Teamwork and Shared Mental Models in Emergency Response

Emergency response is complicated by individual flaws in situational awareness (SA) and sense-making capabilities.
When multiple responders are observing the same environment, the problem is often compounded. Although diverse perspectives can be an asset, they frequently become a significant liability when responders fail to achieve a shared understanding (Figure 17-1).
It is entirely possible for two responders to look at the exact same scene simultaneously and perceive something completely different.
Situational awareness is fundamentally the process of "making sense" of an environment. This process involves:
- Level 1 Situational Awareness: The act of capturing specific clues and cues from the surrounding environment.
- Level 2 Situational Awareness: The comprehension of those captured clues and cues to form a coherent meaning.
When responders fail to reach the same conclusion from the same environment, it is often because they are processing different sets of clues and cues or interpreting them through different frameworks.

A responder's level of expertise significantly dictates what information they are capable of processing.
Positive Clues and Cues: Information that is physically present at the scene (sounds, sights, smells). Most novice responders are capable of identifying these.
Negative Clues and Cues: Information that is missing or absent from a scene (Figure 17-2).
For a novice, the absence of a clue usually carries no meaning. However, for an expert, missing clues and cues provide critical information regarding what is—or is not—happening.
Discrepancies in meaning between two responders occur when one lacks the expertise to recognize the significance of these absent indicators, resulting in a failure to share a mental model.

A "shared mental model" occurs when responders discuss their observations non-judgmentally to seek mutual understanding.
Psychological exercises demonstrate the power and inflexibility of individual perception. When two individuals see different things in the same image, describing those differences in vivid detail often fails to help the other person see the alternate view.
Counterintuitive Observation: Research suggests that the more detail one person uses to describe their perception, the more difficult it becomes for the other person to see the image their counterpart is describing.
Once a responder makes a conscious decision regarding what a clue or cue represents, it is psychologically difficult for them to see it as anything else. A perception, once formed, is highly resistant to change.
In experimental settings, even when a pointer is used to highlight the physical features of an alternate interpretation:
- Some individuals experience an epiphany.
- Many continue to be unable to see the alternative.
- Some individuals may succumb to stress or embarrassment and claim to see the alternative, but when asked to point out the features themselves, they are unable to do so.

In emergency services, the determination of who is "right" when perceptions differ is often unfortunately dictated by rank or official position rather than accuracy.
Responders with low rank, less seniority, or less established respect may never be given the opportunity to voice a perception that differs from their superiors.
Even if allowed to speak, the hierarchical nature of command can result in a supervisor dismissing a subordinate's observations because the supervisor physically and mentally "cannot see" what the subordinate is pointing out, similar to the image exercise.

Ego and self-esteem play a critical role in the ability to admit fallibility in sense-making.
Responders with Healthy Ego/Strong Self-Esteem: These individuals view differences in sense-making as a warning sign. They welcome input and advice from aides/advisors because they recognize the catastrophic potential of what they might miss (Figure 17-3).
Responders with Exaggerated Ego/Low Self-Esteem: These individuals often dismiss the observations of others as inaccurate to protect their own sense of competence.
As noted in Chapter 10, a balanced ego facilitates the acknowledgment of fallibility, whereas an over-inflated ego can suppress it, leading to disastrous outcomes.

Some command officers mistakenly rely on Standard Operating Procedures (SOPs) alone, assuming arriving personnel will instinctively know what to do without specific instructions.
This assumes that every arriving responder will conduct an independent size-up and arrive at the exact same mental model and situational awareness as the previous crews or the commander.
The temporal gap between the arrival of various responders increases the likelihood of different mental models. Because incidents are dynamic and change over time, the clues and cues available to the first-arriving unit will be different from those available to units arriving later.

A commander who has been on-scene longer has the advantage of having observed the progression of events and the evolution of clues and cues.
This allows the commander to sense the "speed" at which an incident is progressing and maintain a "big picture" view that late-arriving units lack.
The Sport Analogy: Entering an incident late is like a friend walking into a room while you are watching a football game.
- The friend can see the current score, the ball position, and the current down.
- However, they are unaware of critical prior events, such as a star quarterback being injured on a previous possession while the team was on offense.
- The friend's sense-making is limited to the current snapshot, whereas the viewer who has been there from the start understands the context and trajectory of the game.

Mutual understanding and effective teamwork are vital to first responder safety.
The ideal state is for all responders and supervisors to capture and comprehend the same clues and cues, leading to aligned predictions of future events.
This is difficult in dynamic environments, yet failure to achieve this alignment is a common finding in after-action reports for casualty incidents.
Casualty reports often reveal that responders involved in the incident lacked a shared understanding of what was happening, what actions were being taken, and how their specific roles fit into the overall mission.