducted on the relationship between fatigue and medical performance. The multidimensional construct of team cohesion (i.e., including task and social subdimensions) was also examined to understand the potential moderating effect of team cohesion on the relationship between fatigue and error.

Results: The empirical evidence on the relationship between fatigue and error is robust. Although the performance-cohesion relationship is strong, the distinctive subdimensions of team cohesion, including task and social, may differentially impact team performance.

Conclusion: Whereas higher levels of social cohesion may contribute to groupthink and degradations in performance when fatigued, evidence suggests that task cohesion is an area for future investigation as a possible countermeasure against fatigue-induced errors.

摘要

目标：当前在紧急医疗服务行业中减轻疲劳和防止不良事件的循证指南的效果微乎其微。由于飞行医学是一项团队活动，因此绩效与凝聚力的关系被视为应对航空医学中与疲劳相关的错误的潜在对策。

背景：疲劳与决策错误有关，表明它会影响认知能力和临床表现。尽管疲劳对航空医学医疗绩效的影响还有待研究，但直觉上，飞行提供者也容易受到疲劳引起的错误的影响。考虑到飞行带来的额外疲劳影响，需要进行研究以阐明可以减少飞行医学中疲劳引起的错误的可能性的保护因素。

方法：对疲劳与医疗表现之间的关系进行文献综合复习。团队凝聚力的多维结构（即，包括任务和社会子维度）也进行了检查，以了解团队凝聚力对疲劳和错误之间关系的潜在调节作用。

结果：关于疲劳和错误之间关系的经验证据是可靠的。尽管绩效与凝聚力的关系很强，但团队凝聚力的独特子维度，包括任务和社交，可能会对团队绩效产生不同的影响。

结论：尽管较高水平的社会凝聚力可能会导致疲劳时出现集体思维和绩效下降，但有证据表明，任务凝聚力是未来调查的一个领域，作为应对疲劳引起的错误的可能对策。