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Table 1 A specification of the most important models and theories that were discussed during the CRM training

From: Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial

SHELL-model [62, 63]

The SHELL-model emphasizes that human error develops during the interaction between a person (central Lifeware) and the other components of the model, which are Software, Hardware, Environment and other Lifeware.

Swiss Cheese Model [37]

The Swiss Cheese Model of Reason distinguishes different layers, or 'slices', that act as defences or barriers to local hazards. Each layer has flaws, or 'holes', due to active failures and latent conditions. An accident opportunity occurs when different holes line up.

Human Factor Analysis Classification Model [64]

The Human Factor Analysis Classification Model is a framework based on the Swiss Cheese model of Reason and identifies and classifies human causes of error. It defines the 'holes in the cheese'.

Sender-Receiver model [31]

The sender sends a (non-)verbal message to the receiver. How this message will be received depends on the content (the objective aspect), the oblivious added information (the expressive aspect), the relation between the sender and receiver (the relational aspect) and the influence that the sender wants to have on the receiver (the appealing aspect).

Situational Leadership [65]

This model is used to illustrate different styles of leadership and their effectiveness (e.g. 'push' and 'pull' strategy or 'relation' versus 'tasks' oriented leadership). Different situations demand different styles to get the desired outcome

Situation awareness [66]

Situational awareness is 1) the perception and the comprehension of the meaning of environmental elements within a volume of time and space, and 2) the projection of their status and 3) the possible consequences in the near future.

The Johari window [67]

The Johari window is an assessment of the self by yourself and others. There are things that you know and don't know about yourself and there are things that others know and don't know about you. To optimise performance it is necessary to enhance the knowledge of yourself and diminish the part that you and others don't know.

Groupthink [68]

Groupthink is a state of mind of a cohesive group with deeply involved members in which an unanimous decision is more important than to appraise alternatives. There are eight classic symptoms of groupthink: 1) Illusions of invulnerability; 2) Rationalizing warnings; 3) Unquestioned belief in morality of the group; 4) Stereotyping those who are opposed to the group; 5) Direct pressure to conform; 6) Self censorship; 7) Illusions of unanimity amongst group members; 8) Mind guards shielding for dissenting information.

Stress (management)

According to the classic Yerkes Dodson law the relation between stress and performance can be described as an inverted U-shaped pattern. It is vital for performance to maintain the most optimal stress level, therefore to much or to little stress has to be prevented (e.g. through anticipation, mental and physical preparation, mutual trust) or be managed by focusing on the problem or changing emotion, thoughts or behaviour that enhances stress.

Dangerous attitudes

To illustrate how personality can influence decision making five prototypes of dangerous attitudes are discussed. These prototypes are: the anti-authority (will not comply to any rule); the impulsive (acts directly without thinking it through); the invulnerable (thinks that accidents happen only to other people); the macho (wants to prove him/herself in any circumstance); the drop-out (thinks that he/she does not matter).