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    Eliciting Context-Mechanism-Outcome configurations: Experiences from a realist evaluation investigating the impact of robotic surgery on teamwork in the operating theatre

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    Publication date
    2017-10-01
    Author
    Alvarado, Natasha
    Honey, S.
    Greenhalgh, J.
    Pearman, A.
    Dowding, D.
    Cope, A.
    Long, A.
    Jayne, D.
    Gill, A.
    Kotze, A.
    Randell, Rebecca
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    Keyword
    Randomised controlled trial
    Realist evaluation
    Surgery
    Teamwork
    Rights
    (c) 2017 SAGE. Full-text reproduced in accordance with the publisher's self-archiving policy.
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    This article recounts our experience of eliciting, cataloguing and prioritizing conjectured Context-Mechanism-Outcome configurations at the outset of a realist evaluation, to provide new insight into how Context-Mechanism-Outcome configurations can be generated and theorized. Our construction of Context-Mechanism-Outcome configurations centred on how, why and in what circumstances teamwork was impacted by robotic surgery, rather than how and why this technology improved surgical outcomes as intended. We found that, as well as offering resources, robotic surgery took away resources from the theatre team, by physically reconfiguring the operating theatre and redistributing the surgical task load, essentially changing the context in which teamwork was performed. We constructed Context-Mechanism-Outcome configurations that explain how teamwork mechanisms were both constrained by the contextual changes, and triggered in the new context through the use of informal strategies. We conclude by reflecting on our application of realist evaluation to understand the potential impacts of robotic surgery on teamwork.
    URI
    http://hdl.handle.net/10454/18000
    Version
    Accepted manuscript
    Citation
    Alvarado N, Honey S, Greenhalgh J et al (2017) Eliciting Context-Mechanism-Outcome configurations: Experiences from a realist evaluation investigating the impact of robotic surgery on teamwork in the operating theatre. Evaluation. 23(4): 444-462.
    Link to publisher’s version
    https://doi.org/10.1177%2F1356389017732172
    Type
    Article
    Collections
    Health Studies Publications

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