Work

Linking physiological coordination and behavioral pattern complexity to team adaptation and performance in medical simulations

Year: 2026

Type: article

Abstract: Introduction In dynamic, high-stakes environments, such as medical emergencies, effective teamwork and team performance rely on team adaptation. Team Behavioral Interaction Patterns (i.e., recurring sequences of team behaviors; TBIPs) have been proposed as markers of adaptive functioning, while physiological coordination among team members may offer an unobtrusive, real-time proxy for such behavioral dynamics. The current paper presents an investigation of whether TBIPs are (1) related to self-reported team adaptation and rated performance, and (2) reflected in physiological coordination. The paper advances the potential use of wearable technology for (near-) real-time team monitoring. Methods We conducted a quasi-experimental study with 19 medical teams ( N = 150) during simulation-based medical emergency team training. Teams were video-recorded and wore wrist-worn sensors capturing electrodermal activity (EDA) and heart rate (HR). Based on video data, we extracted TBIPs via T-pattern detection. We assessed the complexity of TBIPs and calculated physiological coordination (synchrony and regularity) for each pattern. Team adaptation was measured via self-report, and team performance was rated by trainers. We related physiological coordination to team adaptation and team performance, while accounting for the complexity of TBIPs. Results Regression analyses showed no association between TBIP complexity and team performance. Multilevel models revealed that the relationship between physiological synchrony (HR and EDA) and team adaptation, and that between EDA regularity and team performance, depended on TBIP complexity. Specifically, better team adaptation was related to higher HR synchrony during low-complexity TBIPs and lower EDA synchrony during high-complexity TBIPs, whereas better team performance was linked to higher EDA regularity during high-complexity TBIPs. Conclusion Our findings suggest that behavioral pattern complexity moderates the relationship between physiological coordination and team outcomes. This interplay between behavioral and physiological data highlights the value of combining both modalities to understand and potentially support adaptive team functioning.

Source: Frontiers in Neuroergonomics

DOI: 10.3389/fnrgo.2026.1743312