Positive Team Dynamics Research Articles

Enhancing Nursing Excellence: Exploring the Relationship between Nurse Deployment and Performance.

Proper nurse placement is crucial for enhancing the performance and quality of health services. This study aims to explore in-depth the relationship between nurse placement and performance in order to promote nursing excellence. A quantitative analysis was conducted using a descriptive correlational methodology. The population in this study consisted of 214 executive nurses at Medan Government Hospital, with a sample size of 139. The study's findings revealed that nurses performed exceptionally well in providing nursing care, scoring 94.2%, with those well-placed scoring 90.6%. The results from the Spearman rho correlation test showed that nursing qualifications, experience, work environments, and team dynamics have significant relationships with nurse performance. Meanwhile, the nurse's rho factor towards patients and the policy or regulation component showed low significance and relationship. The novelty of this study lies in its indication that nursing performance can be enhanced by aligning the placement of nurses with their abilities and experience, and fostering a work environment and positive team dynamics that encourage collaboration and efficiency. These findings provide vital insights for nursing staff management in order to enhance nursing care quality and patient health outcomes. This study highlights the need for suitable placement and professional development for nurses in order to attain maximum performance.

DEIA: On Paper or in Practice? A Study on the Impact of Authentic and Inauthentic Diversity, Equity, Inclusion, and Accessibility (DEIA) Initiatives in Indian Organizations

This study explores the influence of Diversity, Equity, Inclusion, and Accessibility (DEIA) practices on employees, focusing on the distinction between authentic and inauthentic DEIA initiatives. Through a survey of 212 participants, the study evaluates organizational commitment, motivation, and team dynamics in workplaces with varying levels of DEIA authenticity. Results demonstrate that employees in organizations with authentic DEIA practices report significantly higher levels of organizational commitment, motivation, and positive team dynamics compared to those in inauthentic organizations. These findings underscore the importance of genuine DEIA efforts for enhancing employee experience and organizational performance. Future research should focus on the leadership's role in fostering authentic DEIA practices.

Exploring the impact of social identity and team dynamics on mental health help-seeking behavior among collegiate athletes: a qualitative study

This study explores the influence of social identity and team dynamics on the mental health help-seeking behaviors of collegiate athletes. The research aims to understand how factors such as gender, ethnicity, and social status shape athletes' attitudes and actions regarding mental health assistance. Method: Using a mixed-method approach that included focus group discussions (FGDs) and in-depth interviews, data were collected from 30 athletes representing various sports disciplines, ensuring balanced representation in terms of gender, ethnicity, and social status.Result: Thematic analysis revealed significant themes: male athletes faced substantial stigma in seeking mental health assistance, viewing it as a sign of weakness, while female athletes were more open and supported by a culture of emotional expression. Minority athletes encountered additional barriers due to cultural stigma and a lack of culturally competent services, whereas majority athletes had better access to mental health resources. High-status athletes experienced pressure to maintain their image, leading to reluctance in seeking help, while low-status athletes faced challenges in accessing resources despite their willingness to seek help. Positive team dynamics, characterized by support and open communication, facilitated help-seeking behavior, while negative dynamics, such as bullying and lack of trust, created barriers. Conclusion: The study highlights the need for targeted interventions that address specific needs based on gender, ethnicity, and social status, promote mental health literacy, and foster supportive team environments. Future research should focus on the long-term effects of stigma-reduction interventions, culturally tailored mental health services, and the impact of team dynamics over time. These findings provide valuable insights for developing effective mental health support systems for collegiate athletes. Keywords: Cultural Competency, Ethnicity, Health Literacy, Social Identification, Athletes, Bullying

THE INFLUENCE OF AGILE PRACTICES ON PROJECT OUTCOMES: PERFORMANCE, STAKEHOLDER SATISFACTION, AND TEAM DYNAMICS

Agile methodologies have become a cornerstone in modern software development, promising enhanced project performance, improved stakeholder satisfaction, and positive team dynamics. This study investigates the influence of Agile practices on key project outcomes, focusing on performance, stakeholder satisfaction, and team dynamics. The primary objective is to explore the core principles and practices of Agile methodologies, such as Scrum, Kanban, and Lean, and how these frameworks are applied in diverse project settings. The research examines the direct impact of Agile practices on project performance, including time efficiency, cost management, and quality delivery. Additionally, the study assesses how Agile approaches enhance stakeholder satisfaction by fostering continuous communication, adapting to changes, and ensuring alignment with project goals. Furthermore, the analysis explores the effect of Agile practices on team dynamics, emphasizing collaboration, self-organization, and cross-functional teamwork. By synthesizing findings from case studies, interviews, and surveys across various industries, this study aims to provide valuable insights into how Agile methods influence overall project outcomes and contribute to improved performance, stronger stakeholder relationships, and enhanced team cohesion. The results are intended to guide organizations in effectively implementing Agile practices to maximize project success and foster sustainable growth in dynamic environments.

COVID-induced virtual teams: A phenomenon-based framework and methodological advice for studying novel events

PurposeWe conceptualized the novel phenomenon of COVID-induced virtual teams and its implications and provided researchers with the required information on how to conduct a phenomenon-based study for conceptualizing novel phenomena in relevant ways.Design/methodology/approachThis article stems from phenomenon-based and, thus, theory-building and grounded qualitative research in the German industrial sector. We conducted 47 problem-centered interviews in two phases (February–July 2021 and February–July 2022) to understand how team members and team leaders experienced COVID-induced virtual teamwork and its subsequent developments.FindingsEmpirically, we found COVID-induced virtual teams to be characterized by a high relevance of shaping positive team dynamics via steering internal moderators; crisis is a novel external moderator and transformation becomes the key output factor to be leveraged. Work-from-home leads to specific configuration needs and interrelations between work-from-home and on-site introduce additional dynamics. Methodologically, the phenomenon-based approach is found to be highly suitable for studying the effects of such novel phenomena.Research limitations/implicationsThis article is explorative. Thus, we advocate further research on related novel phenomena, such as post-COVID-hybrid and work-from-home teams. A model of how to encourage positive dynamics in post-COVID-hybrid teams is developed and lays the groundwork for further studies on post-COVID teamwork. Concerning methodology, researchers are provided with information on how to conduct phenomenon-based research on novel phenomena, such as the COVID-induced virtual teams that we studied.Practical implicationsCompanies receive advice on how to encourage positive dynamics in post-COVID teamwork, e.g. on identifying best practices and resilient individuals.Social implicationsIn a country such as Germany that faces labor shortages, our insights might facilitate better labor-market integration for those with care-work obligations and international workers.Originality/valueWe offer a first conceptualization of a relevant novel phenomenon, namely COVID-induced virtual teams. We exemplify the phenomenon-based approach as a suitable methodology that serves to build relevant theory using active categorization.

COVID-19 infection prevention and control for hospital workers in Indonesia.

The outbreak of SARS-CoV-2 in 2019 led to a global pandemic, posing unprecedented challenges to healthcare systems, particularly in hospitals. This study explores the intricacies of strategies employed for preventing and controlling COVID-19 in Indonesian hospitals, with a particular focus on the protocols, challenges, and solutions faced by healthcare professionals. Using a cross-sectional analysis, we examined 27 hospitals and uncovered disparities in their preparedness levels. During our investigation, we observed the robust implementation of infection prevention measures, which encompassed stringent protocols, adequate ventilation, and proper use of personal protective equipment. However, shortcomings were identified in areas such as surveillance, mental health support, and patient management. This study underscores the importance of addressing these gaps, suggesting tailored interventions, and continuous training for healthcare staff. Effective leadership, positive team dynamics, and adherence to comprehensive policies emerge as pivotal factors. Hospitals should strengthen weak areas, ensure the ethical execution of emergency protocols, and integrate technology for tracking and improving standard operating procedures. By enhancing the knowledge and skills of healthcare workers and maintaining strong management practices, hospitals can optimize their efforts in COVID-19 prevention and control, thereby safeguarding the wellbeing of professionals, patients, and communities.

Project performance and the effects of human activity: a case study of the University of Salford

Conflict is common in the project management industry. Project performance may be impacted negatively or favourably by human activities such as competing interests among stakeholders, project team members, and project managers, as well as by the intimidating methodology and structure of the project management process. This case study at the University of Salford looked into how human activity affects project management and performance. The mixed methodology used in this study allowed for a deeper understanding of the real-world experiences of the subjects and project teams. Project management students and professionals from the University of Salford provided the data, which was collected. The survey generated a sample size of 40 responses, of which 37 were reliable enough for analysis. At the University of Salford, it was discovered that relationships among team members were a crucial human activity that promoted cooperation, trust, and the extension of trust to others, thereby reducing conflict and ties of trust between stakeholders and project managers. However, positive team dynamics and strong group cohesion are required to actively and purposefully encourage conflict in order to achieve the project's aim, goals, and deliverables. Conflict in project performance and project management productivity, for example, may be reversed. Therefore, to achieve high performance and productivity, the project management process needs strong communication, positive team dynamics, and an understanding of scope. Conflict can have a negative effect on the process, lowering productivity and performance. Project managers should develop their communication skills to avoid this because it is a soft skill that can be learned and enhanced. This guarantees proper coordination, awareness of all stakeholders, and a decrease in conflict.

Exploring Perfusion Safety: A Review of Clinical and Non-Clinical Factors with Emphasis on Quality Improvement

This literature review examines perfusion safety in cardiothoracic surgery, with a primary focus on cardiopulmonary bypass (CPB) and circulatory devices. PRISMA guidelines were followed and various databases, including PubMed, MEDLINE, and Google Scholar, were searched using relevant keywords to identify pertinent studies and literature on the subject. The review traces the historical development of perfusion techniques and underscores the importance of equipment factors, personnel considerations, and perfusion management strategies in ensuring patient safety during CPB and circulatory device usage. Clinical aspects of perfusion safety, encompassing equipment safety features, temperature management, anticoagulation, and blood conservation, are discussed. Non-clinical aspects, including the implementation of standardized protocols, robust training structures, positive team dynamics, and the fostering of a safety-oriented culture, are also examined. Quality improvement initiatives for blood conservation, monitoring, and incident reporting are explored, along with an acknowledgment of the significant contributions of major perfusion societies and boards (AmSECT, SCPS, EBCP) in establishing standards and promoting excellence in the field. Challenges related to device design, patient selection, and perioperative management are addressed, highlighting the need for standardized practices and ongoing research to enhance perfusion safety. This comprehensive review underscores the enduring commitment to advancing perfusion safety and quality through systematic research, education, and collaborative efforts in cardiothoracic surgery.

Attending to the Emotional Side of Professional Learning Communities (PLCs) by Cultivating Positive Team Dynamics

Professional Learning Communities (PLCs) are becoming increasingly commonplace in America’s schools. As part of the school community, physical educators are positioned to add and receive value within PLCs. Given that school-based PLCs are driven by collaborative teams, reaching high performing status requires external supportive school structures coupled with internal positive team dynamics. A PLC can be an emotionally charged collective action formation with the potential to positively enhance teacher practice and student learning or, conversely, be hindered by adult drama. This paper focuses on and provides research-informed practical suggestions for addressing the internal team dynamics aspects of physical education PLCs (PE-PLCs). Drawing from team dynamics literature, this analysis unpacks and applies sub-constructs associated with team member attitudes, behaviors, and cognitions (ABCs) within a PE-PLC setting. Practical suggestions for enhancing ABCs within PLCs are provided.

A qualitative descriptive study of the impact of the COVID-19 pandemic on staff in a Canadian intensive care unit

PurposeWe sought to explore the lived experiences of a professionally diverse sample of healthcare workers (HCWs) in a single intensive care unit (ICU) serving a large and generalizable Canadian population. We aimed to understand how working during the COVID-19 pandemic affected their professional and personal lives, including their perceptions of institutional support, to inform interventions to ameliorate impacts of the COVID-19 and future pandemics.MethodsIn this qualitative descriptive study, 23 ICU HCWs, identified using convenience purposive sampling, took part in individual semistructured interviews between July and November 2020, shortly after the first wave of the pandemic in Ontario. We used inductive thematic analysis to identify major themes.ResultsWe identified five major themes related to the COVID-19 pandemic: 1) communication and informational needs (e.g., challenges communicating policy changes); 2) adjusting to restricted visitation (e.g., spending less time interacting with patients); 3) staffing and workplace supports (e.g., importance of positive team dynamics); 4) permeability of professional and personal lives (e.g., balancing shift work and childcare); and 5) a dynamic COVID-19 landscape (e.g., coping with constant change). The COVID-19 pandemic contributed to HCWs in the ICU experiencing varied negative repercussions on their work environment, including staffing and institutional support, which carried into their personal lives. ConclusionHealthcare workers in the ICU perceived that the COVID-19 pandemic had negative repercussions on their work environment, including staffing and institutional support, as well as their professional and personal lives. Understanding both the negative and positive experiences of all ICU HCWs working during the COVID-19 pandemic is critical to future pandemic preparedness. Their perspectives will help to inform the development of mental health and wellbeing interventions to support staff during the COVID-19 pandemic and beyond.

Adapt and overcome: Perceptions of adaptive autonomous agents for human-AI teaming

Rapid advances in AI technologies have caused teams to explore the use of AI agents as full, active members of the team. The complex environments that teams occupy require human team members to constantly adapt their behaviors, and thus the ability of AI teammates to similarly adapt to changing situations significantly enhances the team’s chances to succeed. In order to design such agents, it is important that we understand not only how to identify the amount of autonomous control AI agents have over their decisions, but also how changes to this control cognitively affects the rest of the team. Professional organizations often break their work cycles into phases that set limits on the team members’ actions, and we propose that a similar process could be used to define the autonomy levels of AI teammates. Cyber incident response is an ideal context for this proposal, as we were able to use incident response phases to explore how a team’s work cycle could guide an AI agent’s changing level of autonomy. Using a mixed methods approach, we recruited 103 participants to complete a factorial survey containing ten contextual vignettes focused on an AI teammate’s level of autonomy in incident response contexts, and from these participants we conducted twenty-two follow-on qualitative interviews that further explored how the participants felt an AI agent’s adaptive capabilities would affect team performance and cohesiveness. Our results showed that work cycles can be used to assign autonomy levels to adaptive AI agents based upon the degree of formal processes and predictability of the team’s tasks during the cycle, and that dynamic, human-like adaptation methods are vital to effective human-AI teams. This research provides significant contributions to the HCI community by proposing design recommendations for the development of adaptive autonomous teammates that both enhance Human-AI teams’ productivity and promote positive team dynamics.

Golden Hour Education, Standardization, and Team Dynamics: A Literature Review.

The "golden hour" is the critically important first 60 minutes in an extremely low birth weight neonate's life that can impact both short- and long-term outcomes. The golden hour concept involves several competing stabilization priorities that should be conducted systematically by highly specialized health care providers in both the hospital and transport settings for improvement in patient outcomes. Current literature supports utilizing an experienced team in the golden hour process to improve patient outcomes through standardization, improved efficiency, and positive team dynamics. Although a variety of teaching methods exist to train individuals in the care of extremely low birth weight infants, the literature supports the incorporation of low- or high-fidelity simulation-based training. In addition, initial and ongoing educational requirements of individuals caring for a golden hour-eligible infant in the immediate post-delivery phase, as well as ongoing care in the days and weeks to follow, are justified. Instituting standard golden hour educational requirements on an ongoing basis provides improved efficiency in team function and patient outcomes. The goal of this literature review was to determine whether implementation of golden hour response teams in both the inpatient and transport setting has shown improved outcomes and should be considered for neonatal intensive care units admitting or transporting golden hour eligible infants.

Who Learns and What They Learn: Evidence from an Action-Based Entrepreneurship Training Program

Scholars highlight that learning outcomes of entrepreneurship training might not be homogeneous for all participants and call for studies on contextual factors that might affect such outcomes. We respond to the call and explore the role of two contextual factors, team dynamics and the learning environment, on two important learning outcomes that are precursors of entrepreneurial engagement – entrepreneurial readiness and knowledge readiness. Drawing from literature on psychological safety and status differences, we hypothesize the differences in learning outcomes of graduate students and faculty members who participated in action-based technology entrepreneurship program as part of the National Science Foundation’s (NSF) I-Corps program. The findings suggest that positive team dynamics increase entrepreneurial readiness for both types of trainees, but increases knowledge readiness of only graduate students, suggesting differential importance of team-level factors. The findings for learning environment are more complex. While a negative learning environment was not significantly associated with entrepreneurial or knowledge readiness for either trainee type, a positive learning environment was a significant predictor of both entrepreneurial and knowledge readiness for faculty but was only a significant predictor for knowledge readiness among graduate students. This study contributes to the entrepreneurship training literature by showing the impact of team and broader contextual level factors on training efficacy. The findings have implications for both academic and corporate trainers who design action-learning programs.

Getting Ahead While Getting Along: Followership as a Key Ingredient for Shared Leadership and Reducing Team Conflict.

Followership and leadership provide two distinct but complementary sets of behaviors that jointly contribute to positive team dynamics. Yet, followership is rarely measured in shared leadership research. Using a prospective design with a sample of leaderless project teams, we examined the interdependence of leadership and followership and how these leader-follower dynamics relate to relationship conflict at the dyadic and team level. Supporting the reciprocity of leader-follower dynamics, social relations analyses revealed that uniquely rating a teammate higher on effective leadership was associated with being rated higher by that same person on effective followership. Additionally, team members with a reputation as an effective leader also tended to be viewed as an effective follower. As expected, team levels of leadership were tightly linked to team levels of followership. Connecting these results to relationship conflict at the dyadic level, we found that uniquely rating someone as an effective follower or an effective leader would decrease the likelihood of experiencing interpersonal conflict with that person and that having a reputation for effective followership or effective leadership relates negatively to being viewed as a conflict hub within the team. Finally, effective followership was significantly negatively related to team levels of conflict, but we did not find a significant relation between effective leadership and relationship conflict at the team level. Our results highlight that followership is not only a necessary ingredient for high levels of shared leadership to exist within a team, but it underpins more functional team interactions.

Interprofessional Leadership Development: Role of Emotional Intelligence and Communication Skills Training.

IntroductionAmong the many skills required for leading interprofessional health care teams, emotional intelligence and communication skills are critical to building professionalism, establishing patient trust, and providing optimal patient care. Nonetheless, these skills are often overlooked in medical training. We implemented a 2.5-hour workshop for interprofessional trainees to self-assess, reflect, and apply their emotional intelligence and communication skills.MethodsParticipants were interprofessional trainees, including internal medicine residents, medical students, and graduate students in clinical pharmacy, physician assistant, and health psychology training programs. The workshop consisted of reflective activities to self-assess emotional intelligence and communication styles; a didactic presentation focused on leadership, emotional intelligence, and communication styles; and a teamwork activity to apply emotional intelligence and communication skills.ResultsForty-four trainees participated in this workshop. After the workshop, trainees reported increased knowledge about positive strategies to communicate with team members, felt more comfortable working with other professionals to encourage positive team dynamics, and were more prepared to encourage leadership in their interprofessional teams. Examination of learner evaluations suggested that residents endorsed higher mean ratings than the other learner groups in knowledge attainment (p = .02) and meeting all learners' needs (p = .01).DiscussionThis workshop enhanced our trainees' self-reported comfort, awareness, and preparedness regarding using emotional intelligence and communication strategies. An interprofessional approach can be beneficial for leadership training in the health professions.

\u2018You just really have to assert yourself:\u2019 social work, nursing, and rehabilitation counseling student experiences of providing integrated behavioral health services before and after the immediate start of COVID-19

BackgroundEducators who train healthcare students to provide behavioral health services in primary care settings frequently encounter challenges as they work to ensure that students acquire the knowledge and skills to effectively function on interprofessional practice teams. This has become increasingly important during COVID-19, as interprofessional collaborative practice is needed more than ever to address the interrelated health, mental health, and social structural issues linked to the pandemic.MethodsWe used qualitative focus groups to understand the experiences of 6 interprofessional teams (comprised of graduate social work, nursing, and rehabilitation counseling students; n = 19) providing behavioral health services in primary care settings before and after the immediate start of COVID-19. To triangulate data and enrich findings, one focus group with students’ faculty supervisors was also conducted; n = 5). Data were analyzed using thematic analysis.ResultsFour themes highlighted student participants’ need to assert themselves at the beginning of their educational experience, to communicate and learn from one another to develop positive team dynamics, to contend with role confusion and missed opportunities for collaboration, and to manage the emotional impact of COVID-19 on learning.ConclusionFindings indicate that educators should work with clinical faculty and agency supervisors to orient students to ensure they have role clarity within the agency. Graduate students providing behavioral health services should also learn to work collaboratively within their scopes of practice to serve patients virtually, especially in preparation for public health emergencies.

"The Story I Will Never Forget": Critical Incident Narratives in Surgical Residency.

We sought to better understand what defines a critical incident experience for the surgical trainee. Critical incidents are formative moments stamped indelibly on one's memory that shape professional identity. The critical incident technique-using participants' narratives to identify patterns and learn from their perceptions-has been explored in some healthcare settings, but there has been no inquiry within surgery. Surgical residents at 5 residency programs (1 community, 1 university-affiliated, 3 university) were surveyed using an online questionnaire from November to December 2020. Convenience sampling was used to identify the study population. Participants were invited to write about formative, impactful experiences in training. Interpretive description was the qualitative methodology used to locate information, analyze, and record patterns in the data. Individual responses were categorized and assessed for overlying themes. Overall, 28 narratives were collected from surgery residents in 3 specialties (general surgery, plastic surgery, and urology), with postgraduate year representation of post-graduate years 1 to 6. Respondents were 40% female. Nineteen of the narratives reported a negative experience. Four themes were identified from responses: 1) growth through personal self-reflection, 2) difficult interpersonal interactions, 3) positive team dynamics as a psychological safety net, and 4) supportive program cultures that promote learning. Critical incident narratives among surgical residents indicate that unforgettable and formative experiences-both positive and negative- occur in 4 domains: within the individual, within a relationship, among a team, and within a program. Further exploring these domains in surgical training will inform optimal educational programming to support trainee development and wellbeing.

Developing Resilience in Diverse Teams: The Role of Resilience-Enhancing Diversity Training (WITHDRAWN)

In today’s increasingly complex and turbulent business world, teams in organizations need to develop resilience capabilities. However, until now, there has been only few research on team-resilience capabilities and opportunities for their promotion, especially in diverse teams. This paper aims to narrow this research and analyzes the role of diversity training in developing resilience-related capabilities and thus in unleashing the resilience potential of diverse teams. For this purpose, we use a qualitative research design to compare diverse teams with and without resilience-enhancing diversity training. The results of our video-based analysis show that diversity training has a potential to foster both positive team dynamics and the development of resilience-related capabilities (anticipation, relationship-oriented, and task-related capabilities). In this context, we also observed specific effects of different diversity types (experience, knowledge, and cultural diversity). Based on our in-depth observation, this paper provides first insights on the potential role of resilience-enhancing diversity training, that can be used as a foundation for further research.

Systematic Debriefing for Critical Events Facilitates Team Dynamics, Education, and Process Improvement.

Debriefing is used in clinical settings to support interprofessional staff, improve processes, and identify educational needs. Nurses who lead debriefing sessions are empowered to improve processes. Nurse leaders identified the need for debriefing outside the critical care areas due to the rising acuity levels. Two nurse leaders developed a debriefing initiative in one urban teaching hospital following rapid responses, codes, and stressful situations. Nurses developed a Debriefing Facilitation Guide to collect qualitative aspects of clinical emergencies to improve processes, education, and team dynamics. Following each debriefing session, we deductively purposively coded the qualitative data into 3 a priori themes: the American Heart Association's team dynamics, process improvement, and educational opportunities. We identified opportunities for improvement for these themes during our first 54 debriefing sessions. Following each debriefing session, the debriefing nurse leader intervened on all educational and process improvement opportunities identified and facilitated positive team dynamics.

Mixed-Methods Approach to Understanding Determinants of Practice Change in Skilled Nursing Facility Rehabilitation: Adapting to and Sustaining Value With Postacute Reform.

Postacute care reform is driving physical and occupational therapists in skilled nursing facilities (SNFs) to change how they deliver care to produce better outcomes in less time. However, gaps exist in understanding determinants of practice change, which limits translation of evidence into practice. This study explored what determinants impacted change in care delivery at 2 SNFs that implemented a high-intensity resistance training intervention. We used a mixed-methods, sequential explanatory design to explain quantitative findings using qualitative methods with a multiple-case study approach. Quantitative data were collected on therapists' attitudes toward evidence-based practice and aspects of intervention implementation. We conducted focus groups with therapists (N = 15) at 2 SNFs, classified as either high- (SNF-H) or low-performing (SNF-L) based on implementation fidelity and sustainability. Determinants of SNF rehabilitation practice change included the organizational system, team dynamics, patient and therapist self-efficacy, perceptions of intervention effectiveness, and ability to overcome preconceived notions. A patient-centered system, positive team dynamics, and ability to overcome preconceived notions fostered practice change at SNF-H. While self-efficacy and perception of effectiveness positively impacted change in practice at both SNFs, these determinants were not enough to overcome challenges at SNF-L. To adapt to changes and sustain rehabilitation value, further research must identify the combination of determinants that promote application of evidence-based practice. This study is the first step in understanding what drives change in SNF rehabilitation practice. As SNF rehabilitation continues to face changes in health care delivery and reimbursement, therapists will need to adapt, by changing practice patterns and adopting evidence-based approaches, to demonstrate value in postacute care.