Under Pressure

What do astronauts, Antarctic researchers, firefighters and emergency medical staff have in common? They work in extreme environments. Unlike most people working 9-to-5 jobs, their jobs expose them to hostile or dangerous situations and come with the added pressure of knowing that any mistake they make may be fatal. UZH psychologist Jan Schmutz researches how teams work together in these extreme situations. “I’ve always been fascinated with how people under pressure perform at the highest levels and how team members have an almost telepathic understanding,” says Jan Schmutz. Finding out what distinguishes successful teams from unsuccessful ones is difficult, adds the UZH psychologist. But identifying the factors that make teams succeed is a challenge that he relishes.

Jan Schmutz is pursuing several avenues in his quest to find out what makes teams thrive. He reviews literature on the topic and observes and advises teams working in extreme environments. When we meet online, he is speaking from a hospital in the Austrian city of Graz, where he is staging a three-day training program together with medical and healthcare instructors. The program simulates and analyzes medical emergencies, and it is these kinds of trainings that enable the psychologist to share his expertise and see whether it has the desired effect.

What does his research show? Broadly speaking, the success of a team is based on two elements: the team members’ skills and their ability to collaborate. While the members’ individual skills are important, teamwork is the crucial factor for a team’s success, says Jan Schmutz. In other words, a team of experts isn’t necessarily an expert team. The main challenge thus lies in combining and getting the most out of people’s skills. If this isn’t the case, the team won’t work. And this can have devastating consequences. “Studies have shown that up to 80 percent of medical errors arise from poor communication or lack of teamwork,” the psychologist says. Conversely, good teamwork can increase teams’ performance by 20 to 30 percent.

The UZH psychologist has identified three factors that make teams succeed: team reflection, psychological safety and a shared understanding of their work. The cornerstone of successful teamwork is psychological safety. This doesn’t mean that everyone needs to be handled with kid gloves, stresses Schmutz, but that each member of the team feels able to speak up and share their ideas or concerns without fear of being shut down by others. A large-scale study conducted by Google some years ago confirmed the significance of having a safe environment for team members. According to the study, teams thrive when team members listen to one another and show sensitivity to others’ feelings and needs.

This positive team climate will affect everything else. “Psychological safety means increased performance, fewer mistakes, more effective processes and more innovative products,” says Schmutz. Team members who feel safe with one another are more motivated, and the more positive tone also means they’ll share information more readily. This reduces the number of errors and improves processes. Leaders play an important role here. Ideally, they manage their teams in a participatory fashion, seeking the opinions and ideas of their team members. According to a study conducted at ETH Zurich, inclusive language, such as using inclusive pronouns like “we”, helps team members speak up and share their views.

Without such open and constructive interactions, the other two success factors – collective reflection and a shared understanding of the team’s work – aren’t possible. “Reflection helps teams develop,” says Jan Schmutz. This can take place before, during or after significant events or milestones. For emergency medical teams, for example, it helps if they hold a briefing before a patient, whose arrival is announced in advance by the ambulance team and whose main symptoms are thus already known, is brought in. As events in the ER unfold, regular short pauses for reflection of up to 10 to 20 seconds can help the team ensure that they’re on track or help them adapt as required.

Finally, debriefings enable the team to evolve and work together even better when the next patient arrives. Systematic debriefing not only improves the quality of work but also increases the psychological safety of team members. “Debriefings aren’t always easy, especially when things haven’t gone according to plan,” says Schmutz, “but they’re incredibly valuable.” However, this valuable tool isn’t used as often as it should be, adds the psychologist. The impact of debriefings is tremendous. “Regular debriefings not only improve a team’s performance but also make employees feel better and less emotionally drained and prevent them from burning out.” Whenever Jan Schmutz works with teams like the one in Graz, he tries to explain and establish these processes.

The third and final prerequisite for team success is that teams share an understanding of their work. This understanding has to be developed together and realigned on a regular basis, says Schmutz. These shared mental models, to use the psychological term, refer to team members’ joint understanding of their tasks, goals, obligations and roles. The members of a team share the same idea and knowledge structure, enabling them to work together more effectively and complete their tasks. Shared mental models allow teams to coordinate their activities, communicate effectively and jointly reach decisions, since they share similar norms, attitudes and expectations. A team’s performance and teamwork improve when they develop and cultivate shared mental models.

Jan Schmutz’s research on teamwork under extreme conditions shows that the success of a team isn’t primarily linked to the team members’ technical skills, but is determined by their soft skills and an organizational structure that creates an open climate encouraging of exchange. And such insights are not only applicable to teams working in outer space, the Antarctic or the emergency room, believes the psychologist. “If something works in extreme conditions, it usually works in more traditional work environments too.”

This article first appeared in German in the UZH Magazin 2/2023.