Exploring focus group discussions for building knowledge across emergency services organisations : a foundation for road tunnel incidents responses and future research?

• Introduction and aimRoad tunnels are important parts of today’s infrastructure and society, but also with potential for many injured in case of an incident and a challenging work environment for emergency services organisations. If a mass-casualty incident (MCI) occurs in a road tunnel, specific challenges in terms of safety, heat, smoke, long distances to the injured and lack of and contradictory information will impact the response and how collaboration is established (Holgersson et al., 2020; Lockey et al., 2005). In addition, sharing information during responses is, however, often limited due to the lack of knowledge and understanding of each other’s work processes at an individual and organisational level (Sederholm et al., 2021). A key for collaboration here is a good understanding of how their own, and collaborative organisations interpret and operate in a potentially shared task (Edwards, 2012; Wolbers et al., 2017). Thus, the road tunnel environment is one area where research has pointed to the need for a shared understanding of incidents across the organisations (Casse & Caroly, 2019) and for arenas facilitating exchange of experiences and reflections upon work procedures to develop collaboration (Njå & Svela, 2018; Hylander et al., 2022). This calls for activities that could stimulate work-integrated learning. While exercises and simulations are valuable in enhancing response preparedness, the perceived effects have been reported to vary in terms of learning and usefulness (see e.g., Roud et al., 2021). In addition, exercises and simulations are expensive and time consuming, calling for alternative but still effective learning activities for developing collaboration. This abstract aim to present and critically explore an innovative learning activity for development of joint knowledge to improve MCI response in road tunnel environments.Design and participants The learning activity analysed for this abstract was a series of four focus groups á 4 to 4,5 hours, conducted online in a region of Sweden. The overall aim of the series was to share experiences and develop joint knowledge across emergency organisations in tunnel environments. The participants in the focus groups represented the organisations that typically respond to tunnel incidents, i.e., ambulance service (EMS), police service, rescue service, Swedish Transport Administration (RTCC, Trafikverket) and emergency dispatch center (EDC, SOS Alarm) (Table 1). The study participants had extensive work experience within their organisations and are expected to have a tactical or operational management function in a major response.Table 1 not included in this abstractThe researchers designed the focus group series with the intention to alternate experiences, with procedural, conceptual and practical elements. The study used a partly participatory design. For this study, rather than being co-interpreters of the results, the participants were involved to shape the sessions content and questions to be discussed in ways they found valuable (Baum et al., 2005). The researchers built the following session from what the participants had asked for, discussed, or found challenging in the prior sessions. One week in advance, the overarching theme, goal, and suggestions for discussion questions for the session, and a summary of bullet points from the previous session, was sent out to the participants. Session I was set out to be an open discussion to familiarize themselves with each other’s ways of working, and to discern the participants’ understandings of specific challenges and needs for responses in tunnels, but also to illuminate the impact of internal decisions and actions for saving lives safely. The first approximate 20 minutes was discussed as crucial for establishing a tunnel response, which is why this phase was focused on during Session II: a best-practice discussion based on the initial 20 minutes of a full-scaled exercise where several of the participants had been involved. Information gathering and sharing was highlighted as both crucial and challenging, which lead to the research group introducing and participants discussing practical implications of concepts of “situational awareness” in Session III. Session IV was a ‘digital exercise’ based on a crash and vehicle fire in a tunnel, aiming to wrap up the identified challenges and practicing information sharing and management during the initial 20 minutes of the response.The analysis was conducted as critical discussions in the research group, in-between the sessions and when the full series was conducted, set out to identify potential strengths and weaknesses/challenges of the design and content for knowledge development. The results will present the preliminary findings and contributions.Results The analysis performed for this abstract found that the focus groups series ha s strengths and weaknesses/challenges to build knowledge across organisations regarding potential MCI road tunnel responses. First, the opportunity to discuss the same questions from four “basis”/perspectives, including presenting the organisations own perspectives and exercise experiences, a theoretical concept, and a practical moment was a strength. However, rather than a progression of learning (such as becoming more effective in information sharing), the design primarily allowed analysis of a deeper and more complex understanding of the overall question of joint and timely responses. Second, the iterative and participatory design was a strength in terms of that the sessions could to some extent focus on the issues the participants highlighted. By using this method, the participants also had the possibility to reflect upon prior and upcoming sessions (Baum et al., 2006). This could, however, be a limitation for comparing results across different groups if the issues of concern diverge too much.Third, the focus groups could contribute to the organisations’ knowledge development across practices, such as identifying specifically critical moments when establishing a response or sharing thoughts about safety. Using this design could be a complement to the typical focus on actions in exercises and training (Roud et al., 2021). In addition, the nature of focus group data provides opportunities to analyse interactions (Wilkinson, 2021). Still, how the knowledge developed could be further implemented in and across the organisations remains unknown and needs further consideration in research and practice.Fourth, the focus groups were effective for researchers to explore how knowledge is shared and possible contradictions in interpretations and actions. This approach is valuable for developing knowledge in cross-practice collaborations (Edwards, 2012). Including materials from a full-scale exercise and a practical digital exercise was valuable due to the obvious connection to their work tasks and potential challenges, and to contextualize their learning. Further, the amount and various types of data obtained from each session, such as discussing a theoretical concept and a practical exercise moment, could pose challenges for analysis. However, including both structured discussions and practical exercises as stimuli could strengthen the internal validity of the findings (e.g., reduce the discrepancies between what they say they do and what they actually do).Fifth, using online meetings was time-effective (and safe during the COVID-19 pandemic), allowing participants and researchers to work from where they choose. However, the online setting produced primarily a dialogue between moderator and participants, with less initiatives for dialogues between participants. It co uld be valuable to further evaluate the design in physical meetings. Moreover, it was easier to drop out or pop out, to simultaneously manage other work tasks, from online meetings compared to physical meetings.ConclusionIn conclusion, we would here argue that using inter-organisational focus groups, that acknowledge participants needs for learning and providing various stimuli to engage in a shared problem, can contribute to knowledge development for future tunnel responses. Research and practice should further explore how various interpretations and actions can be used to improve strategies, communication and organizational changes. Further research could 67 also explore how discussion-based learning activities can be used as a platform to develop and main tain collaborative learning networks, and as a complement to exercises and simulations.

Ämnesord

SAMHÄLLSVETENSKAP  -- Utbildningsvetenskap -- Pedagogik (hsv//swe)

SOCIAL SCIENCES  -- Educational Sciences -- Pedagogy (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

SAMHÄLLSVETENSKAP  -- Utbildningsvetenskap -- Lärande (hsv//swe)

SOCIAL SCIENCES  -- Educational Sciences -- Learning (hsv//eng)

Nyckelord

Emergency services organisations

mass-casualty incident

road tunnel

collaboration

professional learning

focus group

Work Integrated Learning

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vet (ämneskategori)

kon (ämneskategori)