Team Awareness Research Articles

Factitious disorders and Münchausen syndrome

This population-based study evaluates the prevalence of factitious disorders, Münchausen syndrome, and Münchausen syndrome by proxy in a clinical setting. All children referred to the Pediatric Unit of the Department of Pediatrics of the Catholic University Medical School (Agostino Gemelli Hospital) in Rome were recruited between November 2007 and March 2010. An experienced interdisciplinary team of medical professionals analyzed all suspected cases. A total of 751 patients were hospitalized. Factitious disorders were diagnosed in 14/751 patients, resulting in a prevalence of 1.8%. Three of 14 (21.4%) patients fulfilled the criteria for Münchausen syndrome. Münchausen syndrome by proxy was identified in four of 751 patients, resulting in a prevalence of 0.53%. The perpetrator was the mother in three of four of these cases. The epidemiological data obtained in this population-based study indicate that the prevalence of factitious disorders, Münchausen syndrome, and Münchausen syndrome by proxy is higher than previously observed. Moreover, early detection was possible thanks to the awareness of an expert interdisciplinary team. We suggest that physicians must consider the possibility of these diagnoses whenever there are discrepancies in a child's illness presentation.

Adapting Team Awareness and Replication

Adapting Team Awareness and Replication

Drug-nutrient interactions in the intensive care unit: literature review and current recommendations.

ObjectiveTo describe the interactions between drugs and nutrients and their frequency in the intensive care unit and to assess the professional team's awareness regarding this subject.MethodsThe keywords "drug interactions" and "nutrition therapy" were searched in the PubMed (specifically MeSH) electronic database. The studies were systematically reviewed for descriptions of the types of interactions between drugs and nutrients, including their frequency and consequences. ResultsSixty-seven articles were found. Among these, 20 articles were appropriate for the methodology adopted and accomplished the objectives of the study. Of these 20 articles, 14 articles described interactions between drugs and enteral nutrition, three described interactions between drugs and parenteral nutrition, and three described the importance and care required to avoid such interactions.ConclusionsThe literature about drug and nutrient interactions is limited and suggests the inability of health care teams to recognize the potential for these interactions. Possibly, the elaboration of a protocol to evaluate drug-nutrient interactions will increase the safety and efficacy of therapeutics.

Effectiveness of a Myocardial Infarction Protocol in Reducing Door-to-Ballon Time

BackgroundAn adequate door-to-balloon time (<120 minutes) is the necessary condition for the efficacy of primary angioplasty in infarction to translate into effectiveness. ObjectiveTo describe the effectiveness of a quality of care protocol in reducing the door-to-balloon time. MethodsBetween May 2010 and August 2012, all individuals undergoing primary angioplasty in our hospital were analyzed. The door time was electronically recorded at the moment the patient took a number to be evaluated in the emergency room, which occurred prior to filling the check-in forms and to the triage. The balloon time was defined as the beginning of artery opening (introduction of the first device). The first 5 months of monitoring corresponded to the period of pre-implementation of the protocol. The protocol comprised the definition of a flowchart of actions from patient arrival at the hospital, the team's awareness raising in relation to the prioritization of time, and provision of a periodic feedback on the results and possible inadequacies. ResultsA total of 50 individuals were assessed. They were divided into five groups of 10 sequential patients (one group pre-and four groups post-protocol). The door-to-balloon time regarding the 10 cases recorded before protocol implementation was 200 ± 77 minutes. After protocol implementation, there was a progressive reduction of the door-to-balloon time to 142 ± 78 minutes in the first 10 patients, then to 150 ± 50 minutes, 131 ± 37 minutes and, finally, 116 ± 29 minutes in the three sequential groups of 10 patients, respectively. Linear regression between sequential patients and the door-to-balloon time (r = - 0.41) showed a regression coefficient of - 1.74 minutes. ConclusionThe protocol implementation proved effective in the reduction of the door-to-balloon time.

Teaching Reform Research of Mechanical Drawing Based on the Theory of CDIO

In order to improve the traditional teaching model of mechanical drawing, based on the theory of CDIO, we reformed the teaching model by using case teaching pattern and teaching based on the project. We actively carried out the teaching of the CDIO model, created a favorable environment for the cultivation of innovative talents, encouraged students' innovative spirit, and innovative ability. It would meet the needs of society for engineering talents knowledge structure and ability requirements, explore the new mechanical drawing course teaching.It was very important to cultivate the students' consciousness of engineering, awareness of quality, awareness of team and sense of responsibility. Therefore, better teaching results were obtained in our practice.

The Mind’s Eye on Personal Profiles: A Cognitive Perspective on Profile Elements that Inform Initial Trustworthiness Assessments and Social Awareness in Virtual Project Teams

Collaboration in virtual project teams heavily relies on interpersonal trust, for which perceived professional trustworthiness is an important determinant. In face to face teams colleagues form a first impression of each others trustworthiness based on signs and signals that are `naturally' available. However, virtual project team members do not have the same opportunities to assess trustworthiness. This study provides insight in the information elements that virtual project team members value to assess professional trustworthiness in the initial phase of collaboration. The trustworthiness formed initially is highly influential on interpersonal trust formed during latter collaboration. We expect trustors in virtual teams to especially value information elements (= small containers for personal data stimulating the availability of specific information) that provide them with relevant cues of trust warranting properties of a trustee. We identified a list with fifteen information elements that were highly valued across trustors (n?=?226) to inform their trustworthiness assessments. We then analyzed explanations for preferences with the help of a theory-grounded coding scheme for perceived trustworthiness. Results show that respondents value those particular information elements that provide them with multiple cues (signaling multiple trust warranting properties) to assess the trustworthiness of a trustee. Information elements that provide unique cues (signaling for a specific trust warranting property) could not be identified. Insight in these information preferences can inform the design of artefacts, such as personal profile templates, to support acquaintanceships and social awareness especially in the initial phase of a virtual project team.

Evidence-based answers to 15 questions about leveraging 360-degree feedback.

Despite the popularity of 360-degree feedback, meta-analytic findings suggest that these interventions can lead to a significant change in behavior but the effect sizes are typically modest and when done poorly may lead to both disengagement and a decline in performance. The research evidence addressing practical issues for coaches to successfully implement 360-degree feedback interventions is updated since previous review studies (e.g., Craig & Hannum, 2006; Fleenor, Taylor, & Craig, 2008). This article reviews 15 specific questions that are common to most 360-degree feedback interventions (purpose and goals, methodology and psychometric properties, and process and implementation) designed to facilitate enhanced awareness and successful behavior change in individuals and teams.

The impact of a dual-project action learning program: a case of a large IT manufacturing company in South Korea

The primary purpose of this article is to evaluate the impact of a dual-project action learning program (DPALP) conducted in South Korea. A dual-project program requires each participant to carry out both team and individual projects. Cho and Egan's [2009. Action learning research: A systematic review and conceptual framework. Human Resource Development Review 8: 431–62] four dimensions of action learning are employed as an analytical framework for this case study. Accordingly, this article reports the antecedents, process, proximal outcomes, and distal outcomes of the DPALP. This article further examines the effectiveness of the program in the following areas: (a) key areas of learning, (b) increased level of business awareness, (c) increased level of leadership competencies through pre- and post-360-degree assessments, and (d) return on investment of the business results achieved through team projects. The analyses revealed that the DPALP had an impact on individuals’ learning, business awareness, leadership competencies, and solving of team and organizational issues. Further research and practice need to be accumulated to validate the effects of the DPALP in other settings.

Y is best: How Distributed Situational Awareness is mediated by organisational structure and correlated with task success

Teams are widely used in safety critical environments to deal with high levels of complexity. The ability of teams to develop relevant and appropriate Situational Awareness has been considered a vital part of safe operation with breakdown in Situational Awareness acknowledged as a contributing factor in human error and fratricide. Organisational structure has similarly been found to have an effect upon team performance. Indeed, a relationship has been suggested between Situational Awareness and performance, however, as of yet little research has found a relationship between Distributed Situational Awareness and team performance. This paper presents a study which sought to shed light on this issue. A large experimental study was undertaken where five different organisational structures were compared in terms of team performance and Distributed Situational Awareness. A relationship was found between organisational structure and performance, confirming similar findings presented in the literature. Most importantly, a positive correlation was observed between task success and Distributed Situational Awareness. This study has implications for the organisation of teams and for the further understanding of Distributed Situational Awareness in teams and the impact on performance.

Teachers’ perceptions, beliefs and concerns about cyberbullying

AbstractSchools and teachers nowadays face new difficulties and challenges as a result of the fast growth of cyberbullying. The aim of the study is to examine the perceptions, beliefs and concerns about cyberbullying, as well as the needs, of a professionally diverse group of teachers. Three‐hundred and twenty‐eight teachers (88.4% female, 11.6% male) from different types of schools and professional foci were randomly selected and completed a cyberbullying questionnaire regarding their perceptions of cyberbullying and about their personal experiences in relation to cyberbullying. They also provided background information. Findings indicate that teachers noted that cyberbullying is a problem in their school, suggesting that urgent attention be paid to three aspects: policy making, enhancing awareness of the school team and coping strategies for parents. About half the teachers reported that students complain of harassment through the mobile phone and Internet, and some teachers were themselves cyberbullied. It was found that the teachers’ gender, education level and the age of the students they taught affected their level of concern about cyberbullying, and therefore how credible they found the school's commitment to act on it. Female teachers expressed more concern than male teachers, as did teachers of younger children. Special education teachers were more concerned than mainstream teachers and were more likely to believe that the cyberbullying must be confronted. The results contribute to our understanding of the teachers’ perceptions, beliefs and concerns about cyberbullying, which could serve as a basis for developing policy guidelines in schools as well as establishing programs for school teachers to cope with cyberbullying.

Knowledge contribution in information system development teams: An empirical research from a social cognitive perspective

The extent of knowledge contribution is the key to the success of system development projects. Knowledge contribution refers to the knowledge that is provided to increase a team's efficiency and achieve its goal. This study proposes a research model exploring factors that influence the extent of knowledge contribution from a social cognitive perspective. These factors include the team relationship commitment, team relationship norms, and awareness of expertise location. Additionally, this study argues that a team's awareness of expertise location mediates the effects of affective commitment and relationship norms on knowledge contribution. The result shows that the awareness of expertise location plays a crucial mediating role in the relationships between the two socially prescribed motivations and knowledge contribution. Moreover, team relationship commitment has an important impact on team established relational norms.

Factors that impact on the safety of patient handovers: An interview study

Improvement of clinical handover is fundamental to meet the challenges of patient safety. The primary aim of this interview study is to explore healthcare professionals' attitudes and experiences with critical episodes in patient handover in order to elucidate factors that impact on handover from ambulance to hospitals and within and between hospitals. The secondary aim is to identify possible solutions to optimise handovers, defined as "situations where the professional responsibility for some or all aspects of a patient's diagnosis, treatment or care is transferred to another person on a temporary or permanent basis". We conducted 47 semi-structured single-person interviews in a large university hospital in the Capital Region in Denmark in 2008 and 2009 to obtain a comprehensive picture of clinicians' perceptions of self-experienced critical episodes in handovers. We included different types of handover processes that take place within several specialties. A total of 23 nurses, three nurse assistants, 13 physicians, five paramedics, two orderlies, and one radiographer from different departments and units were interviewed. We found eight central factors to have an impact on patient safety in handover situations: communication, information, organisation, infrastructure, professionalism, responsibility, team awareness, and culture. The eight factors identified indicate that handovers are complex situations. The organisation did not see patient handover as a critical safety point of hospitalisation, revealing that the safety culture in regard to handover was immature. Work was done in silos and many of the handover barriers were seen to be related to the fact that only few had a full picture of a patient's complete pathway.

Quasi-Experimental Evaluation of a Substance Use Awareness Educational Intervention for Nursing Students

This article reports on a study that evaluated the effectiveness of an educational intervention, Addressing Nurse Impairment, for addressing nursing students' knowledge acquisition, changes in self-efficacy to intervene, and changes in substance abuse stigma. A gap exists in nursing students' education regarding the risks of addiction within the profession and how to handle a colleague suspected of having a substance use disorder. The seminar was adapted from an existing evidence-based prevention program called Team Awareness, as well as information from focus groups and a pilot test. A quasi-experimental pretest-posttest design was used to evaluate the effect of the seminar. When the control and experimental groups were compared, the results indicated that the seminar significantly affected knowledge and self-efficacy to intervene but did not significantly affect stigma. This research contributes to the body of evidence related to educational interventions for nursing students regarding substance abuse in the nursing profession.

Negative Affect Reduces Team Awareness

This article presents research on the effects of varying mood and stress states on within-team communication in a simulated crisis management environment, with a focus on the relationship between communication behaviors and team awareness. Communication plays a critical role in team cognition along with cognitive factors such as attention, memory, and decision-making speed. Mood and stress are known to have interrelated effects on cognition at the individual level, but there is relatively little joint exploration of these factors in team communication in technologically complex environments. Dyadic communication behaviors in a distributed six-person crisis management simulation were analyzed in a factorial design for effects of two levels of mood (happy, sad) and the presence or absence of a time pressure stressor. Time pressure and mood showed several specific impacts on communication behaviors. Communication quantity and efficiency increased under time pressure, though frequent requests for information were associated with poor performance. Teams in happy moods showed enhanced team awareness, as revealed by more anticipatory communication patterns and more detailed verbal responses to teammates than those in sad moods. Results show that the attention-narrowing effects of mood and stress associated with individual cognitive functions demonstrate analogous impacts on team awareness and information-sharing behaviors and reveal a richer understanding of how team dynamics change under adverse conditions. Disentangling stress from mood affords the opportunity to target more specific interventions that better support team awareness and task performance.

Macmillan end of life discharge pilot project at the James Cook university hospital (JCUH)

BackgroundCurrent end of life initiatives emphasise the importance of achieving the preferred place of care for patients approaching end of life. National survey data suggest 50–60% patients would prefer a...

Measuring situation awareness of operation teams in NPPs using a verbal protocol analysis

Situation awareness (SA) continues to receive a considerable amount of attention from the ergonomics community given that need for operators to maintain SA is frequently cited as a key to effective and efficient performance. Although complex and dynamic environments such as that of a main control room (MCR) in a nuclear power plant (NPP) are operated by operation teams, and while team situation awareness (TSA) is also cited as an important factor, research is limited to individual SA. However, understanding TSA can provide a window onto the characteristics of team acquisition as well as the performance of a complex skill. Therefore, such knowledge can be valuable in diagnosing team performance successes and failures. Moreover, training and design interventions can target the cognitive underpinnings of team performance, with implications for the design of technological aids to improve team performance. Despite these advantages and the importance of understanding TSA, measures and methods targeting TSA are sparse and fail to address it properly. In this study, an objective TSA measurement method is developed in an effort to understand TSA. First, key considerations for developing a method are derived. Based on these considerations, the proposed method is developed while mainly focusing on the creation of logical connections between team communications and TSA. A speech act coding scheme is also implemented to analyze team communications. The TSA measurement method developed in this study provides a measure for each level of TSA. It was revealed from a preliminary study that this TSA measurement method is feasible for measuring TSA to a fair extent. Useful insight into TSA is also derived.

‘Achieving ensemble’: communication in orthopaedic surgical teams and the development of situation awareness—an observational study using live videotaped examples

Focused dialogue, as good communication between practitioners, offers a condition of possibility for development of high levels of situation awareness in surgical teams. This has been termed "achieving ensemble". Situation awareness grasps what is happening in time and space with regard to one's own unfolding work in relation to that of colleagues, and is necessary to maintain patient safety throughout a surgical list. We refined a typology, initially developed for use in studying the dynamics of teams in aviation safety, of 10 kinds of communication within two broad areas: 'Reports', or authoritative acts of communication setting up a monological or authoritative climate; and 'Requests', or facilitative acts of communication setting up a dialogical or participatory climate. We systematically mapped how orthopaedic surgical teams use verbal communication through analysis of videotaped operations using the typology. We asked: 'do orthopaedic surgical teams set up the conditions of possibility for the emergence of situation awareness through effective communication?' We found that orthopaedic surgical teams tend to produce monological rather than dialogical climates. Dialogue increases with more complex cases, but in routine work, communication levels are depressed and one-way, influenced by surgeons working within a traditionally hierarchical and authoritative culture. We suggest that such a monological climate inhibits development of situation awareness and then compromises patient safety. The same teams, however, generate potentially rich educational climates through exchange of profession-specific knowledge and skills, and we suggest that where technical skill exchange is good, non-technical or interpersonal communication skill levels can follow.

„Berufliche Zukunft“ – Kurzzeiteffekte eines Behandlungsprogramms bei sozialmedizinisch relevanter Problemlage im Verlauf einer medizinischen Rehabilitation

To analyze the short-term efficacy of the Vocational Perspective programme for patients identified as having extensive work-related problems during rheumatology or orthopaedic inpatient rehabilitation. The primary objectives of the programme on patient level are to convey information about the legal provisions regarding earning incapacity and occupational reintegration, to suggest strategies for dealing with one's own occupational situation, and to strengthen the motivation to stay employed. The programme is explicitly designed for patients who wish to retire or have applied for a pension. On the systemic level, the main goals are to facilitate doctor-patient communication and to increase rehabilitation teams' awareness of occupational problems. In a controlled quasi-experimental design, 359 subjects were consecutively assigned to either the control group (CG, n=177) or the intervention group (IG, n=182). The control group received standard care only, whereas the intervention group additionally participated in the 5-part Vocational Perspective programme. Evaluation criteria were assessed by questionnaire at the beginning (t1) and at end of rehabilitation (t2). Survey participation was 92.2% at t2. The socio-medically relevant knowledge status was objectively documented using a specially designed knowledge questionnaire. Aspects of treatment satisfaction were evaluated using individual items, and the subjective prognosis of gainful employment was assessed using the Subjective Prognosis of Gainful Employment (SPE) scale. Facilitation of communication between doctor and patient was operationalized at patient level in terms of patient satisfaction with medical care, and increased awareness of the rehabilitation team was operationalized in terms of the rate of recommendations to apply for vocational reintegration (LTA) services at discharge. Emotional and functional parameters were exploratively analyzed (anxiety and depression using the IRES 3.1 scales, and subjectively experienced pain-related impairment using the Pain Disability Index). Scores for subjective satisfaction with job-related information, medical care, socio-medical assessment, and the overall benefits of rehabilitation were significantly higher in the intervention group than in the control group. IG subjects moreover were better able to use the rehabilitation measure to clarify their occupational situation and exhibited significantly greater improvement of socio-medically relevant knowledge. Age proved to be an important predictor of change in a patient's subjective prognosis for gainful employment (SPE): A positive change in SPE was observed in both groups in subjects under 50, in those aged 50 and older, however, only in the intervention group. No differences between the two groups were observed in terms of functional and emotional parameters (e. g., disability through pain, anxiety, and depression). A total of 60% of the subjects received a recommendation at discharge to apply for vocational reintegration services, the proportion however was significantly higher in the IG. The Vocational Perspective programme met the patients' high demand for information on relevant socio-medical facilities and services regarding career change and facilitated communication between the doctor and patient by creating greater transparency. The improvement of subjective prognosis for gainful employment observed in the subgroup of older patients indicates that specialized interventions are needed in precisely this disadvantaged group in order to improve their own vocational expectations and thus to improve their chances of reintegration into work life. The high rate of recommendations to apply for vocational reintegration services suggests that rehabilitation teams already have a high awareness of job-related problems even under “usual care” conditions.

Sistematizando la literatura sobre acreditación hospitalaria: de 2005 a 2010

Objective : to verify how the issuetheme of accreditation and / or assessmentevaluation of health care services is treated being discussed in the literature. Method : integrative review of the literature in electronic databases: LILACS, IBECS, BEDENF, and MEDLINE. Descriptors used were used: accreditation, health care quality, access and evaluation, with a temporal cut between the years 2005 to 2010. Results : were examined 18 (eighteen) full articles online and a master dissertation were examined. To analyze our data, we used the interpretive reading and thematic analysis. Categories emerged: Outcome and evaluation process criteria; Benefits for care and Cultural change. Conclusion : accreditation of health care services is a tool being used globally and has continually developed itstheir processes to to account for reach its their goals with excellence. Although not preventing the occurrence of professional errors, it has been an opportunity forof health care institutions to improve the quality of assistance, attention and care to patients. Concerning to the Nursing Department, the study identified itstheir participation in the process, stressing the need for adjustments for more effective evaluation of care provision and awareness of the whole team.

Sistematizando la literatura sobre acreditación hospitalaria: de 2005 a 2010

Objective: to verify how the issuetheme of accreditation and / or assessmentevaluation of health care services is treated being discussed in the literature. Method: integrative review of the literature in electronic databases: LILACS, IBECS, BEDENF, and MEDLINE. Descriptors used were used: accreditation, health care quality, access and evaluation, with a temporal cut between the years 2005 to 2010. Results: were examined 18 (eighteen) full articles online and a master dissertation were examined. To analyze our data, we used the interpretive reading and thematic analysis. Categories emerged: Outcome and evaluation process criteria; Benefits for care and Cultural change. Conclusion: accreditation of health care services is a tool being used globally and has continually developed itstheir processes to to account for reach its their goals with excellence. Although not preventing the occurrence of professional errors, it has been an opportunity forof health care institutions to improve the quality of assistance, attention and care to patients. Concerning to the Nursing Department, the study identified itstheir participation in the process, stressing the need for adjustments for more effective evaluation of care provision and awareness of the whole team.