Team Confidence Research Articles

Improving Procedural Skills, Teamwork and Confidence in just One Day: A NICU Fellow Boot Camp.

This article was migrated. The article was marked as recommended. Objective: To develop a compact, simulation-based orientation session aimed at improving confidence and teamwork amongst new trainees. Methods: Two cohorts of five fellows participated in the one-day boot camp. Confidence in team leading and neonatal procedures was assessed using a pre and post survey administered on the day of boot camp as well as a delayed post-test after 6 months. Teamwork and communication were assessed using the TEAM scale. Results: We found that fellows confidence was significantly improved in 5 out of 6 categories (team leader in code (p < 0.001), team leader in delivery room (p < 0.001), decision making (p < 0.001), intubation (p < 0.001), chest tube placement (p < 0.001) and umbilical catheter placement (p = 0.09)). There was an overall improvement in teamwork, team leadership and communication throughout the day (p < 0.001). There was no significant change in self-reported confidence scores in all categories 6 months following boot camp. Conclusions: We demonstrated a significant improvement in confidence in first year neonatal-perinatal medicine fellows following a one-day simulation-based boot camp. The format for this boot camp could be emulated in institutions across the country to improve the confidence and skills of incoming fellows.

An experiment on the impact of coaches' and athlete leaders' competence support on athletes' motivation and performance.

Grounded in the Cognitive Evaluation Theory, the present experiment aimed to compare the relative impact of competence support provided by coaches versus athlete leaders on players' competence satisfaction, intrinsic motivation, and performance. We recruited 18 existing competitive male basketball teams (ie, 126 players) to participate in the experiment. Each team was randomly assigned to one of three conditions: (a) the coach provided competence support (ie, by encouraging, providing positive feedback, and expressing team confidence); (b) the athlete leader provided competence support; or (c) neither the coach, nor the athlete leader provided competence support (ie, control condition). Teams in which the athlete leader provided competence support reported higher levels of competence satisfaction and intrinsic motivation than teams in the control condition, a difference that did not emerge when the coach provided competence support. Furthermore, teams in which either the coach or the athlete leader supported team members' competence performed better compared to teams in the control group. Our findings highlight the importance of providing competence support to enhance team performance. Given athlete leaders' unique impact on teammates' competence satisfaction and motivation, instructing athlete leaders how to provide competence support constitutes an important motivational pathway for coaches to optimize team functioning.

Parent experience in the resuscitation room: how do they feel?

The aim of this study is to describe the experience of parents present in the resuscitation room during the attention given to their children in the pediatric emergency department, and to identify areas for improvement in this regard. This was a prospective study carried out in a third-level pediatric hospital. Children with life-threatening pathologies are treated in the resuscitation room of the pediatric emergency department. A survey was carried out among parents present in the resuscitation room during the period September 2016-August 2017. Excluded were the parents of children that died and those with a language barrier. The parents were interviewed in person or over the phone within 72h of the care provided in the resuscitation room. Fifty surveys were completed (15 in person and 35 by phone). Forty mothers and 10 fathers responded, with an average age of 41. In the resuscitation room, 39 parents were accompanied by a health professional and 22 were given information about how the resuscitation room operated. The feelings most frequently reported by the parents were nervousness (39) and trust in the healthcare provided (20). All of the parents wished to be present. They felt that their presence was beneficial for the child (46), for themselves (50), and for the healthcare personnel (28).Conclusion: The experience of the parents in our resuscitation room is a positive one. Nevertheless, some aspects need to be improved, such as accompaniment of the parents and the information that they are provided. What is Known: • There is an international recommendation for parental presence during invasive procedures and cardiopulmonary resuscitation. • Few studies have been carried out on how parents in the resuscitation room feel and how they encounter the experience. What is New: • Even though most of the parents feel nervous in the resuscitation room, they expressed confidence in the medical team and they would wish to be present under similar circumstances.

Coaching Behaviors That Enhance Confidence in Athletes and Teams

Confidence is a well-known psychological quality that is relevant for performing at one’s best. Previous literature examined sources from which athletes derive their confidence, what behaviors coaches perceive to be the most effective at building confidence, and the level of congruence between athletes’ and coaches’ perceptions on confidence-building techniques. However, research has rarely asked athletes what they believe are the most important behaviors coaches can do to build confidence in both individuals and teams. The purpose of this study, therefore, was to explore athletes’ perceptions of what coaches can do to build confidence from the perspective of athletes. Collegiate student-athletes (n = 264) completed two open-ended questions regarding specific behaviors that coaches do to build confidence in athletes and teams. A total of 649 interpretable meaning units were analyzed into 13 lower-order themes and 5 higher-order categories. Results revealed that creating a nurturing positive environment, responding to athletes productively, developing effective practices for training, developing interpersonal relationships with athletes, and possessing effective intrapersonal qualities themselves are all behaviors identified as important for building confidence. Many of the behaviors were common to building confidence in both athletes and teams, though there were confidence-building behaviors unique to either group.

The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study.

The primary aim of this study was to determine the surgical team's learning curve for introducing robotic-arm assisted unicompartmental knee arthroplasty (UKA) into routine surgical practice. The secondary objective was to compare accuracy of implant positioning in conventional jig-based UKA versus robotic-arm assisted UKA. This prospective single-surgeon cohort study included 60 consecutive conventional jig-based UKAs compared with 60 consecutive robotic-arm assisted UKAs for medial compartment knee osteoarthritis. Patients undergoing conventional UKA and robotic-arm assisted UKA were well-matched for baseline characteristics including a mean age of 65.5 years (sd 6.8) vs 64.1 years (sd 8.7), (p = 0.31); a mean body mass index of 27.2 kg.m2 (sd 2.7) vs 28.1 kg.m2 (sd 4.5), (p = 0.25); and gender (27 males: 33 females vs 26 males: 34 females, p = 0.85). Surrogate measures of the learning curve were prospectively collected. These included operative times, the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire to assess preoperative stress levels amongst the surgical team, accuracy of implant positioning, limb alignment, and postoperative complications. Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time (p < 0.001) and surgical team confidence levels (p < 0.001). Cumulative robotic experience did not affect accuracy of implant positioning (p = 0.52), posterior condylar offset ratio (p = 0.71), posterior tibial slope (p = 0.68), native joint line preservation (p = 0.55), and postoperative limb alignment (p = 0.65). Robotic-arm assisted UKA improved accuracy of femoral (p < 0.001) and tibial (p < 0.001) implant positioning with no additional risk of postoperative complications compared to conventional jig-based UKA. Robotic-arm assisted UKA was associated with a learning curve of six cases for operating time and surgical team confidence levels but no learning curve for accuracy of implant positioning. Cite this article: Bone Joint J 2018;100-B:1033-42.

Low major trauma confidence among emergency physicians working outside major trauma services: Inevitable result of a centralised trauma system or evidence for change?

Regionalised civilian trauma systems improve patient outcomes, but may deskill clinicians outside major trauma services (MTSs). We aimed to characterise experience and confidence in trauma management among emergency physicians working in MTS to those working elsewhere. Emergency physicians working within the Victorian State Trauma System were surveyed about their pre- and post-fellowship training experience, their estimated hours per fortnight in different centres, the frequency of performance/supervision of critical emergency skills and their confidence in a range of trauma skills. The 138 respondents analysed represented 33% of active Victorian FACEMs. The cohort were mostly males (69.6%), younger than 50 (75.4%) and were generally (69.6%) six or more years post-fellowship. FACEMs working in a MTS were more likely to have been a trauma registrar prior to fellowship (13.3% vs 3.7%, P = 0.046). MTS clinicians performed more, supervised more and were more confident in trauma team leading, traumatic airway management and rapid infusion catheter and multi-access catheters. Confidence in trauma team leading was only associated with exposure to performance or supervision of trauma team leading. Performance of trauma team leading was more common in clinicians at a MTS (odds ratio 3.19, 95% CI 1.00-10.20, P = 0.05). Exposure to major trauma is associated with time spent working in a MTS and exposure is associated with confidence. A mature inclusive trauma system must ensure clinicians across the system gain the experience or training to provide trauma care that will result in similar outcomes for patients regardless of initial presenting hospital.

Investigating the Links of Interpersonal Trust in Telecommunications Companies

The purpose of this paper is to determine if there are links between interpersonal trust and competences, relations, and cooperation in Polish telecommunications companies. It examines which factors affect trust in co-workers and managers in sustainable organizations. The paper surveys a sample of 175 employees of telecommunications companies in Poland by means of a questionnaire. The results indicate that competences, relations, and cooperation are related to interpersonal trust. Regression analysis showed that competences and relations predict a significant variance in trust amongst co-workers. Additionally, cooperation contributes to prediction of trust in mangers. Given the importance of trust in sustainable organizations, better comprehension of which factors are related to team confidence provides valuable information for stakeholders and about how to improve interpersonal trust in sustainable organizations.

Quantification of Critical Success Factors of Contractors in Cambodia: AHP Approach

Project success is commonly defined as a completion of a construction project within stipulated time, estimated cost and required quality. Undoubtedly, contractor’s, who is one of the influencing stakeholders for project activities, performance is critical for successful project completion. Thus, being the first work in its kind, this study evaluates the CSFs for contractors in Cambodia. The AHP approach was adopted for pairwise comparison of 22 identified critical success factors (CSFs) documented by 41 construction experts of various construction projects in Cambodia. The research findings revealed that the most critical factors for contractor’s success are: complexity of a project; social/cultural environment; ability to make timely decision; client confidence in construction team; contractor’s cash flow; client influence; project size; site management; contractor’s experience; and project planning.

Families' Experiences With Pediatric Family-Centered Rounds: A Systematic Review.

Family-centered rounding (FCR) is of increasing importance in pediatric medicine. Although researchers have begun to understand the effect of FCR on providers and systematic health care outcomes, we provide a systematic review of the literature regarding families' experiences with FCR. To systematically review patient and family experiences with pediatric FCR. Our data sources included PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus, and Embase. Inclusion criteria included publication in a peer-reviewed journal between January 2007 and February 2017, written in the English language, pediatric population (patients 0-21 years), and specific measurement of a families' experience with FCR. Data extracted were sample size, participating medical unit, measures of family experience, and overall results of family experience. Twenty-eight studies were included. It is unclear whether participation in FCR increases family satisfaction compared with standard rounds; however, families report a strong desire to participate in FCR. Family benefits of FCR included increased understanding of information and confidence in the medical team, as well as reduced parental anxiety. There were only 2 studies in which researchers examined pediatric patients' experiences with FCR, and literature on the communication needs of non-English-speaking families was also limited. Overall, it is suggested that families positively perceive their experience with FCR, although more research is needed to determine if satisfaction is greater in FCR versus standard rounds as well as to better understand different perspectives of adolescent patients and non-English-speaking families.

It Takes a Village to Move a Hospital: Simulation Improves Intensive Care Team Preparedness for a Move to a New Site.

To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing. Response rates were initially 100% and 67% at the 6-month follow-up. In the initial phase, all questions had statistically significant improvements in post- versus presimulation scores. Participants felt better prepared (presimulation: 6.20, postsimulation: 7.90, P < .001) and more confident about caring for real patients (presimulation: 5.49, postsimulation: 7.41, P < .001). They felt more comfortable working in the new unit (presimulation: 5.65, postsimulation: 7.50, P < .001) and better able to deliver safe care (presimulation: 5.85, postsimulation: 7.60, P < .001). Six months postmove, participants still believed that simulation was helpful (7.43, SD: 2.20) and still reported improved team confidence (7.36, SD: 2.11). Only 1 of 28 participants preferred less simulation. Exercises were described as helpful in identifying process and latent patient safety issues. Our pediatric intensive care team found simulations to be beneficial in preparation for providing care to critically ill children in a complex new setting. Simulations uncovered latent process, personnel, and patient-safety issues that were addressed before actual patient care.

When a Team is More Like a Group: Improving Individual Motivation by Managing Integrity Through Team Action Processes

An important interdisciplinary opportunity to conduct field research examines how to improve an individual’s contribution on a team that requires little to no interaction in order to accomplish the team’s mission, goals, and objectives. This field study examined 308 volunteers organized into 78 membership recruitment teams. A specific planned team intervention was implemented which blended two approaches: integrity management and team action processes. The results of the intervention showed that even when a team is more like a group, individual effort improves. The intervention had a significant indirect effect on individual performance through individual effort. Results further demonstrate that the intervention is distinct from self-efficacy and team confidence. Identifiability of contributions and visibility of effort are discussed as mechanisms through which team interventions influence effort and performance within teams for which the task itself does not require higher levels of interdependent work.

Managing virtual teams for open innovation in Global Business Services industry

PurposeThe purpose of this paper is to investigate the impact of human dimensions, team climates, and technological features on Global Virtual Team (GVT) performance in the Malaysian Global Business Services (GBS) industry. Attention has also been paid to examine the moderating effect of team diversity and the extent of virtuality on GVT performance.Design/methodology/approachData were collected using structured questionnaire and tested using partial least square – structural equation modelling. The authors collected 263 sample and the assessment of reflective measurement models, structural model, reliability and validity were conducted subsequently.FindingsThis paper found that team climates like team cohesion, team confidence, and team knowledge, skills, and abilities demonstrated different impact on the human dimensions which include trust and creativity. It will then subsequently affect GVTs’ performance. Besides, team diversity which comprised of three major components that include age diversity, functional diversity, and attitudes/values diversity was found to moderate the relationships between the antecedents and consequent. In spite of that, the extent of virtuality was found to have no moderating effects on the relationships between the team creativity and trust and perceived team performance.Originality/valueAs nowadays an increasing number of firms are becoming global, inquiring into GVTs efficient management is of crucial importance for successful implementation of open innovation practices, while GBS companies could represent the most suitable setting to examine the GVT’s underlying principles. This paper integrates adaptive structuration theory with input-mediator-output-input model to provide a holistic study on GVTs’ performance. In addition, this study also illustrated how the extent of virtually can be measured quantitatively.

Mortality From Cardiac Arrest After Cardiac Surgery: What Can be Done?

Purpose: Internationally, mortality following cardiac arrest after cardiac surgery is high. The Virginia State (USA) registry of 79,582 cardiac operations reported a mortality rate of 49%–69% in those suffering cardiac arrest after surgery. Factors such as education, teamwork, and communication are crucial in improving outcomes. Recent European Association for Cario-Thoracic Surgery (2009) and Society of Thoracic Surgeons (2016) guidelines address the resuscitative management of such patients. The Australasian Cardiac Surgery Advanced Life Support (CALS) course is taught in Sydney, Melbourne, and Adelaide. We report the impact of the inaugural New Zealand course on resuscitation team confidence.

La influencia del liderazgo del entrenador en los deportistas

Debido a la respaldada importancia que concede la investigación a las capacidades de liderazgo de los entrenadores deportivos, planteamos una revisión sistemática. El objetivo que perseguimos es dar una visión actual y detallada del estado de la cuestión en la actualidad sobre el estudio de la influencia del liderazgo del entrenador en los deportistas. La metodología que utilizamos es la propia de una revisión sistemática establecida por la declaración PRISMA, con cinco fases. Como base de datos a consultar, nos centramos en la Web of Science. Resultados: Obtenemos un total de 11 artículos válidos para el estudio. Entre otros resultados, encontramos que se han llevado a cabo estudios de este tipo en 9 países diferentes, que se ha estudiado sobre 14 deportes diferentes y que el cuestionario más utilizado para medir el liderazgo del entrenador es el LSS (Leadership Scale for Sport). Discusión y conclusiones: Concluimos que es un tema que está en auge y goza de un creciente interés a escala mundial, pues los estudios que integran el presente trabajo, argumentan la importancia e impacto del liderazgo ejercido por los entrenadores, en aspectos tan importantes en el deporte como, la cohesión de grupo, la confianza del equipo, la satisfacción y bienestar de los atletas, y el rendimiento del equipo.

Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage

ObjectiveTo develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH). DesignOnline didactic modules in combination with an interdisciplinary skills program consisting of seven hemorrhage-related stations. Setting/Local ProblemThe project was conducted in the Women’s Health Department in a quaternary-care Magnet- and Baby Friendly–designated academic medical center in Philadelphia, Pennsylvania. Women cared for at this center have comorbidities that place them at greater risk for PPH. A need was identified to implement a multidisciplinary and comprehensive program to assess hemorrhage risk and appropriately recognize and intervene with all PPHs in this setting. ParticipantsThe 276 participants, including registered nurses, obstetric and family medicine attending physicians and residents, advanced practice nurses, and ancillary staff in the hospital’s Women’s Health Department, completed the initial obstetric hemorrhage program. Intervention/MeasurementsThe program included online didactic modules, seven interdisciplinary skills stations led by trained nurses and providers, and an in situ simulation. Successful completion of the online modules was a prerequisite for participation in the skills stations. All participants completed a written program evaluation at the conclusion of the program. ResultsResults of the postassessment survey indicated that participants rated the program 3.94 of 4.00 for overall effectiveness to improve interdisciplinary team responses to PPH. Comments were overwhelmingly positive, and participants expressed increased confidence and knowledge related to PPH after completion of the program. ConclusionAn interdisciplinary program that included online didactic modules, interactive skills stations, and simulation improved team confidence and responses to PPH.

37. 3D Personalized dosimetry for Yttrium-90 microsphere radioembolization of liver tumors: feedback and clinical cases

Introduction Today, dose computation for Selective internal radiation therapy (SIRT) is based on methods easy to apply clinically. Several studies highlight dose-effect relationship for SIRT. As a result, interest enhances for advanced calculations and dose analysis tools as the ones used in external beam radiation therapy (EBRT). The Nuclear Medicine department of Montpellier University Hospital (MUH) implemented a new system to meet this need. This study describes the methodology applied, its interest and the questions raised illustrated by some clinical cases. Methods For every patient treated by SIRT, the dosimetry referred as “standard” applied at MUH follows the method described by Garin et al. [1] . This is based on the partition model for which the volumes of interest are defined using Syngo® software (Siemens, Erlangen, Germany) on SPECT images acquired after the injection of macro-aggregates of albumin (MAA) labelled with 99Tcm. Recently, the implementation of a treatment planning system (TPS), PLANET® Dose (DOSIsoft, Cachan, France), allows to perform dosimetry at the voxel level. This is done through two major steps: predictive dosimetry based on MAA-SPECT images and in vivo control dosimetry using PET images acquired after the injection of yttrium-90 (90Y) microspheres ( Fig. 1 ). Dose distribution is especially evaluated for tumoral and non-tumoral liver delineated on the injected CT or MR images by the radiology team. Dose computation rests on a convolution method based on voxel S factors. Pre and post treatment dosimetries are analyzed by the mean dose to the volume, the dose-volume histograms (DVH) and the isodose curves. Results The comparison between both dosimetric approaches (standard and at the voxel level) pointed out some differences. This particularly allowed to highlight the TPS contribution according to various aspects that were observed through clinical cases. A first aspect is related to the volume definition (functional only vs. anatomical and/or functional) for which the TPS contribution is especially interesting for complex clinical cases (multiple tumor sites, heterogeneous or partially targeted lesions, liver failure). This kind of system then allows dose evaluation in any compartment (volume at risk, portal vein thrombosis, multiple lesions, viable tumor, etc.). Moreover, voxelized dosimetry allows to analyze dose distribution uniformity with advanced tools (isodoses, DVH, etc.) in order to better assess areas of over/under dosing. Finally, being able to perform post-treatment dosimetry in order to know the real delivered dose and to sum several treatment sessions can play an important role in the patient therapeutic care. Conclusion Integrating a TPS like the ones used in EBRT in the SIRT process allowed to increase the medical team confidence and accuracy in the prescription of the activity to administer and to better control the dose delivered during the treatment. Setting up these new tools open the way to a more advanced personalization of this therapy.

The Integrated Pain Team: A Mixed-Methods Evaluation of the Impact of an Embedded Interdisciplinary Pain Care Intervention on Primary Care Team Satisfaction, Confidence, and Perceptions of Care Effectiveness.

To evaluate the impact of the Integrated Pain Team (IPT)-an interdisciplinary chronic pain care intervention embedded in primary care at a large Veterans Affairs health care system. Outcomes evaluated included IPT's impact on the perceived effectiveness of chronic pain care; provider self-confidence; and primary care team satisfaction, stress, and burnout. This mixed-methods quality-improvement study employed: 1) qualitative semistructured interviews of 61 primary care providers, other primary care team members, and organizational stakeholders; and 2) a supplementary quantitative survey of 65 providers, comparing those who had referred patients to IPT with those who had not. Most interview participants reported that IPT improved chronic pain care by providing patients with a comprehensive pain treatment plan, educating them about opioid risks, and introducing multimodal treatment options. Interviewed care team members reported improved patient education and fewer emotionally charged contacts from patients. Interviewed providers felt that IPT allowed them to focus their time on health concerns other than pain. However, our supplemental survey found that IPT-utilizing providers were no more confident than other providers in their own pain care skills or in their relationships with chronic pain patients. Integrating an interdisciplinary chronic pain care intervention into primary care can provide needed support to care teams and may improve chronic pain care. Elements of the IPT model identified as important to its effectiveness include its interdisciplinary biopsychosocial approach and attentive patient follow-up. However, enhancing providers' confidence and self-efficacy in chronic pain care may require educational and support resources beyond the current IPT model.

Emergency Airway Response Team Simulation Training: A Nursing Perspective

Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period. Sixty-three nurses from the emergency department (ED) and the intensive care units (ICUs) completed the simulation. Participants were evaluated before and after the simulation program with a knowledge-based test and a team dynamics and confidence questionnaire. Additional comparisons were made between ED and ICU nurses and between nurses with previous EART experience and those without previous EART experience. Comparison of presimulation (presim) and postsimulation (postsim) results indicated a statistically significant gain in both team dynamics and confidence and Knowledge Test scores (P < .01). There were no differences in scores between ED and ICU groups in presim or postsim scores; nurses with previous EART experience demonstrated significantly higher presim scores than nurses without EART experience, but there were no differences between these nurse groups at postsim. This project supports the use of simulation training to increase nurses' knowledge, confidence, and team dynamics in an EART response. Importantly, nurses with no previous experience achieved outcome scores similar to nurses who had experience, suggesting that emergency airway simulation is an effective way to train both new and experienced nurses.

Patient experience and overall satisfaction after emergency abdominal surgery

BackgroundThere is a growing recognition of the importance of patient experience in healthcare, however little is known in the context of emergency abdominal surgery. This study sought to quantify the association between patient experience and overall satisfaction.MethodsPatient demographics, operation details and 30-day clinical outcome data of consecutive patients undergoing emergency abdominal surgery were collected. Data was collected using validated Patient Reported Experience Measures (PREMs) questionnaires. Categorical data were tested using Mann Whitney U test. Multivariable regression was used to determine independent factors associated with satisfaction.ResultsIn a well-fitting multivariable analysis (R2 = 0.71), variables significantly associated with a higher global satisfaction score were “sufficient information given about treatment” (β = 0.86, 95% CI 0.01–1.70, p = 0.047), "sufficient explanation of risks and benefits of surgery" (β = 1.26, 95% CI 0.18–2.34, p = 0.020), “absence of night-time noise” (β = 1.35, 95% CI 0.56–2.14, p = 0.001) and “confidence and trust in nurses” (β = 1.51, 95% CI 0.54–2.49, p = 0.003).ConclusionsOverall patient satisfaction was strongly associated with perceptions of good communication and transfer of information. Confidence and trust in the clinical team is an important determinant of patient experience. Improving the ward environment by reducing noise at night may also improve the overall experience and satisfaction in emergency surgery.

“That was a good shift”

PurposeThe purpose of this paper is to investigate a boundary spanning, interprofessional collaboration between advanced practice nurses (APNs) and junior doctors to support junior doctors’ learning and improve patient management during the overtime shift.Design/methodology/approachA mixed methods evaluation of an intervention in an adult tertiary referral hospital, to enhance interprofessional collaboration on overtime shifts. Phase 1 compared tasks and ward rounds on 86 intervention shifts with 106 “regular” shifts, and examined the effect on junior doctor patient management testing a model using regression techniques. Phase 2 explored the experience of the intervention for stakeholders. 91 junior doctors participated (89 percent response rate) on 192 overtime shifts. Junior doctors, APNs and senior medical professionals/administrators participated in interviews.FindingsThe intervention was associated with an increase in self-initiated ward rounds by junior doctors, partially explained by junior doctors completing fewer tasks skilled nurses could also complete. The intervention significantly reduced doctors’ engagement in tasks carried over from day shifts as well as first year (but not more experienced) junior doctors’ total tasks. Interviews suggested the initiative reduced junior doctors’ work pressure and promoted a safe team climate, situation awareness, skills, confidence, and well-being.Originality/valueJunior doctors overtime shifts (5 p.m. to 11 p.m.) are important, both for hospitals to maintain patient care after hours and for junior doctors to learn and develop independent clinical decision making skills. However, junior doctors frequently report finding overtime shifts challenging and stressful. Redesigning overtime shifts to facilitate interprofessional collaboration can improve patient management and junior doctors’ learning and well-being.