Collaborative Team Members Research Articles

A neural machine translation method based on split graph convolutional self-attention encoding

With the continuous advancement of deep learning technologies, neural machine translation (NMT) has emerged as a powerful tool for enhancing communication efficiency among the members of cross-language collaborative teams. Among the various available approaches, leveraging syntactic dependency relations to achieve enhanced translation performance has become a pivotal research direction. However, current studies often lack in-depth considerations of non-Euclidean spaces when exploring interword correlations and fail to effectively address the model complexity arising from dependency relation encoding. To address these issues, we propose a novel approach based on split graph convolutional self-attention encoding (SGSE), aiming to more comprehensively utilize syntactic dependency relationships while reducing model complexity. Specifically, we initially extract syntactic dependency relations from the source language and construct a syntax dependency graph in a non-Euclidean space. Subsequently, we devise split self-attention networks and syntactic semantic self-attention networks, integrating them into a unified model. Through experiments conducted on multiple standard datasets as well as datasets encompassing scenarios related to team collaboration and enterprise management, the proposed method significantly enhances the translation performance of the utilized model while effectively mitigating model complexity. This approach has the potential to effectively enhance communication among cross-language team members, thereby ameliorating collaborative efficiency.

Integrating Implementation Science in a Quality and Patient Safety Improvement Learning Collaborative: Essential Ingredients and Impact.

There is a current lack of research exploring the contextual factors of why and how quality improvement collaboratives (QICs) work. To this end, a mixed methods study was undertaken to improve our understanding of what works for whom and in what context among participants in a nationwide Canadian QIC. The authors used a mixed methods approach consisting of a written survey and 30-to-45-minute telephone interviews with collaborative team members, coaches, and senior leaders of participating safety improvement project (SIP) organizations to identify the essential elements of an integrated approach involving implementation science/knowledge translation, quality improvement (QI), patient safety, and collaborative learning/networked approach to enhancing safety and quality and building implementation capabilities. Survey data were analyzed using descriptive statistics. Interview data were analyzed by three team members using thematic analysis and development of an emergent coding schema. Four themes emerged as the essential elements: (1) integrating implementation science into the QI/patient safety learning collaborative; (2) reinforcing of and opening eyes to implementation science by an expert implementation specialist; (3) valuing the sense making and strategies shared by coaches; and (4) experiencing challenges to implementation amplified by the COVID-19 pandemic. Teams also reported improvements in teamwork and patient outcomes as a result of participating in the QIC. This study's findings provide deeper insight into the "essential ingredients" (expert implementation specialist, coaches) grounded in an integrated approach that drew from QI, patient safety, and implementation science. Organizations can use the key learnings on how best to implement quality and safety projects by leveraging the sense making of the expert implementation specialist and coaches in an integrated networked learning approach.

Care Need Combinations for Dementia Patients with Multiple Chronic Diseases

The purpose of this study was to find care need combinations for dementia patients with multiple chronic diseases and their caregivers. A cross-sectional study was conducted with 83 patients who had multiple chronic diseases. Variables from patients included age, gender, severity of clinical dementia rating, feeding, hypnotics, mobility, getting lost, mood symptoms, and behavioral and psychological symptoms. Moreover, 26 types of care needs were included in this study. The Apriori algorithm was employed to first identify care need combinations and then to find the relationships between care needs and variables from dementia patients with multiple chronic diseases. Six rules were generated for care need combinations. Four care needs could be formed as a basic care need bundle. Moreover, two additional care needs could be added to provide a wider coverage for patients. In the second stage, 93 rules were found and categorized into three groups, including 2, 6, and 28 general rules with support of 30% but less than 40%, 20% but less than 30%, and 10% but less than 20%, respectively. When the support value is 10% but less than 20%, more variables from patients were found in rules which help the dementia collaborative care team members provide tailor-made care need bundles. Four basic care needs were social resources referral and legal support (Care (1)), drug knowledge education (Care (3)), memory problem care (Care (5)), and fall prevention (Care (8)). Besides, disease knowledge education (Care (2)) and hypertension care (Care (16)) were frequent unmet needs in this specific population. Moreover, care for the mood of the caregiver (Care (11)) should be considered especially in dementia patients with preserved ambulatory function or with symptoms of hallucination. The collaborative care team should pay more attention to those care needs when assessing this specific population.

Be Explicit: Identifying and Addressing Misaligned Goals in Collaborative Research Teams

ABSTRACTThe misalignment of goals among researchers, external organizational partners (OPs), and study participants is thought to pose a challenge to the successful implementation of collaborative research projects. However, the goals of different collaborative team members almost never are elicited, making identification of misalignment and its potential consequences a difficult task. In this evaluation of a United Nations Nonviolent Communication Program conducted in Bangladesh, the Maldives, and Sri Lanka, I collected qualitative and quantitative data on OPs’ and study participants’ expected program impacts. I find that there are differences in OP and participant goals and that misalignment appears to bear some responsibility for participant dissatisfaction with the program. I also observe evidence that as the program progressed, participants’ expected program impacts began to more closely approximate those of the OPs. I conclude with thoughts on the benefits of explicitly measuring research team goals and expectations and addressing their misalignment.

Single-player videogames in leadership learning.

This article offers an overview and analysis of the ways in which first‐person videogames can be effectively used in the leadership classroom. Specifically, videogames can be used to encourage students to develop the skills necessary both to analyze leadership and to begin to consider the ramifications of leadership decisions from the varying positions of leaders, followers, and collaborative team members. This article discusses videogames as artifacts of popular culture and leadership and offers an example‐driven discussion of how specific games have been used in a leadership studies classroom to teach about and for leadership.

783 Use of Multidisciplinary Collaboration to Establish a Standardized Endotracheal Tube Wiring Guideline

IntroductionPediatric patients with facial burns and advanced airway needs precipitate acute situations requiring multidisciplinary team member collaboration. Significant facial burns, particularly involving considerable edema or smoke inhalation, may warrant dental or circum-mandibular endotracheal tube (ETT) wiring for stabilization. Guidelines were created, trialed, and revised based on patient outcomes and clinician feedback at a pediatric verified burn center.MethodsThe guideline was created by the burn team in 2019. This standard work was utilized with pediatric burn cases presenting to the burn center. Guideline variances, such as prolonged time from door to ETT wiring, prompted a gap analysis need to improve the process. Through two case review sessions held in 2020, a multidisciplinary team consisting of the burn providers, emergency department providers, nursing, and respiratory therapists revealed process knowledge deficits, unclear role expectations, and supply issues. Literature was reviewed and a myAmeriburn listserv inquiry of current practice was made to seek additional guidance.ResultsBased on feedback from the multidisciplinary group and data gathered from the literature and collegial burn community, action plans and guideline modifications were developed in 2021. The respiratory therapy department developed education for their staff highlighting use of twill tape and taping. The use of ETT suturing was removed from the guidelines.ConclusionsMultidisciplinary contribution and engagement was necessary to produce, execute, and evaluate the pediatric endotracheal tube wiring guidelines. Through dialogue, patient trial, and constructive feedback, guidelines were amended to produce a smoother team process and better patient experience. The standard work is currently being evaluated in its modified version.

Applying Healthcare Failure Mode and Effect Analysis and the Development of a Real-Time Mobile Application for Modified Early Warning Score Notification to Improve Patient Safety During Hemodialysis.

ObjectivePatients undergoing hemodialysis are a high-risk population. This study identified possible errors by using a healthcare failure mode and effect analysis system to improve patient safety during hemodialysis.MethodsA multidisciplinary collaborative team, including physicians, nurses, information technicians, and medical staff members, was assembled. A flow diagram was used to indicate each process of the hemodialysis procedure from evaluating patient condition to transporting the patient back to the ward from the hemodialysis center. We scored all possible failure modes using the hazard scoring method as a combination of the occurrence frequency and severity. These potential failure modes were used to identify and evaluate possible risks by using a risk scoring matrix.ResultsThirty failure modes were identified across 6 processes, and their potential causes were explored. Four major strategies for addressing most of the failure modes were implemented: establishment of a mobile application that sends real-time automated alerts to the medical team based on the Modified Early Warning Score, design of a modified dialysis Identify-Situation-Background-Assessment-Recommendation checklist for dialysis, technician education and training, and internal auditing and monitoring of the implementation of the entire process. After the implementation of the strategies, the hazard scores of patients during dialysis dropped by 71.2% from 170 points to 49 points.ConclusionsThe healthcare failure mode and effect analysis system was useful for evaluating potential risk during dialysis. Using the mobile application reduced the occurrence of emergency resuscitation during hemodialysis and significantly improved the communication between medical personnel.

Effectiveness of an escape room for undergraduate interprofessional learning: a mixed methods single group pre-post evaluation

BackgroundInterprofessional practice (IPP) has been shown to contribute to quality service provision and improved health outcomes. This knowledge has led to the integration of interprofessional education into course curricula for many health-care disciplines. Offering interprofessional education in rural areas to students undertaking work integrated learning placements is challenging particularly because of the diversity of students and placement dates combined with the student focus on the assessable placement curriculum.This research investigated and evaluated the utility of an escape room as an educational modality that facilitates learning whilst providing a supportive and motivating learning environment. Our project focused on the acquisition of interprofessional practice knowledge and experience by a health professional student cohort.MethodsThis study used the novel intervention of an escape room combined with an interactive teaching session to test student engagement and learning about interprofessional practice and teamwork. The research used a mixed methods single group pre-post design.ResultsFifty students (78% female) from seventeen universities and seven professions participated in teams of three to six members. Most participants (66%) had not previously completed an escape room. The results showed that the intervention provided effective and engaging learning and was intrinsically appealing to students despite its non-assessable nature. Individual student reflection on their participation showed developing insight into the critical importance of clear communication and intentional team member collaboration in the provision of effective interprofessional practice.ConclusionsThe escape room intervention added value to the placement curriculum and proved flexible for a heterogeneous student cohort.

Critical Realist Investigation of Real-Time Decision-Making Process Under Uncertainty

The construction of training programs for psychotherapists, requires the production of a practical knowledge database, through research with a coherent epistemology, methodology and method. In order to locate an epistemology which correlated with the researcher-practitioner’s practical approach to knowledge, exploration of existing epistemologies was necessary. The Critical Realist (CR) position enabled composition of the practice approach in coherent academic text. A method for tacit practical knowledge extraction based on dialog between an experienced psychotherapist and his trainee, while she underwent practical training, was developed. Practical knowledge was transferred from teacher to trainee and was transformed while it was apperceived and utilised by the trainee in her practice. A duoethnography was used to contextualise the dialog. That method was elaborated into a collaborative, cyclic research method, which is based on the notion that theories are fallible hypotheses which should be either verified or refuted, in the face of a reality test. In this paper the method is explored and presented including discussion regarding the different roles of the collaborative team members.

Perceptions of collaborative care team members on facilitators and barriers to care and glycosylated hemoglobin level as a diabetes quality metric at a federally qualified health center in Texas

ObjectivesFacilitators and barriers to collaborative patient care have been explored in previous studies. Few studies provide information about collaborative care team (CCT) members’ roles in treating patients with diabetes and how CCT members should be evaluated for their contributions to diabetes care. To describe the roles and responsibilities of CCT members at CommUnityCare (CUC), a federally qualified health center in Central Texas; identify the facilitators and barriers affecting referrals to other CCT members within CUC; explore the facilitators and barriers to collaborative patient care at CUC; and assess CCT members’ perceptions of quality metrics for diabetes care. MethodsA cross-sectional design was used. Data was collected by a survey and semistructured interviews of CCT members. The survey (32 questions) assessed roles and responsibilities, including the percentage of time spent on clinic activities, referral criteria, perceptions of quality diabetes care, and facilitators and barriers to care. The interview (32 questions) gathered a description of the CCT member’s role, referral process, and ideas for diabetes quality metrics. Descriptive statistics and content analysis were used for data analysis. ResultsTwenty-two CCT members (4 diagnosticians, 4 clinical pharmacists, 4 behavioral health professionals, 4 registered dietitians, 2 community health workers, and 4 care managers) participated in this study. Co-location (54%) and professional relationships with coworkers (32%) facilitated referrals to other CCT members. Appointment availability (32%) and lack of referral criteria knowledge (27%) were barriers to other CCT member referrals. Seventy-five percent of the dietitians and care managers thought that the glycosylated hemoglobin (A1C) level was a good quality metric for diabetes care, followed by 50% of the clinical pharmacists, 25% of the behavioral health counselors, and 0% of the community health workers and diagnosticians. ConclusionCo-location and professional relationships facilitated referrals to CCT members, whereas lack of CCT member availability and lack of referral criteria knowledge were barriers to CCT referrals. Metrics other than the lowering of the A1C level should be further explored to assess the quality of diabetes care.

Social Determinants of Health as Potential Influencers of a Collaborative Care Intervention for Patients with Hypertension.

The use of collaborative care teams, comprising nurse care managers and community health workers, has emerged as a promising strategy to tackle hypertension disparities by addressing patients' social determinants of health. We sought to identify which social determinants of health are associated with a patient's likelihood of engaging with collaborative care team members and with the nurse care manager's likelihood of enlisting community health workers (CHW) to provide additional support to patients. We conducted a within-group longitudinal analysis of patients assigned to receive a collaborative care intervention in a pragmatic, cluster randomized trial that aims to reduce disparities in hypertension control (N=888). Generalized estimating equations were used to identify which social determinants of health, reported on the study's baseline survey, were associated with the odds of patients engaging with the collaborative care intervention, and of nurses deploying community health workers. Patients who were unable to work and those with higher health literacy were less likely to engage with the collaborative care team than those who were employed full time or had lower health literacy, respectively. Patients had a greater likelihood of being referred to a community health worker by their care manager if they reported higher health literacy, perceived stress, or food insecurity, while those reporting higher numeracy had lower odds of receiving a CHW referral. A patient's social determinants of health influence the extent of engagement in a collaborative care intervention and nurse care manager appraisals of the need for supplementary support provided by community health workers.

Improving the Quality of Care in Care Homes Using the Quality Improvement Collaborative Approach: Lessons Learnt from Six Projects Conducted in the UK and The Netherlands.

The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach, but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs and share their learning of applying the QIC approach in the care home sector. Overall, five care home-specific lessons were learnt: (i) plan for the resources needed to support collaborative teams with collecting, processing, and interpreting data; (ii) create encouraging and safe working environments to help collaborative team members feel valued; (iii) recruit collaborative teams, QIC leads, and facilitators who have established relationships with care homes; (iv) regularly check project ideas are aligned with team members’ job roles, responsibilities, and priorities; and (v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.

Value-Based Health Care in Undergraduate Medical Education.

Value-based health care (VBHC) is an innovative framework for redesigning care delivery to achieve better outcomes for patients and reduce cost; however, providing students with the skills to understand and engage with these topics is a challenge to medical educators. Here, the authors present a novel, VBHC curriculum integrated into a required course for post-core clerkship students-launched in 2018 at Harvard Medical School and taught in conjunction with Harvard Business School faculty-that highlights key principles of VBHC most relevant to undergraduate medical education. The course integrates VBHC with related health disciplines, including health policy, ethics, epidemiology, and social medicine, using a case-based method. Students practice active decision making while learning key concepts to address value in clinical practice. Since the course's inception in March 2018, 95 students (87%) completed the standardized course evaluation; the majority said VBHC content and pedagogical style (i.e., case-based learning) enhanced their learning. Students' critiques focused on too little integration with other disciplines (e.g., social medicine, ethics), the physical space, and inadequate time for debates about potential tensions between VBHC and other course disciplines. The authors believe that by exposing medical students to the principles of VBHC, students will fulfill the expectations of graduating physicians by excelling as critical thinkers, collaborative team members, and judicious care providers throughout their residency, clinical practice, and beyond. Future VBHC curricula expansions may include elective coursework, intensive seminar series, and formal dual degrees.

Treatment of Anxiety Disorders - The Role of Pharmacists

Abstract Anxiety disorders represent the group of the most prevalent mental diseases which may have serious negative consequences for mental and social health. Anxiety is generally treated with a combination of the psychotherapeutic treatment and pharmacotherapy. Pharmacotherapy of anxiety implies the use of antidepressants, which are used as basic drugs, and an additional therapy with anxiolytics. This therapeutic approach in the treatment of anxiety disorders is accompanied by significant limitations. Adherence of anxiety patients is often insufficient due to the late onset of the effects of antidepressants, the appearance of adverse effects, the stigmatization of psychiatric patients in society and other reasons. Certain exogenous factors, such as an excessive use of coffee, smoking of marijuana, sleep disorders and personal problems, such as family problems or financial problems, can exacerbate anxiety and make it more difficult to treat it. Prolonged use of benzodiazepines, as an adjunct therapy in the treatment of anxiety, may be accompanied by the development of psycho-physical dependence. Finally, the drugs used to treat anxiety have a serious potential for the drug-drug interactions. All of these limitations may be completely or partially overcome through the active participation of Pharmacists as equal members of collaborative medical teams for the treatment of anxiety disorders.

An endnote: Advice and recommendations from University of Waikato education professionals, for teachers as researchers


 
 
 We conclude this issue with some advice for teachers as researchers from members of the Division of Education staff at the University of Waikato along with some recommendations for helpful reference books. The emphasis of this article, in the words of four of the staff, is one of the support available to assist education researchers. Educational research is not conducted in solitary but by researchers within a variety of relational contexts. Therefore, University teachers and class peers, supervisors, members of collaborative research teams and journal editors can all provide support in a teacher- researcher’s research journey.
 
 

Mutual Support, Role Breadth Self-Efficacy, and Sustainable Job Performance of Workers in Young Firms

Coworking space has flourished in the past decade. Unlike traditional shared services organizations, coworking spaces put a much greater emphasis on ‘sharing’. Members not only can share the physical office space, but also the virtual social spaces created by the coworking space operators managing the office. As coworking spaces provide a community to foster the culture of sharing, which gives rise to social interactions and thus knowledge and idea exchange, entrepreneurs favor such coworking spaces to achieve a higher level of job performance among their workers. Although it is generally accepted that a worker’s job performance varies over time within a job, there have been limited studies on within-person performance sustainability and its comparison with between-person sustainability. We sampled 101 workers of young firms operating in six coworking spaces in Singapore who completed daily surveys twice a day across ten consecutive workdays. By treating participants as the first level and daily observations as the second level, our study develops a dual-path model to explain how daily mutual support influences daily job performance. Our results indicated that daily mutual support is positively related to sustainable job performance after controlling for sleep quality, job requirements and workload stress. Within-person sustainability in mutual support was found to account for part of within-person variance in job performance. We established that mutual support not only predicts job performance, but also varies across workdays. As the collaboration of team members depends on cooperation rather than competition, mutual support is considered essential for team work and thus employees’ job performance. Our study also demonstrated the importance of role breadth self-efficacy as a moderator in the link between mutual support and sustainable job performance. Role breadth self-efficacy refers to the extent to which people feel confident that they are able to carry out a broader and more proactive role, beyond traditional prescribed technical requirements. The results revealed an enhancing moderation effect, where increasing the role breath self-efficacy would enhance the effect of the mutual support predictor on sustainable job performance of workers in young firms operating in the coworking space.

A smart performance measurement approach for collaborative design in Industry 4.0

Industry 4.0, the fourth industrial revolution, focuses on intelligent and smart manufacturing. This article investigates a smart design performance measurement approach, which can be utilized to support performance measurement implementation during a collaborative design process. First, we develop a smart product design framework with Industry 4.0 enabling technologies to support key design stages in an iterative fashion. Second, based on this framework, we propose a smart design performance measurement approach to potentially support a smart product design project management via its performance management. Third, we adapt our existing design performance measurement, for a traditional design environment into a smart design environment at its early stage to test its feasibility. This approach features integration of a flexible performance measurement setup, a multi-feedback design performance measurement mechanism and a multiple design performance measurement results presentation which allows the design performance measurement approach to produce flexible and customized operations by connecting design performance measurement with the stage-based design objectives, balancing design performance measurement feedbacks through interoperability between collaborative design team members and providing real-time design performance measurement results to guide design activities. An empirical industrial evaluation case study indicates that the proposed design performance measurement approach can support design team members in improving their collaborative design performance.

Learning Professionalism on the Touch-Line: Pedagogical Challenges and Recommendations

Context:Professionalism education is essential for the professional development and workplace readiness of allied health care students across the globe, but it presents a pedagogical challenge for educators. Students' understanding of professionalism varies at different educational stages and across different disciplines.Objective:To conceptualize professionalism education, with a particular focus on the sports environment, and to apply pedagogical frameworks to professionalism education in this field.Background:Traditional approaches to teaching professionalism have focused on role models; however, poor role modeling and the “hidden curriculum” present a threat to student professional development. Specific challenges to learning professionalism become apparent in the sports environment where students are exposed to cultures and practices that may be discordant with what is taught in the classroom.Synthesis:The idea of threshold concepts provides a useful pedagogical framework for conceptualizing the challenge of learning professionalism for students and can help to uncover the hidden curriculum. The evolving professional curriculum provides a framework for student professional development, focusing on developing students as reflective practitioners, skilled communicators, and collaborative team members. Students need to learn the skill of reflective practice, which can be facilitated through structured reflective models, reflective journal writing, and critical reflective group discussions. Creating opportunities for authentic reflection and discussion can facilitate students linking theory to real-world practice and help to make sense of their experiences.Recommendation(s) and Conclusion(s):Pragmatic recommendations for curriculum planning, teaching, and learning activities; stakeholder engagement; and research are proposed to develop professionalism education in the sports environment and to mitigate some risks presented by the hidden curriculum.

Collaborative teaching in flexible learning spaces: Capabilities of beginning teachers

Abstract Increasingly, New Zealand primary and intermediate schools are adopting the concept of flexible learning spaces and promoting team teaching approaches. Such open spaces and pedagogy can be challenging for even experienced teachers to adapt to. Is it realistic, therefore, to expect novices to work successfully in these challenging spaces from the onset of their teaching careers? Initial Teacher Education (ITE) programmes in New Zealand equip graduates with the knowledge and skills to plan, teach and evaluate learning for a diverse class of children with individual learning, social and cultural needs. However, while researching their own practice working within new spaces and pedagogy, some experienced Bay of Plenty intermediate and primary teachers articulated additional necessities for beginning teachers starting out in such complex teaching environments. Analysis of their ideas suggests such spaces require teachers to have particular capabilities if they are to work collaboratively in open learning spaces. This paper argues that ITE programmes and leaders need to be proactive and include appropriate theoretical and pragmatic coursework, to assist student teachers to cultivate the capabilities required of collaborative team members, by the time they graduate.

Improving Health of At-Risk Rural Patients project: A collaborative care model.

The design elements of the Improving Health of At-Risk Rural Patients (IHARP) care model are described. The IHARP project evaluated the clinical, economic, and humanistic outcomes associated with the collaborative care model relative to usual care in the community. The care model was initiated in 22 level 3- certified patient-centered medical homes. The primary outcomes are the absolute change in all relevant clinical and laboratory values of patients with hypertension, hyperlipidemia, and diabetes within and between the intervention and comparator groups; the change in the absolute number of emergency department visits and hospitalizations; and the change in the cost of care among the Medicare and Medicaid intervention patients. The lessons learned during the implementation and conduction of this project over the past three years are also presented. Patient enrollment ended in December 2014, final patient care visits were concluded in the fall of 2015, and results are expected in late 2016 or early 2017. This project will provide information from patients, physicians, and midlevel providers regarding their perceptions of clinical pharmacists as collaborative care team members. Data on health outcomes, health services utilization, and costs of care drawn from over 1600 Medicare beneficiaries will provide a robust assessment of the value of the IHARP care delivery model.