Team Meetings Research Articles

Action research communities as a whole-of-school teaching improvement initiative: a multi-method multi-informant study

AbstractProfessional learning communities (PLCs) actioned through collaborative action research (CAR) have been found in the literature to be beneficial for both teachers and students. However, previous studies mainly examined teachers’ perceived effectiveness of CAR-based PLCs, as well as identified steps and elements involved in such PLCs, either self-initiated by teachers themselves or by university researchers in a school-university partnership model. Few have focused on a whole-of-school teaching improvement initiative based entirely on PLCs through CAR. In this study, we provide preliminary evaluation of a 3-year whole-of-school teaching improvement initiative (the SETaRI), based on PLCs through CAR at a regional primary school in NSW, Australia. Analysis of students’ various assessment measures (N = 206), teachers’ survey (N = 44), observation of professional learning team meetings, and various types of student artefacts revealed that students showed general and consistent improvement in both their reading and maths performance over time following the implementation of the SETaRI model, with greater progressive learning effects for those whose initial learning outcomes were lower than their peers. The findings also highlighted data-driven decision making, teacher collaboration, and school leadership as potent elements underlying teachers’ positive attitudes toward the implementation of the model as well as student learning outcomes and improvement. This study provides useful implications for a school improvement agenda focused on action research communities.

Prognostication As an Interactionally Delicate Matter: A Conversation Analytic Study of Hospice Multidisciplinary Team Meetings

ABSTRACT Prognostication has been found to be a delicate matter in interactions between palliative care professionals and patients. Studies have investigated how these discussions are managed and how speakers orient to their delicate nature. However, the degree to which prognostication is a delicate matter in discussions between palliative care professionals themselves has yet to be investigated. This study explored how hospice multidisciplinary team (MDT) members oriented to the delicacy of prognostication during their meetings. Video-recordings of 24 hospice MDT meetings were transcribed and analyzed using Conversation Analysis. In-depth analysis of the interactions showed how prognostic discussions were oriented to as delicate. This was displayed through markers such as pauses and self-repair organization including cutting off words and restarts, and through accounts accompanying the prognosis. In this way, it was seen that prognostication was not necessarily straightforward. This was further evidenced when prognostic requests were problematic to respond to. It is noteworthy that prognostic discussions are delicate during hospice MDT meetings. Potential reasons may reach further than the taboo of death and lie within prognostic uncertainty and accountability. Research is warranted to explore what causes this delicacy and whether specific support is needed for hospice staff.

More Teams, More Meetings? Toward an Understanding of Multiteam System Meeting Design, Facilitation, and Effectiveness

The growing literature on meeting science has begun to offer numerous best practices for designing and facilitating team meetings. However, similar considerations are limited for meetings that take place within multiteam systems (MTSs). These MTSs require meetings to occur both within and between teams to achieve both proximal and distal goals. Accordingly, the unique attributes of and challenges faced by MTSs may impact meeting inputs, processes, outcomes, and performance in these complex systems. In this review, we integrate core theoretical and empirical evidence from the meeting science, teaming, and MTS literature to inform the development of key propositions. Specifically, these propositions address how the design, facilitation, and effectiveness of MTS meetings may be influenced and impacted by core linkage attributes of MTSs. We conclude with a discussion of theoretical and practical implications as well as of future avenues for research that further explores and refines our understanding of meetings in MTS contexts.

A Comparison of ChatGPT and Multidisciplinary Team Meeting Treatment Recommendations in 10 Consecutive Cervical Cancer Patients.

Background The preparation of multidisciplinary team (MDT) meetings can be time-consuming. In additionto the clinical data being available digitally in subsystems, the preparation of more complex cases requires literature research. Several expert systems have been developed to support this process. However, the interaction with these systems has to be trained. Current development enables linguistic interaction with such artificial intelligence (AI) systems. To the best of our knowledge, these have not been tested as premedical screening tools for MDT. Methods This is a retrospective consecutive case series of 10 cervical cancer cases comparing the medical recommendations of the MDT and artificial intelligence (AI) on a low level (i.e., surgery, systemic treatment, and radiotherapy). Results The clinical cases ranged from primary diagnosis via suspected recurrence to palliative settings. The AI repeatedly stated that medical professionals need to be consulted before treatment decisions. The AI answers ranged from no agreement to overachievement by mentioning treatment options for preexisting risk factors (such as obesity). In standard cases, the AI answer matched well with the expert recommendations. In some cases, the AI answers were contrary to our treatment recommendation. Conclusion The interaction with current language AIs is temptingly easy, and the replies are very understandable. Despite the AI warning regarding medical recommendations in the majority of our cases, there was a good match with the MDT recommendations. However, in some cases, the medical evidence behind the answers was missing or in the worst case fictional. In our case series, the AI did not meet the requirements to support a clinical MDT meeting by prescreening the therapeutic options. However, it did exceed the expectations regarding the risk factors of the patients.

The Invisibility of Integrative and Complementary Practices in Primary Healthcare.

Invisibility is an issue that requires more attention among healthcare professionals, as some activities in Primary Care go unnoticed. One example is the offer of complementary therapies, whose implementation has been frail and, consequently, can be overlooked in the Unified Health System. This study aims to understand the factors contributing to the public invisibility of Integrative and Complementary Practices in Primary Care. It is a descriptive, exploratory, and qualitative research involving semi-structured interviews with 20 professionals in the Metropolitan Region of Goiânia. Thematic content analysis was applied to the interviews, revealing elements indicating the public invisibility of these practices, such as insufficient discussion in team meetings, inconsistency in the recording in user files, and low prioritization in implementation. In the interviews, social humiliation, a product of public invisibility, can also be perceived due to overload, embarrassments, and lack of physical space for the provision of practices to the users. It is concluded that Integrative and Complementary Practices are often overlooked in Primary Care.

Audit Committee Characteristics and Financial Reporting Quality of Consumer Good Firms in Nigeria

The paper examined the impact of audit committee features on the reporting quality of consumer goods firms in Nigeria. The paper used an ex post facto design. Data were gathered from the audited annual reports of the target firms. By employing the Hausman test, the study used a fixed and random effect model. The F-statistic of 2.238984, p-value = 0.023456 < 0.05 alpha, suggests that audit team meetings, size and financial knowledge jointly have a substantial implication on the calibre of financial reporting. In light of the foregoing, the study suggested among others that firms should maintain an optimal size that balances efficiency with diverse expertise that is neither too small nor too large for thorough financial oversight.

Virtual Multidisciplinary Team Meetings: A Tool to Increase Radiology Access in Global Health Settings

Virtual Multidisciplinary Team Meetings: A Tool to Increase Radiology Access in Global Health Settings

Early Integrated Palliative Care in Patients With Advanced Cancer

Limited data suggest that early palliative care (EPC) improves quality of life (QOL) and survival in patients with advanced cancer. To evaluate whether comprehensive EPC improves QOL; relieves mental, social, and existential burdens; increases survival rates; and helps patients develop coping skills. This nonblinded randomized clinical trial (RCT) recruited patients from 12 hospitals in South Korea from September 2017 to October 2018. Patients aged 20 years or older with advanced cancer who were not terminally ill but for whom standard chemotherapy has not been effective were eligible. Participants were randomized 1:1 to the control (receiving usual supportive oncological care) or intervention (receiving EPC with usual oncological care) group. Intention-to-treat data analysis was conducted between September and December 2022. The intervention group received EPC through a structured program of self-study education materials, telephone coaching, and regular assessments by an integrated palliative care team. The primary outcome was the change in overall QOL score (assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care) from baseline to 24 weeks after enrollment, with evaluations also conducted at 12 and 18 weeks. Secondary outcomes were social and existential burdens (assessed with the McGill Quality of Life Questionnaire) as well as crisis-overcoming capacity and 2-year survival. A total of 144 patients (83 males [57.6%]; mean [SD] age, 60.7 (7.2) years) were enrolled, of whom 73 were randomized to the intervention group and 71 to the control group. The intervention group demonstrated significantly greater changes in scores in overall health status or QOL from baseline, especially at 18 weeks (11.00 [95% CI, 0.78-21.22] points; P = .04; effect size = 0.42). However, at 12 and 24 weeks, there were no significant differences observed. Compared with the control group, the intervention group also showed significant improvement in self-management or coping skills over 24 weeks (20.51 [95% CI, 12.41-28.61] points; P < .001; effect size = 0.93). While the overall survival rate was higher in the intervention vs control group, the difference was not significant. In the intervention group, however, those who received 10 or more EPC interventions (eg, telephone coaching sessions and care team meetings) showed a significantly increased probability of 2-year survival (53.6%; P < .001). This RCT demonstrated that EPC enhanced QOL at 18 weeks; however, no significant improvements were observed at 12 and 24 weeks. An increased number of interventions sessions was associated with increased 2-year survival rates in the intervention group. ClinicalTrials.gov Identifier: NCT03181854.

Preoperative imaging of colorectal liver metastases: what the radiologist and the multidisciplinary team need to know.

The management of patients with colorectal liver metastases (CRLM) has transformed over the past 2 decades. Advances in surgical techniques, systemic therapies, and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings. The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the multidisciplinary team when assessing resectability and/or the need for additional liver-directed therapies.

A Peer-Supported School Engagement Intervention for Youth with Attention Problems: Development and Implementation

Youth with attention problems are at increased risk for school disengagement (Booster et al., JAD 16:179–189, 2012; DuPaul & Langberg, in: Barkley (ed), Attention-deficit/hyperactivity disorder: A handbook for diagnosis and treatment, Guilford, New York, 2014), which portends risk for poor outcomes (Bond et al., JAH 40:357.e9–357, 2007; Carter et al., JA 30:51–62, 2007; Fredricks et al., RER 74:59–109, 2004). Interventions that target school engagement may benefit from peer delivery because peers are widely available in schools and potentially more credible than adults. In this study, a peer-supported school-based school engagement intervention for middle school students with attention problems, Together Engaging and Achieving Meaningfully (TEAM) was developed with educators and students. In initial development (Study One), community development team meetings with partners (N = 9 school staff and students) were conducted. Thematic analysis was used to identify themes used to refine TEAM. In Study Two, a single-case pilot with one student with attention problems and one peer coach was conducted. Measures of fidelity, attendance, acceptability, and satisfaction were collected. Results were used to refine TEAM. Then in pilot implementation (Study Three), a non-randomized pilot was conducted with 10 fifth- through seventh-grade students with attention problems (n = 6 in the intervention group) and six eighth-grade coaches. Measures of fidelity, attendance, acceptability, satisfaction, and clinician-required time for implementation were collected. Cohen’s d mean difference effect sizes were calculated between and within groups over implementation. Feedback from partners highlighted barriers and aspects that were acceptable and feasible. Results from implementation suggested high attendance, high coach fidelity with revised implementation support, and low clinician-required time. Lessons learned and avenues for future development and research are discussed.

Development and psychometric evaluation of a pneumatic tourniquet work standards scale

ObjectivePneumatic tourniquets are among the most essential equipment for controlling bleeding in orthopedic surgeries. However, incorrect application of pneumatic tourniquets is accompanied by many hazards and complications for patients. Evaluation of surgical teams’ use of pneumatic tourniquets and establishment of protocols can play an important role in improving patient safety, minimizing risks, and increasing the lifetime of this equipment. Accordingly, the present study was conducted to develop and assess the psychometric properties of a pneumatic tourniquet work standards scale.MethodsThe present study is a methodological work carried out in two stages. In the first stage, an initial version of the scale was developed based on existing research and panel reviews. In the second stage, the psychometric properties of the scale were tested in terms of face validity (measured qualitatively and quantitatively), content validity (measured qualitatively and quantitatively), item analysis, construct validity, and reliability (internal consistency and stability).ResultsThe initial version of the scale consisted of 91 items. After several meetings of the research team, the number of items decreased to 81. In the course of face and content validity testing, 40 items were eliminated, leaving 41 items on the scale when it entered the construct validity testing stage. For evaluation of construct validity, a sample of 300 operating room nurses was recruited. The Exploratory Factor Analysis (EFA) results showed a structure supported by seven factors and 41 items. The reliability of the scale was confirmed by internal consistency analysis, with a good Cronbach’s alpha (0.85), and test–retest analysis, with good values of ICC (0.95).ConclusionThe present instrument is a reliable and valid scale which fills the gap in assessment of surgical team members’ use of pneumatic tourniquets. The developed scale can be employed by researchers and managers of medical centers to identify hazards in applying pneumatic tourniquets and devise educational programs to eliminate or reduce the existing issues.

Clinical impact of MRI on indeterminate findings on contrast-enhanced CT suspicious of HCC

Objectives In patients evaluated for hepatocellular carcinoma (HCC), magnetic resonance imaging (MRI) is often used secondarily when multiphase contrast-enhanced computed tomography (ceCT) is inconclusive. We investigated the clinical impact of adding MRI. Materials and methods This single-institution retrospective study included 48 MRI scans (44 patients) conducted from May 2016 to July 2023 due to suspicion of HCC on a multiphase ceCT scan. Data included medical history, preceding and subsequent imaging, histology when available, and decisions made at multidisciplinary team meetings. Results In case of possible HCC recurrence, 63% of the MRI scans were diagnostic of HCC. For 80% of the negative MRI scans, the patients were diagnosed with HCC within a median of 165 days in the suspicious area of the liver. In case of possible de-novo HCC in patients with cirrhosis, 22% of the scans were diagnostic of HCC and 33% of the negative MRI scans were of patients diagnosed with HCC within a median of 109 days. None of the non-cirrhotic patients with possible de-novo HCC and negative MRI scans (64%) were later diagnosed with HCC, but 3/5 of the indeterminate scans were of patients diagnosed with HCC in a biopsy. Conclusions Secondary MRI to a multiphase ceCT scan suspicious of HCC is highly valuable in ruling out HCC in non-cirrhotic patients and in diagnosing HCC non-invasively in cirrhotic patients and patients with prior HCC. Patients with cirrhosis or prior HCC are still at high risk of having HCC if MRI results are inconclusive or negative.

Evolution and Effects of Ad Hoc Multidisciplinary Team Meetings in the Emergency Intensive Care Unit: A Five-Year Analysis.

Background: Multidisciplinary team meetings (MDTMs) are crucial in the ICU. However, daily rounds may not address all sensitive issues due to time constraints and the complexity of cases. This study aimed to describe detailed information and characteristics of ad hoc MDTMs in the ICU. Methods: This single-center, retrospective study analyzed adult emergency ICU admissions at Okayama University Hospital from 1 January 2019 to 31 December 2023. During this period, weekly regular multidisciplinary team ICU rounds were introduced in June 2020, and regular weekday morning MDTMs began in April 2022. A multiple logistic regression analysis was applied to determine the impact of these changes on the frequency of ad hoc MDTMs, adjusting for variables including annual changes. Results: The study analyzed 2487 adult EICU patients, with a median age of 66, and 63.3% of them male. MDTMs were held for 168 patients (6.8%), typically those with severe conditions, including higher COVID-19 prevalence and APACHE II scores, and longer ICU stays. Despite a constant total number of MDTMs, the likelihood of conducting ad hoc MDTMs increased annually (adjusted OR 1.19; 95% CI, 1.04-1.35). Of the 329 MDTMs conducted for these patients, 59.0% addressed end-of-life care, involving an average of 11 participants, mainly nurses and emergency and critical-care physicians. Conclusions: Changes in ICU round and meeting structures might be associated with a higher frequency of conducting ad hoc MDTMs, highlighting their evolving role and importance in patient care management.

Dimensions of Evidence-Based Practice in Nursing: Results of a Factor Analysis.

Clinical decision support systems (CDSS) are capable of bridging evidence and practice. However, it is unclear what dimensions determine evidence-based practice under real world conditions. To answer this question, 126 registered nurses and nursing students from the Munich municipal hospital group filled in a systematically developed and validated questionnaire with 26 items. An exploratory factor analysis revealed the three dimensions "Knowledge", "Trust" and "Practice" which explain 56.5% of the total variance. They are corroborated by the literature and match findings about evidence-based practice in medicine. These results not only provide insights into the construct evidence-based practice but also give practical hints how to foster evidence-based daily work in nursing. A supportive clinical environment seems to be paramount to achieve this goal: access to evidence-based resources, team meetings to reflect the experience and the inclusion of the patients' needs.

Unveiling the Invisible: Challenges Faced by Arab Women International Medical Graduates in U.S. Academia.

The Arab experience is understudied because Arabs are categorized as White on the U.S. Census, leading to diminished documentation of their personal experiences. There is also little understanding of the Arab experience and its intersectionality with gender, being an international medical graduate (IMG), and working in academia. The authors studied the experience of Arab women IMGs working in the U.S. academic system. This qualitative study used interpretative phenomenological analysis to analyze in-depth interview data from 20 first-generation U.S. immigrant Arab women who were IMGs. Interpretative phenomenological analysis involved data familiarization, immersion, and coding. Codes were grouped into potential themes on the participants' experience. The authors explored connections between the themes and engaged in reflexive practice through memo writing and team meetings. The study was performed from November 2022 to May 2023. The experiences of the 20 first-generation U.S. immigrant Arab women IMGs were as diverse as the Arab identity itself but congruent with some documented IMG experiences. Political turmoil, desire for new opportunities, and career goals were all reasons that led them to emigrate, but cultural differences, isolation from their home countries, and missing family were central to their experiences. Muslim women wearing the hijab or those with heavy accents faced more microaggressions and xenophobia in academic clinical settings. Those in environments that embraced their differences and supported them described less discrimination. They all, however, felt that they benefited from training in the United States. However, they noted room for improving cultural humility in residencies and the need for a more inclusive workplace. This study highlights the visible and invisible challenges that affect Arab women IMGs' experience in the United States. Program directors and department leaders should try to learn about the backgrounds of IMGs and current geopolitical events that might affect IMGs and extend support.

ESGO Quality Indicators for Surgical Management of Cervical Cancer: An Audit of Compliance of a Tertiary Care Center

Objective This article assesses the compliance of surgical management of carcinoma cervix, to the quality indicators for treatment put forth by the European Society of Gynaeacological Oncology (ESGO), at a tertiary care center. Methods This is a retrospective analysis and audit of data collected from electronic medical records of patients with carcinoma cervix who underwent surgical management in the department of gynecologic oncology from June 1, 2017 to May 31, 2020. Results Compliance to all 15 quality indicators under 5 categories was assessed. The first two structural indicators were met. The mean number of parametrectomies was 24 and all were operated by a specialist. With regard to targets addressing overall management, only 46% cases were preoperatively planned in multidisciplinary team meetings and 74% met the target of required preop investigations. There was deficiency in recording pertinent intraoperative details and postoperative pathological information. On assessing the quality of surgical care, there were no postoperative urological fistula, but 18% had involved surgical margins, 16% were upstaged postsurgery, and 15% had recurrence within 2 years. All were counseled about fertility-sparing technique when relevant but only 7% had undergone lymph node staging as per recommendations and 51% had received adjuvant chemoradiation. Conclusion This audit revealed that the department did not meet the ESGO quality standards published in 2020. The department has implemented structural and procedural changes to meet these standards and a plan to continuously assess compliance to the same.

Implementing distributed leadership in Irish voluntary secondary schools from the principals’ perspective

ABSTRACT In 2018, the Irish Department of Education and Skills (DES) officially recommended a distributed leadership model as a new approach to leadership and management in post-primary schools. Policy implementation guidance was circulated to school management via DES circular CL003/2018. This study investigates the perspective of voluntary secondary school principals implementing CL003/2018 within the voluntary secondary school sector, where the role of the school principal is pivotal in its implementation. A pragmatic approach to the research methodology led to the adoption of a case study methodology within a mixed-method sequential quantitative > qualitative research design. The quantitative research instrument was an online survey distributed to a census population of voluntary secondary school principals in Ireland. Using Zoom, semi-structured interviews with ten voluntary secondary school principals informed the qualitative research. The findings are examined and interpreted within the literature on distributed leadership, with the concepts of power, accountability, and sustainability emerging from the research. The research identifies recommendations on professional learning for principals to develop sustainable leadership capacity within the voluntary secondary school sector, and the essential time to hold strategic leadership team meetings.

Spanish translation of the Expert Recommendations for Implementing Change (ERIC) compilation

BackgroundMost implementation science resources (e.g., taxonomies) are published in English. Linguistic inaccessibility creates a barrier to the conduct of implementation research among non-English-speaking populations, so translation of resources is needed. Translation into Spanish can facilitate widespread reach, given the large proportion of Spanish speakers around the world. This research aimed to systematically translate the Expert Recommendations for Implementation Change (ERIC) compilation into Spanish as an exemplar for the linguistic translation process.MethodsUsing the World Health Organization guidelines, this work translated the ERIC compilation strategy names, short definitions, and thematic clusters through a three-step process: 1) forward translation into Spanish by a native Spanish-speaking implementation scientist, 2) back-translation into English by a bilingual global health researcher, and 3) piloting via virtual focus group discussions with bilingual researchers not conducting implementation research. To achieve a generalizable translation, recruitment targeted a multicultural group of Spanish-speaking researchers. At the conclusion of each step, the transdisciplinary research team (N = 7) met to discuss discrepancies and refine translations. The Spanish version of the ERIC compilation was finalized through group consensus. Reflections from research team meetings and focus group discussions were synthesized qualitatively.ResultsGiven that dialectical nuances exist between Spanish-speaking regions, efforts prioritized universally accepted terminology. Team discussions focused on difficult translations, word choice, and clarity of concepts. Seven researchers participated in two focus groups, where discussion surrounded clarity of concepts, alternative word choice for Spanish translations, linguistic formality, grammar, and conciseness. Translation difficulties highlighted lack of precision in implementation science terminology, and the lack of conceptual clarity of words underscored limitations in the application of the compilation.ConclusionsThe work demonstrated the feasibility of translating implementation science resources. As one of the first systematic efforts to translate implementation resources, this study can serve as a model for additional efforts, including translation into other languages and the expansion to conceptual modifications. Further, this work yielded insights into the need to provide conceptual clarity in implementation science terminology. Importantly, the development of Spanish resources will increase access to conduct implementation research among Spanish-speaking populations.

Artificial intelligence in colorectal multidisciplinary team meetings. What are the medicolegal implications?

To give an insight into areas for future development and suggestions in the complexities of incorporation of AI into human colorectal cancer (CRC) care while bringing into focus the importance of clinicians' roles in patient care. Existing literature around AI use in CRC care is reviewed and potential regulatory issues and medicolegal implications around its implementation in CRC multidisciplinary team meetings (MDTs) are identified. Challenges with patient privacy and confidentiality, patient consent, inequity and bias, patient autonomy, as well as AI system transparency and the liability and accountability issues arising from complications that arise from AI-aided clinical decisions are important focusses associated with the use of AI in CRC MDTs. Consideration of various medicolegal aspects of the use of AI in CRC MDTs is warranted to ensure its safe and smooth incorporation into CRC MDTs. AI function as a clinical decision support system and does not replace professional expertise.

Tensions between institutional and professional frames in team talk in gerontological social work

Team meetings are central to social workers’ decision-making practices. These meetings often function as a forum for collegial consultations, when applications are processed and recommendations on decisions are discussed. In this paper, we present findings from a case study on team talk and decision-making practices in gerontological social work. The data come from a body of material gathered within the framework of a larger project covering the process of assessing elder care for older persons in three Swedish municipalities. The case concerns an application, due to homelessness, from a couple for an apartment in special housing. The team meeting was analysed using a data-driven perspective within a micro-analytical approach to talk, focusing in detail on how conflicting perspectives in the assessment of the couple’s needs are dealt with, and how tensions between divergent views and opinions are handled in relation to institutional and professional conversational frames. The findings show how the care managers (in Sweden the professional title for social workers working in elder care) negotiated the boundaries of responsibility and power within both the institutional and professional frames, revealing that the institutional frame dominated when it came to making decisions. The findings have implications for practice, as they give insight into the interactional dynamics involved in social workers’ assessments when navigating different conversational frames within their decision-making practices.