Interview with Professor Emerita Franziska Tschan Semmer
Conducted by Prof. Claudio Bassetti, Dean of the Faculty of Medicine
When you look back on the beginning of your academic career, what was the deciding factor in choosing your field of research?
This decision was strongly influenced by Mario von Cranach, who was a professor of psychology at the University of Bern from 1971 until his retirement in 1996. In fact, I originally wanted to become a child therapist. But on the fringes of a seminar in Grindelwald, which I attended toward the end of my studies, I had a very inspiring discussion with Mario von Cranach about groups. That’s when I knew that this is what I want to devote the rest of my life to.
My fascination with group research was sparked both by Mario von Cranach as a person and by his theory. His approach to viewing groups as “acting and information-processing units” stemmed from systems theory and was completely new at the time. Today, many years later, the approach is relatively widespread.
What led you to study groups in medicine?
When I was appointed to the University of Neuchâtel in 1995, I switched from social psychology to industrial and organizational psychology. I asked myself: Where can I find groups of people who are confined to a single space and have to work together? As an observer, you need to be on site and able to continuously record everything that might be relevant from a psychological perspective.
That’s how I came to medicine and sought a collaboration with the University Hospital of Basel. Prof. Marsch was heading the ICU there at the time and conducting simulations. I contacted him, and we’ve been working together ever since. Over the years, my research group and I have analyzed many simulation videos, for example on resuscitation.
How did you find yourself in the operating room?
The operating room found me! Guido Beldi and Daniel Candinas from the Department of Visceral Surgery and Medicine at the Inselspital had identified a link between postoperative complications and group behavior in their operating room and wanted to investigate this further. That’s why they contacted a colleague of mine, who in turn contacted me and my husband Norbert Semmer from the University of Bern because he knew I was already working in this field. That’s how the collaboration with Guido Beldi came about around 2008.
The fact that medical professionals reached out to a psychologist was truly remarkable at that time. Such interactions were rare back then. Today, collaboration between medicine and psychology is much more widespread.
To what extent can observations and insights from the operating room be applied to other group situations?
Every situation requires a specific solution. Interaction in the OR is strongly influenced by the OR setting. That’s why it is essential to study the specific situation and ask questions such as: What are the communication requirements? At what points is coordination or teamwork important? When do team members come together? What should be discussed at those times?
Therefore, the general conclusion is that there is no one-size-fits-all solution for all group situations. However, there are certainly important principles that are generally useful and even essential.
Can you give some examples of such principles?
I’d like to give three examples. The first principle can be called “situational awareness” or a “shared mental model.” When working together, it’s important that everyone is on the same page. Because medical care involves interprofessional collaboration, this can be quite difficult to achieve. It requires training, time, and communication. But this applies to any kind of teamwork.
The second principle is that you should identify the points in the collaboration where communication is particularly important and take the time to exchange information at those points. We have introduced the “StOP? protocol” in the OR, which we developed from our earlier research, and have been able to demonstrate positive effects on mortality as a result. A second study is about to be finished.
“StOP?” stands for status, objectives, and problems and the question mark means “ask for contributions”. The “StOP? protocol” is a quick 30- to 90-second briefing that surgeons conduct during the operation. They pause briefly to update the team. In addition to this informative aspect, there’s also a social aspect. The surgeons also ask if anyone else has anything to share or any questions.
The third transferable principle is that team members treat each other with respect. We investigated when and above all why interpersonal interactions in the operating room become tense. In most cases, this has been caused by coordination problems. These problems cause stress and have often not been discussed sufficiently; but this can be addressed.
You have been retired since August 2020. Looking back on your academic career, what are you particularly grateful for?
For having had the opportunity to gain insight into so many different areas of work. I found all of them fascinating, but the operating room was particularly so. I’m especially pleased that we were able to conduct our research in so many hospitals. I was present at several hundred surgeries! Such acceptance can’t be taken for granted. Personally, I’d find it rather uncomfortable if someone were watching me work all day and writing down exactly what I was doing.
Being able to get a glimpse into so many different work environments has been one of the most rewarding aspects of my career as an occupational psychologist. Whether it was operating rooms or industrial production facilities, I found it incredibly exciting to explore workplaces I would never otherwise have had the chance to visit.
Prof. Tschan Semmer, thank you very much for speaking with us, and congratulations on your honorary doctorate.
