Team Model Research Articles

Do acting interns need residents? A comparison of acting intern experience on hospital medicine resident versus nonresident teams.

The clinical demands for hospitalist groups have grown at academic medical centers, without similar growth of teaching opportunities for faculty. Traditional resident teaching teams are often crowded with learners which can limit acting intern (or subintern) patient encounters. Medical students are often placed on nonresident teaching teams, although there are few studies on learner experience on a nonresident teaching team model. To address these concerns, we created two nonresident teaching teams composed of one attending and two acting interns. We compared acting intern experience on the nonresident teaching teams to the traditional resident teams to determine if there were significant differences in student experience by reviewing course evaluation data on the two team models. Of the 276 students who completed the Internal Medicine Acting Internship from 2019 to 2023, 224 students (81%) completed the course evaluation. The course was highly rated, and the ratings were similar in both models demonstrating that the nonresident teaching team model is an effective option for acting interns. The nonresident teaching team model can offload crowded teaching teams, add additional acting intern experiences, and add teaching opportunities for hospital medicine attendings.

Removing Barriers to Degree Completion: The Dennis-Montagnino TEAMS Model for Student-Centered Transfer Credit

This paper presents the development of a comprehensive framework from which to engage with the process of college transfer credit. The Dennis-Montagnino Transparency, Empowerment, Attainability, Mentorship, and Sustainability (TEAMS) Model provides guidelines for the development of clear and accessible policy that serves to empower students and institutions alike. Further, the model outlines effective practices for improving the attainability of credit through streamlined and engaging practices, such as mentorship. Sustainability is discussed in the context of relevant innovations in the higher education landscape. Future directions, including the design and implementation of a pilot are discussed.

Stand in surgeon's shoes: virtual reality cross-training to enhance teamwork in surgery.

Teamwork in surgery depends on a shared mental model of success, i.e., a common understanding of objectives in the operating room. A shared model leads to increased engagement among team members and is associated with fewer complications and overall better outcomes for patients. However, clinical training typically focuses on role-specific skills, leaving individuals to acquire a shared model indirectly through on-the-job experience. We investigate whether virtual reality (VR) cross-training, i.elet@tokeneonedotexposure to other roles, can enhance a shared mental model for non-surgeons more directly. Our study focuses on X-ray guided pelvic trauma surgery, a procedure where successful communication depends on the shared model between the surgeon and a C-arm technologist. We present a VR environment supporting both roles and evaluate a cross-training curriculum in which non-surgeons swap roles with the surgeon. Exposure to the surgical task resulted in higher engagement with the C-arm technologist role in VR, as measured by the mental demand and effort expended by participants ( ). It also has a significant effect on non-surgeon's mental model of the overall task; novice participants' estimation of the mental demand and effort required for the surgeon's task increases after training, while their perception of overall performance decreases ( ), indicating a gap in understanding based solely on observation. This phenomenon was also present for a professional C-arm technologist. Until now, VR applications for clinical training have focused on virtualizing existing curricula. We demonstrate how novel approaches which are not possible outside of a virtual environment, such as role swapping, may enhance the shared mental model of surgical teams by contextualizing each individual's role within the overall task in a time- and cost-efficient manner. As workflows grow increasingly sophisticated, we see VR curricula as being able to directly foster a shared model for success, ultimately benefiting patient outcomes through more effective teamwork in surgery.

Application of multidisciplinary team model based on full-course management in health promotion of patients with breast cancer.

e13546 Background: To explore the application effectiveness of the multidisciplinary team model based on full-course management, in advancing the health promotion of breast cancer patients. Methods: This research involved a cohort of 84 breast cancer patients, recruited from the First Affiliated Hospital of Nanjing Medical University, spanning December 2022 and June 2023. These participants were divided into a control group and an intervention group using a convenience sampling method. The control group accepted routine nursing care, while the intervention group was treated with the multidisciplinary team approaches based on full-course management. These approaches included informal pre-admission interventions and multi-dimensional improvements to peri-operative patient comfort, integrated regimens combining Chinese and Western medicine to alleviate chemotherapy complications, diversified and extended nursing care focused on improving patients' quality of life, and facilitating physical and psychological rehabilitation. The two groups of patients were evaluated in satisfaction, comfort, quality of life, psychological state and other aspects. The results were evaluated by self-made satisfaction scale, breast cancer complications during chemotherapy questionnaire, Kolcaba Comfort Scale, Quality of Life Scale (QLQ-C30), self-rating Anxiety Scale (SAS) and self-rating Depression Scale (SDS). Patient outcomes were assessed in terms of satisfaction, comfort, quality of life, and psychological state. The results were evaluated by the self-made satisfaction scale, the breast cancer chemotherapy complications questionnaire, the Kolcaba Comfort Scale, the Quality of Life Scale (QLQ-C30), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Results: The intervention group showed statistically significant improvements in patient satisfaction, comfort and quality of life scores compared to the control group (P<0.05). Additionally, they exhibited a lower incidence of chemotherapy complications, severe anxiety and depression during the extended care period (P<0.05). Conclusions: The multi-disciplinary team model based on the full-course management demonstrated significant clinical benefits in the application of the full-course management of breast cancer patients. It effectively reduced chemotherapy-related complications, improved peri-operative comfort, decreased the incidence of severe anxiety and depression during the period of extended care, improved the physical and mental well-being of patients, leading to greater satisfaction and an enhanced quality of life.

Impact and Sustainability of Virtual Teams in an Adaptive World

Abstract Virtual Teams Model is nowadays a framework, moreover a structure designed to guide the organization of teams that collaborate remotely, and there are still different voices which are debating the effectiveness and efficiency of related structure in an adaptive environment. The current scientific literature is likely continuing to evolve, researchers are exploring topics related to impact of virtual collaboration and the sustainability of the model for business success, looking at motivation as the main human factor which values high. The research method was appointed quantitative and qualitative methods, two structured, three months’ period surveys and questionnaires were conducted, the qualitative phase aimed to uncover rich, context-specific information that quantitative methods alone might not capture. 30 IT specialists from Bucharest, average 32, were asked the three semi structured questions about the overall impact, long term sustainability and employers’ motivation of virtual teams’ setup in their organizations. The analysis unveils a significant boost in impact, and a simultaneous decline in sustainability and motivation. While heightened impact signals successful outcomes, reduced sustainability shows challenges in keeping long-term effectiveness. At the same time, waning motivation poses a risk to team engagement and overall performance. Striking a balance is crucial; strategies focusing not only on maximizing immediate impact but also on sustaining effectiveness and bolstering motivation are vital for enduring success in team dynamics. Initiative-taking measures and adaptive leadership are imperative to navigate and mitigate potential setbacks in the interplay of impact, sustainability, and motivation.

European Achondroplasia Forum Practical Considerations for Following Adults with Achondroplasia.

Achondroplasia is a lifelong condition requiring lifelong management. There is consensus that infants and children with achondroplasia should be managed by a multidisciplinary team experienced in the condition. However, many people are lost to follow-up after the transition from paediatric to adult care, and there is no standardised approach for management in adults, despite the recent availability of international consensus guidelines. To address this, the European Achondroplasia Forum has developed a patient-held checklist to support adults with achondroplasia in managing their health. The checklist highlights key symptoms of spinal stenosis and obstructive sleep apnoea, both among the most frequent and potentially severe medical complications in adults with achondroplasia. The checklist acts as a framework to support individuals and their primary care provider in completing a routine review. General advice on issues such as blood pressure, pain, hearing, weight, adaptive aids, and psychosocial aspects are also included. The checklist provides key symptoms to be aware of, in addition to action points so that people can approach their primary care provider and be directed to the appropriate specialist, if needed. Additionally, the European Achondroplasia Forum offers some ideas on implementing the checklist during the transition from paediatric to adult care, thus ensuring the existing multidisciplinary team model in place during childhood can support in engaging individuals and empowering them to take responsibility for their own care as they move into adulthood.

Community rehabilitation for people with severe and enduring mental health difficulties: a description and evaluation of a new community enhanced rehabilitation team

Background/Aims The community enhanced rehabilitation team was implemented in 2021 as part of the NHS Long Term Plan. This evaluation assesses whether the team is meeting its aims and objectives.. Methods Qualitative and quantitative methods were used to assess the team's progress. This included semi-structured interviews with service users, staff questionnaires and a review of data collected as part of routine clinical care.. Results Findings showed 117 interventions had been provided via the community enhanced rehabilitation team since May 2021. Service user anxiety had reduced following intervention, and service users were less likely to be re-hospitalised if they were under the community enhanced rehabilitation team compared to other teams. Conclusions The community enhanced rehabilitation team is meeting its aims and objectives, suggesting this is an effective model for community rehabilitation teams. Implications for practice Community enhanced rehabilitation teams can be created using this model as an example.

Individual perceptions of complex projects: A window into project team and stakeholder mental models

Understanding the current state of a complex project is challenging but essential for project teams to make effective management decisions. This research explores whether the indirect elicitation and comparison of mental models measured through individual level perceptions can encourage project team double loop learning about a complex project to inform management decisions. The best-worst scaling object case method was applied at the individual level to measure system-wide perceptions of two case study projects, demonstrating its efficacy in capturing team and stakeholder perceptions, and measuring how these change over time. Analysis of the case studies showed that highlighting the differences in mental models uncovered using the best-worst scaling object case method at the individual level can facilitate double loop learning and prompt management decisions about complex projects.

Progress and implementing of novel surgical concepts and techniques in patients with resectable gastric cancer liver metastasis

In recent years, advances in surgical techniques and evolving concepts have significantly improved treatment strategies and prognosis for patients with gastric cancer liver metastases. In particular, patients diagnosed with initially resectable gastric cancer liver metastases shows marked improvement in survival. Despite variations in the definition of initially resectable gastric cancer liver metastases among different consensus and guidelines, surgical resection and hepatic physiotherapy are increasingly crucial components of comprehensive treatment. Meanwhile, the advancement of the multidisciplinary team model for diagnosis and treatment, along with the evolution of minimally invasive surgical concepts, offers patients increasingly personalized and less intrusive therapeutic alternatives. According to the Chinese Consensus Classification System for Gastric Cancer Liver Metastasis, the optimal clinical pathway for patients initially diagnosed with resectable gastric cancer liver metastasis involves precise categorization, guided selection of surgical approaches and physiotherapy using the multidisciplinary team model, and consideration of molecular classification. However, the refinement and confirmation of these clinical strategies is still required through high-quality clinical trials.

Model development of empowered on the job training program to improve the school leadership effectiveness

Purpose: The development of an on-the-job training program manual model is a critical step for educational units within the framework of sustainable human resource capacity development, which aims to see the need for an on-the-job training program for school leadership teams to improve their leadership effectiveness. This certainly needs to be supported by the design of an on-the-job training program for school leadership teams to improve their leadership effectiveness as an alternative means of capacity building for school leadership teams in managing schools. In addition, it is also to see the validity, practicality, and effectiveness of the on-the-job training program model for the school leadership team to improve their leadership effectiveness which in turn can provide significance to the education services managed in schools. Method: This study used a development research method based on Smith and Ragan's design. The instruments used in the study were validation and practicality sheets, model needs analysis questionnaires, interviews, and observations. Data on the validity and practicality of the model were obtained during data processing. Data processing was continued with paired sample t-test analysis using SPSS and N-Gain to determine the effectiveness. Results: The results of existing research show: 1) an assessment of the feasibility of the EMPOWERED OJT model to increase the effectiveness of school leadership shows a very high validity category with an average value of 84%, and its practicality is considered very practical with an average value of 95%; 2) an assessment of effectiveness, there is a Sig value. (2-tailed) is <.001, which is < 0.05, indicating that H0 is rejected and Ha is accepted. This shows the influence of using the OJT program model manual to increase the effectiveness of school leadership. It is also seen that there is an increase in the average (gain) of the pretest and posttest data of 0.73, which is included in the medium group criteria. Based on the results of this research, the developed product model is effective and contributes positively to increasing the effectiveness of leadership in schools, in this case, in the ranks of school leaders.

What Is the Incidence of Anesthesia-Related Adverse Events in Oral and Maxillofacial Surgery Offices? A Review of 61,237 Sedation Cases From a Large Private Practice Consortium

BackgroundThe safety of the anesthesia team model performed in oral and maxillofacial surgery (OMS) offices has been criticized by professional and mainstream media. PurposeThis study aims to assess the incidence of adverse anesthetic events (AE) associated with the OMS anesthesia team model and identify risk factors associated with AEs. Study design, setting, sampleThis was a retrospective cohort study utilizing a patient database from Paradigm Oral Health®, Lincoln, Nebraska, a managed service organization (MSO). Subjects included were 14 and older, undergoing open-airway intravenous anesthesia for ambulatory OMS procedures using the OMS anesthesia team model at multiple private practices in the MSO network between June 30th, 2010, and September 30th, 2022. Exclusion criteria included patients younger than 14 or patients with incomplete medical records. Predictor variablePrimary predictor variables were age, sex, American Society of Anesthesiologists physical status classification system (ASA) score, type of surgical procedure performed, and the types of medications administered during sedation. Main outcome variableThe presence of an AE. The definition of an AE was modeled on the World Society of Intravenous Anesthesia (SIVA) definition. All AEs were identified through surrogate markers which were identified through chart review. One example of an AE is ventricular fibrillation, which necessitates application of medications, here the medication is the surrogate marker. CovariatesNone. AnalysesThe data were analyzed using t-tests and χ2 tests. P values ≤.05 were considered statistically significant. ResultsIncluded in the study were 61,237 sedation cases (53.87% female and 46.13% male), for 56,076 unique patients ranging from 14 to 98 years of age (mean 33.26 ± 18.35). An AE incidence of 3 per 100,000 per year (25 total events) was observed. Neither age, sex, ASA score, nor type of surgical procedure exhibited statistically significant associations with AEs. A statistically significant association was found between AEs and fentanyl (P = 0.0008). Conclusions and RelevanceThis investigation shows a smaller incidence of AEs than previous studies of the OMS anesthesia team model.

Teams need to be healthy, too: toward a definition and model of healthy teams

PurposeTeams across a wide range of contexts must look beyond task performance to consider the affective, cognitive and behavioral health of their members. Despite much interest in team health in practice, consideration of team health has remained scant from a research perspective. The purpose of this paper is to address these issues by advancing a definition and model of team health.Design/methodology/approachThe authors review relevant literature on team stress, processes and emergent states to propose a definition and model of team health.FindingsThe authors advance a definition of team health, or the holistic, dynamic compilation of states that emerge and interact as a team resource to buffer stress. Further, the authors argue that team health improves outcomes at both the individual and team level by improving team members’ well-being and enhancing team effectiveness, respectively. In addition, the authors propose a framework integrating the job demands-resources model with the input-mediator-output-input model of teamwork to illustrate the behavioral drivers that promote team health, which buffers teams stress to maintain members’ well-being and team effectiveness.Originality/valueThis work answers calls from multidisciplinary industries for work that considers team health, providing implications for future research in this area.

A Novel Computational Mathematical Model for Team and Route Selection of the Emergency Response Operations

During the daily operations of emergency response, the decision maker is faced with the complex challenge of selecting a team and route in a short time period to respond and attend to the emergency. This study presents the combined use of the Analytic Hierarchy Process (AHP), the Élimination Et Choix Traduisant la Realité II (ELECTRE II), and the Dijkstra algorithm to deal with such situations. First, the AHP method is implemented to rank the aspects that are most relevant to a given emergency. Subsequently, this ranking is employed in ELECTRE-II to determine which emergency response team is best prepared to provide support. In the last stage of the proposed model, regarding the geographic coordinates of the team and the emergency, the Geographic Information System (GIS) utilizes the Dijkstra algorithm to regulate the most suitable route for assistance.

Factors that influence scope-of-practice decisions of early-career family physicians: Focus group study in Canada.

To explore perceptions of early-career family physicians on the personal, educational, organizational, community, and system factors that had influenced their scope-of-practice decisions and to compare the similarities and differences among these factors across all 13 Canadian jurisdictions. Qualitative descriptive study. Canada. Fifty-nine early-career family physicians who were 2 to 5 years into independent practice. Data were collected using focus groups and were analyzed using deductive and inductive analysis techniques to identify patterns in the data within and across jurisdictions. Participants across all jurisdictions highlighted that personal factors (ie, interest, work-life balance and family life, financial considerations, and self-perceived competence and confidence) were most influential on scope-of-practice decisions. Educational (ie, exposure during training, mentorship), organizational (ie, collegial support), community (ie, needs), and system (ie, payment models, funding for team-based care, governance) factors also influenced decisions about scope of practice. Experiences were similar across all jurisdictions for personal factors. Differences in experiences were reported across jurisdictions for educational, organizational, community, and system factors. Decisions about scope of practice by early-career family physicians are highly influenced by personal factors followed by organizational, educational, community, and system factors. These findings suggest numerous strategies are needed to increase individuals' interest in providing comprehensive care in Canada. Educators should cultivate interest in comprehensive care among learners, strategically recruit trainees, provide targeted exposure and experiences, ensure competence and confidence are evaluated throughout and at the end of training, and introduce formal mentorship programs. Policy-makers should invest in the spread of effective team models and alternative payment models. Together, these strategies could broaden the scopes of practice of family physicians and their capacity to deliver accessible and comprehensive care to Canadians.

Ohio START: An adaption of the National Sobriety Treatment and Recovery Teams model

BackgroundThe Sobriety Treatment and Recovery Teams (START) model is an evidence-supported intervention for families with at least one child under age 6 involved in the child welfare system due to substance misuse. The hallmark of the START model is early identification and linkage to addiction treatment services. To address the dual problem of heightened need for addiction treatment services and limited treatment availability in the wake of the opioid epidemic, Ohio’s adaptation extended the model to serve all eligible families regardless of the age of children in the household. ObjectiveTo investigate the delivery of the START model for parents and caregivers of older youth (age 6–18) only as compared to the population for which it was originally intended. MethodsWe used data from 40 counties and with parents as the unit of analysis (N = 714). We used multilevel models to estimate the relationship between the age of children in the home and 1) meeting fidelity for timely access to treatment services and 2) successful completion of the model. ResultsThere was no statistically significant difference in the likelihood of meeting fidelity requirement for timely access to treatment services, nor in successful completion for families with older children as compared to those with at least one child aged 0–5. ConclusionsThese results lend support to the use of the START model for all eligible families, regardless of the children’s ages. Future studies can examine more nuanced relationships to include the role of specific substances, child placement, and the role of family peer mentors.

Exploring Best Practices of University Table Tennis Teams in China: Basis for Improving Table Tennis Sports Training

This article is a qualitative research, using interview method to investigate the table tennis teams of six Chinese universities to understand the development of Chinese university table tennis teams from the perspective of their management structure, enrollment process, cultural learning, team training, source of funding, team's budget, and assisting organizations to the teams. Through the interviews, it was learned that the table tennis teams of these universities are mainly divided into three types, the first one is independent enrollment, which requires that the students applying for the exams have a Level 2 Athlete Certificate, and the table tennis exams and the cultural learning exams are both conducted independently. The second type is for students who are admitted to the university by the general college entrance examination, they will participate in the school's selection competition after entering the university, and the winners will be selected to join the school's table tennis team. The third type is a combination of a high-level enrollment test and a college entrance exam. After passing the school's table tennis test, the student will take the college entrance exam and be admitted on merit after reaching the school's admission line. Coaches and athletes generally believe that nowadays the examination system for college athletes is getting better and fairer, and that coaches and athletes have high recognition of their school table tennis teams, and that each school has a good atmosphere for training and competition with perfect training, teaching, and medical facilities and security, and participates in regular competitions in the province or the whole country. By understanding the different development models of university table tennis teams in China, we hope to help university table tennis teams to summarize their experiences and find a better development direction.

An adaptive network model for AI-assisted monitoring and management of neonatal respiratory distress

This article presents the use of second-order adaptive network models of hospital teams consisting of doctors and nurses, interacting together. A variety of scenarios are modelled and simulated, in relation with respiratory distress of a neonate, along with the integration of an AI-Coach for monitoring and support of such teams and of organizational learning. The research highlights the benefits of introducing a virtual AI-Coach in a hospital setting. The practical application setting revolves around a medical team responsible for managing neonates with respiratory distress. In this setting an AI-Coach act as an additional team member, to ensure correct execution of medical procedure. Through simulation experiments, the adaptive network models demonstrate that the AI-Coach not only aids in maintaining correct medical procedure execution but also facilitates organizational learning, leading to significant improvements in procedure adherence and error reduction during neonatal care.

Are Top Management Teams Compensated as Teams? A Structural Modeling Approach

I develop two empirical models to quantify agency friction caused by moral hazard in top management teams. They capture shareholders’ distinct perspectives on compensating top managers: the Individual Model, in which managers in a firm unilaterally shirk, and the Team Model, in which managers choose effort jointly. The Team Model rationalizes observed compensation better than the Individual Model, underlining the importance of managerial coordination and team-based incentives. This paper also offers novel estimates of agency friction in a team production setting. Risk premium explains a large portion of the pay differential across and within firms. Firm value would have dropped between 4% and 15% if managers shirked. Additional counterfactual estimation suggests that shareholders could reduce the total compensation by up to $17 million if they were to switch from the individual perspective to the team perspective. This paper was accepted by Shivaram Rajgopal, accounting. Funding: This work was supported by the Professional Staff Congress and the City University of New York (PSC-CUNY) [Grant 67780-00 45]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2024.4982 .

Integrating substance use peer support and screening brief intervention and referral to treatment services in the emergency department: a descriptive study of the ED leads program

BackgroundThe ED Leads program was introduced to 11 emergency departments (EDs) within New York City public hospitals from 2018 to 2019 to address a need for addiction support services in the ED. The purpose of this study is to (i) describe the ED Leads blended licensed-clinician and peer counselor team model in the ED at three hospitals, (ii) provide a descriptive analysis of patient engagement and referrals to substance use disorder (SUD) care post-intervention, and (iii) highlight potential barriers and facilitators to implementing the model.MethodsThe program intended to combine Screening Brief Intervention and Referral to Treatment and peer support services. The authors analyzed electronic medical records data for patients encountered by ED Leads in the first 120 days of program launch. Data included the outcome of an encounter when a patient was engaged with one or both staff types, and 7-day attendance at an SUD treatment appointment when a patient accepted a referral within the 11-hospital system.ResultsThere were 1785 patients approached by ED Leads staff during the study period. Engagement differed by staff type and patient demographics, and encounter outcomes varied significantly by hospital. Eighty-four percent (N = 1503) of patients who were approached engaged with at least one staff type, and 6% (N = 86) engaged with both. Patients were predominantly male (N = 1438, 81%) with an average age of 45 (SD = 13), and enrolled in Medicaid (N = 1062, 59%). A majority (N = 801, 45%) had alcohol use disorder. Of the patients who accepted a referral within the system (N = 433), 63% received treatment services within 7 days of the ED Leads encounter, a majority at detoxification treatment (N = 252, 58%).ConclusionsThis study describes the potential value and challenges of implementing a blended peer counselor and licensed clinician model in the ED to provide SUD services. While teams provided a high volume of referrals and the analysis of post-intervention treatment follow up is promising, the blended team model was not fully realized, making it difficult to assess the benefits of this combined service. Further research might examine patient outcomes among ED patients who are offered services by both a peer counselor and licensed clinician.

How do medical schools influence their students' career choices? A realist evaluation.

The career choices of medical graduates vary widely between medical schools in the UK and elsewhere and are generally not well matched with societal needs. Research has found that experiences in medical school including formal, informal and hidden curricula are important influences. We conducted a realist evaluation of how and why these various social conditions in medical school influence career thinking. We interviewed junior doctors at the point of applying for speciality training. We selected purposively for a range of career choices. Participants were asked to describe points during their medical training when they had considered career options and how their thinking had been influenced by their context. Interview transcripts were coded for context-mechanism-outcome (CMO) configurations to test initial theories of how career decisions are made. A total of 26 junior doctors from 12 UK medical schools participated. We found 14 recurring CMO configurations in the data which explained influences on career choice occurring during medical school. Our initial theories about career decision-making were refined as follows: It involves a process of testing for fit of potential careers. This process is asymmetric with multiple experiences needed before deciding a career fits ('easing in') but sometimes only a single negative experience needed for a choice to be ruled out. Developing a preference for a speciality aligns with Person-Environment-Fit decision theories. Ruling out a potential career can however be a less thought-through process than rationality-based decision theories would suggest. Testing for fit is facilitated by longer and more authentic undergraduate placements, allocation of and successful completion of tasks, being treated as part of the team and enthusiastic role models. Informal career guidance is more influential than formal. We suggest some implications for medical school programmes.