Team Setting Research Articles

Work alone then meet: Cognitive attributes and team interaction in engineering design using evolutionary algorithms

Engineering products are becoming increasingly more complex and require skills from multiple disciplines to design, something hardly realizable by a single individual. As a result, most organizations form design teams, assembling which, is a challenging task. This work presents an agent-based model along with a framework for investigating team dynamics as the designers work on a representative engineering design problem. The model simulates evolutionary systems wherein, designs are generated, selected, and improved upon, as in biological evolution. A binary-coded genetic algorithm evolves the designs under the influence of the designers’ cognitive attributes, both individually and in a team setting. The results show that product complexity generally decreases the quality of designs, while increasing the number of team members initially increases team performance. However, as the number of team members increases further, their performance levels out and finally declines. An interesting find is that the longer the designers work individually on a design before a team meeting, the better the overall performance. Furthermore, increasing the number of candidate solutions brought to the team meeting initially increases team performance followed by a decrease, indicating that there is an optimal number. The paper concludes with proposed directions that future work can take.

“Groupwork or teamwork?”: Creating the same page for improving team-based learning experience

The increasing popularity of the team-based learning (TBL) approach signifies how much the student-centered learning environment contributes to the effectiveness of teaching. Given the need to establish an agreement for groups to communicate their visions for collaborative efforts within the teamwork, this activity provides a basic communicative template for group members to exchange their thoughts and ideas on what distinguishes teamwork from groupwork and what constitutes good teamwork. This activity essentially offers a playground for student groups to engage with the notion of teamwork, identify potential challenges in their team communication, and actively seek solutions to improve their TBL experience. Courses: This activity applies to foundational courses in communication (courses requiring students to work in a team setting for an extended time). Objectives: This activity engages students in a conversational space within a group-based setting, sharing their understanding of what constitutes good teamwork. Thus, the activity is intended to: (1) encourage team members to communicate their goals and expectations, (2) increase the understanding of contribution and appreciation of teamwork, (3) improve the overall TBL experience for team members, and (4) help students understand the differences between group-based learning and TBL experiences.

Using Smartwatches to Observe Changes in Activity During Recovery From Critical Illness Following COVID-19 Critical Care Admission: 1-Year, Multicenter Observational Study.

BackgroundAs a sequela of the COVID-19 pandemic, a large cohort of critical illness survivors have had to recover in the context of ongoing societal restrictions.ObjectiveWe aimed to use smartwatches (Fitbit Charge 3; Fitbit LLC) to assess changes in the step counts and heart rates of critical care survivors following hospital admission with COVID-19, use these devices within a remote multidisciplinary team (MDT) setting to support patient recovery, and report on our experiences with this.MethodsWe conducted a prospective, multicenter observational trial in 8 UK critical care units. A total of 50 participants with moderate or severe lung injury resulting from confirmed COVID-19 were recruited at discharge from critical care and given a smartwatch (Fitbit Charge 3) between April and June 2020. The data collected included step counts and daily resting heart rates. A subgroup of the overall cohort at one site—the MDT site (n=19)—had their smartwatch data used to inform a regular MDT meeting. A patient feedback questionnaire and direct feedback from the MDT were used to report our experience. Participants who did not upload smartwatch data were excluded from analysis.ResultsOf the 50 participants recruited, 35 (70%) used and uploaded data from their smartwatch during the 1-year period. At the MDT site, 74% (14/19) of smartwatch users uploaded smartwatch data, whereas 68% (21/31) of smartwatch users at the control sites uploaded smartwatch data. For the overall cohort, we recorded an increase in mean step count from 4359 (SD 3488) steps per day in the first month following discharge to 7914 (SD 4146) steps per day at 1 year (P=.003). The mean resting heart rate decreased from 79 (SD 7) beats per minute in the first month to 69 (SD 4) beats per minute at 1 year following discharge (P<.001). The MDT subgroup’s mean step count increased more than that of the control group (176% increase vs 42% increase, respectively; +5474 steps vs +2181 steps, respectively; P=.04) over 1 year. Further, 71% (10/14) of smartwatch users at the MDT site and 48% (10/21) of those at the control sites strongly agreed that their Fitbit motivated them to recover, and 86% (12/14) and 48% (10/21), respectively, strongly agreed that they aimed to increase their activity levels over time.ConclusionsThis is the first study to use smartwatch data to report on the 1-year recovery of patients who survived a COVID-19 critical illness. This is also the first study to report on smartwatch use within a post–critical care MDT. Future work could explore the role of smartwatches as part of a randomized controlled trial to assess clinical and economic effectiveness.International Registered Report Identifier (IRRID)RR2-10.12968/ijtr.2020.0102

Mind the gap! A survey comparing current strength training methods used in men’s versus women’s first team and academy soccer

ABSTRACT Purpose Much less is known about strength and conditioning (S&C) practice in women’s versus men’s soccer. The aim of this study was to compare S&C practice between coaches working in men’s or women’s soccer, at first team or academy level, worldwide. Methods A total of 170 participants, who were involved with S&C support at their soccer club (in Europe, USA and South America, within men’s or women’s first team or academy settings) completed a comprehensive online survey, designed to evaluate (i) their academic qualifications and S&C coaching experience; and their preferred methods for (ii) physical testing; (iii) strength and power development; (iv) plyometric training; (v) speed development; and (vi) periodization. Results Women’s academies had fewer weekly in-season S&C sessions than men’s academies (1.6±0.6 vs. 2.3±0.9, p=0.005). Relatively, fewer women’s academy S&C coaches (6%) used Olympic weightlifting movements than men’s academy S&C coaches (32%, p=0.030). Relatively, more women’s academy coaches (47%) used the Nordic hamstring exercise (NHE) compared to men’s academy coaches (15%, p=0.006), but relatively more women’s vs. men’s first team coaches (61% vs. 38%, p=0.028) and women’s vs. men’s academy (61% vs. 38% coaches, p=0.049) utilised rating of perceived exertion-based load prescriptions. Conclusion Notable differences in S&C practice exist between coaches of men’s and women’s soccer squads, particularly at academy level. Fewer weekly S&C sessions in women academy players may have implications for physical development, while the greater use of subjective load prescriptions in both academy and first team women’s squads may lead to sub-optimal performance gains.

Pluralistic Ignorance in Concussion Reporting Among Student- Athletes

Background:The underreporting of concussions is a persistent problem among student athletes and has the potential to lead to negative health outcomes. The reasons for underreporting are multifactorial and included cultural norms and peer pressures of which one component is pluralistic ignorance.Purpose:To evaluate the impact of pluralistic ignorance on the decisions of concussion reporting amongst Division III athletes. We propose that gender, age, and type of sport will impact the responses that individuals make within a survey that they took in a group setting.Methods:A Qualtrics® survey was created which contained an array of questions including; concussion knowledge, impulsivity, intention of self and teammate to report concussions and cultural reporting norms. The survey was administered in a group team setting and contained video vignettes depicting concussions and other injuries. The survey was administered to 295 NCAA Division III athletes representing 13 different sports: men’s baseball, basketball, ice hockey, football, and women’s field hockey, volleyball, soccer, softball, squash, and men’s and women’s Nordic skiing, lacrosse, rugby, ultimate frisbee.Results:295 student athletes participated, 150 were women, 142 were men, 3 gender identified as other, and their ages ranged from 18 to 26. Individuals were excluded from the analysis if the individual responded inconsistently to both validator questions. Contact sport participants had higher scores on the knowledge questions and had increased agreement for teammate intention to report than their non-contact and collision counterparts (Kruskal-Wallis H = 9.61, P = .008) and had overall lower measures of impulsivity (H = 7.88, P = .019). Collision sport participants were less likely (59%) to endorse a teammate culture that was supportive of concussion reporting (C2 = 13.56, P = .036) however female athletes (72%) and non-contact participants (79%) were more likely to endorse a culture supportive of self-reporting. Overall, regardless of gender, intention to play (self and teammate) despite concussion symptoms was endorsed by 66% of athletes and was more common among collision (75%) and contact participants (70%, C2 = 12.14, P = .016).Conclusion:Despite the fact that the majority of college athletes don’t endorse pluralistic ignorance within their teams (i.e. a cultural of not reporting) two-thirds of the college athletes still indicate they would not report their concussion symptoms.

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

AAIM Recommendations to Promote Equity in the Clerkship Clinical Learning Environment

Explore to Learn

Explorative information systems behaviors are the ways in which individuals actively revise their usage and discover creative means of applying the system, extending the potentials of the system, and enhancing task performance. This study has developed a specific concept of explorative system behavior-explorative information technology (IT) learning-to describe users' post-training learning behavior-novel use. Adapting a herding lens, we study the individual and team-level triggers of explorative learning cognitions. The study tests the proposed cross-level model and collects data from 225 individuals who are divided into 51 teams. The results indicate that individuals tend to innovatively use a system through developed exploration cognitions in team settings as a response to examined herd behavior triggers. The study uncovered that members of cohesive teams and learners with high uncertainty perceptions are more likely to imitate the observed explorative learning behaviors of their peers and reproduce such behaviors in the long term.

Safety gaps in medical team communication: Closing the loop on quality improvement efforts in the cardiac catheterization lab.

Closed-loop communication (CLC) is a fundamental aspect of effective communication, critical in the cardiac catheterization laboratory (cath lab) where physician orders are verbal. Complete CLC is typically a hospital and national mandate. Deficiencies in CLC have been shown to impair quality of care. Single center observational study, CLC for physician verbal orders in the cath lab were assessed by direct observation during a 5-year quality improvement effort. Performance feedback and educational efforts were used over this time frame to improve CLC, and the effects of each intervention assessed. Responses to verbal orders were characterized as complete (all important parameters of the order repeated, the mandated response), partial, acknowledgment only, or no response. During the first observational period of 101 cases, complete CLC occurred in 195 of 515 (38%) medication orders and 136 of 235 (50%) equipment orders. Complete CLC improved over time with various educational efforts, (p < 0.001) but in the final observation period of 117 cases, complete CLC occurred in just 259 of 328 (79%) medication orders and 439 of 581 (76%) equipment orders. Incomplete CLC was associated with medication and equipment errors.CLC of physician verbal orders was used suboptimally in this medical team setting. Baseline data indicate that physicians and staff have normalized weak, unreliable communication methods. Such lapses were associated with errors in order implementation. A subsequent 5-year quality improvement program resulted in improvement but a sizable minority of unacceptable responses. This represents an opportunity to improve patient safety in cath labs.

Multidisciplinary Consulting Team for Complicated Cases of Neurodevelopmental and Neurobehavioral Disorders: Assessing the Opportunities and Challenges of Integrating Pharmacogenomics into a Team Setting.

Neurodevelopmental disorders have steadily increased in incidence in the United States. Over the past decade, there have been significant changes in clinical diagnoses and treatments some of which are due to the increasing adoption of pharmacogenomics (PGx) by clinicians. In this pilot study, a multidisciplinary team at the Arkansas Children’s Hospital North West consulted on 27 patients referred for difficult-to-manage neurodevelopmental and/or neurobehavioral disorders. The 27 patients were evaluated by the team using records review, team discussion, and pharmacogenetic testing. OneOme RightMed® (Minneapolis, MN, USA) and the Arkansas Children’s Hospital comprehensive PGx test were used for drug prescribing guidance. Of the 27 patients’ predicted phenotypes, the normal metabolizer was 11 (40.8%) for CYP2C19 and 16 (59.3%) for CYP2D6. For the neurodevelopmental disorders, the most common comorbid conditions included attention-deficit hyperactivity disorder (66.7%), anxiety disorder (59.3%), and autism (40.7%). Following the team assessment and PGx testing, 66.7% of the patients had actionable medication recommendations. This included continuing current therapy, suggesting an appropriate alternative medication, starting a new therapy, or adding adjunct therapy (based on their current medication use). Moreover, 25.9% of patients phenoconverted to a CYP2D6 poor metabolizer. This retrospective chart review pilot study highlights the value of a multidisciplinary treatment approach to deliver precision healthcare by improving physician clinical decisions and potentially impacting patient outcomes. It also shows the feasibility to implement PGx testing in neurodevelopmental/neurobehavioral disorders.

Reintroducing rest: evaluation of a patient-guided sleep workbook in a community mental health team setting

Purpose Sleep disturbance is a common difficulty in the general population. It has become particularly prevalent in the context of disruption to routine brought about by the COVID-19 pandemic. The purpose of this study was to trial a patient-guided “sleep workbook” intervention, which was developed by multidisciplinary team members, combining principles of sleep hygiene education and cognitive behavioural therapy for insomnia behavioural strategies, and to evaluate its efficacy in a mixed-methods study. Design/methodology/approach Service users of the community mental health service were invited to participate. A total of 30 service users agreed to participate. A total of 15 participants completed both the intervention and the mixed-methods survey. Four participated in the focus group. Descriptive and inferential statistics were performed on the collected quantitative data. A thematic analysis was carried out of qualitative survey responses and focus group discourse. Findings There was a statistically and clinically significant improvement in quantity and quality of sleep following intervention. Mean hours of sleep prior to the intervention was 4.4 hours [standard deviation (SD) = 2.2], compared to 6.1 hours (SD = 2.2) afterwards (p = 0.003). Quality of sleep improved from a mean of 2.5 (SD = 2.1) to 6.1 (SD = 2.3) following the intervention (p = &lt;0.001). Four themes were developed using the qualitative data: “under-recognition of sleep difficulties”, “ruminations”, “practical utility” and “therapeutic autonomy”. Originality/value There is a growing need for occupational therapists and clinicians to provide interventions for patients with sleep difficulties and to develop sleep management practice. This patient-guided sleep workbook may be an effective intervention for these patients.

Should Primary Stroke Centers Perform Advanced Imaging?

Should Primary Stroke Centers Perform Advanced Imaging?

Bulls in a China Shop: Narcissism, Intragroup Conflict, and Task Cohesion.

When given opportunities for personal glory in individual settings, people high in narcissism excel. However, less is known about narcissists' influence in team contexts. Across two studies (utilizing cross-sectional and two-wave longitudinal designs) involving 706 athletes from 68 teams in total, we tested a conceptual model linking narcissism to task cohesion, via intragroup conflict, moderated by narcissistic group composition. We tested a new sports-oriented measure of intragroup conflict using Bayesian estimation and evaluated our theorizing using a multilevel conditional indirect effect hybrid model. Across both studies, we found that narcissism influenced perceptions of task cohesion via process conflict only, with a negative influence at low narcissistic group composition that was weakened (Study 1) or nullified (Study 2) at high narcissistic team composition. Collectively, these findings offer the first example of how narcissism influences task cohesion in team settings and the contextual effects of narcissistic group composition.

Case report: Utilisation of the paramedian approach to epidural insertion in a case of klippel-feil syndrome

Klippel–Feil Syndrome (KFS) is a complex heterogeneous entity that can result in cervical spondylosis and thoracolumbar vertebral fusion. Combined, these features contribute to both a difficult airway and neuraxial anaesthesia. Previously, these patients required general anaesthesia in the obstetric setting, incorporating advanced airway techniques as the first line. Herein, we describe the novel use of the paramedian approach to epidural anaesthesia in a primigravid woman, with a background of KFS. The patient had a vaginal septum and double cervix and was considered at higher risk of obstetric complications. Antenatal assessment and forward planning within the multidisciplinary team setting were vital in the formulation and provision of safe care for this patient. Neuraxial ultrasound (US), undertaken at preassessment, yielded adequate views of the posterior complex in the paramedian sagittal oblique plane only. An anaesthetic plan with emphasis on early paramedian epidural insertion was thus formulated. The patient was admitted to early labour by the obstetric team. Neuraxial US replicated the previously attained windows and in keeping with the plan, the paramedian approach was utilised with successful insertion on the first attempt. Patient-controlled epidural anaesthesia infusion was utilised over her 6-hour labour with instrumental delivery. Epidural analgesia was maintained with a bilateral T6 sensory block with the patient comfortable throughout. This case study outlines the novel use of the paramedian approach to epidural anaesthesia in a patient with KFS. We also believe it exemplifies the need to pre-assess patients with abnormal spinal anatomy and utilises the neuraxial US to formulate an anaesthetic plan.

Group Size and Group Performance in Small Collaborative Team Settings: An Agent‐Based Simulation Model of Collaborative Decision‐Making Dynamics

The relationship between size and performance of collaborative human small groups has been studied broadly across management, psychology, economics, sociology, and engineering disciplines. However, empirical research findings on this question remain equivocal. Many of the earlier studies centered on empirical human‐subject experiments, which inevitably involved many confounding factors. To obtain more theory‐driven mechanistic explanations of the linkage between group size and performance, we developed an agent‐based simulation model that describes the complex process of collaborative group decision‐making on problem‐solving tasks. To find better solutions to a problem with given complexity, these agents repeatedly explore and share solution candidates, evaluate and respond to the solutions proposed by others, and update their understanding of the problem by conducting individual local search and incorporating others’ proposals. Our results showed that under a condition of ineffective information sharing, group size was negatively related to group performance at the beginning of discussion across each level of problem complexity (i.e., low, medium, and high). However, in the long run, larger groups outperformed smaller groups for the problem with medium complexity and equally well for the problem with low complexity because larger groups developed higher solution diversity. For the problem with high complexity, the higher solution diversity led to more disagreements which in turn hindered larger groups’ collaborative problem‐solving ability. Our results also suggested that, in small collaborative team settings, effective information sharing can significantly improve group performance for groups of any size, especially for larger groups. This model provides a unified, mechanistic explanation of the conflicting observations reported in the existing empirical literature.

The differential effects of integral pride and gratitude on divergent moral judgment for the self versus others

Individuals tend to have divergent moral judgment when judging oneself versus others, which is termed moral hypocrisy. While prior research has examined different factors that might influence moral hypocrisy, there are limited insights on the influences of different, discrete emotions. The present research seeks to address this gap and examines the differential influences of pride and gratitude on moral hypocrisy. Results of a pilot study and three main studies demonstrate that pride (but not gratitude) leads to moral hypocrisy. These effects are replicated across different cases of questionable behaviors and prosocial behaviors in a team setting. More importantly, this research identifies one mechanism that potentially explains this effect—the appraisal of self-other similarity. The findings of this research thus provide empirical evidence that distinct emotions arising from an organizational setting can differentially influence moral hypocrisy and offer practical implications. JEL Classification: C91, D23, D91

103 ORTHOGERIATRIC SERVICES IN THE FACE OF COVID-19

BackgroundNationally agreed standards improve the level of care delivered to all older, frail, multi-morbid patients presenting with hip fractures. Dedicated Orthogeriatric services allow for these standards to be achieved in a multi-disciplinary team (MDT) setting. As the COVID-19 pandemic reached our shores, the model of care set out by the Irish Hip Fracture Standards (IHFS) was under threat. Our dedicated Orthopaedic Trauma ward became an acute COVID ward and the Orthogeriatric service was re-deployed to acute medicine for Quarter 2.MethodsUsing the Irish Hip Fracture Database, local data was analysed and compared with national data from Quarter 1 to 4 (Q1–4) in 2020.ResultsWhen comparing local IHFS’s with national figures, ongoing challenges and future goals are highlighted.In 2020, there were 222 hip fracture patients (mean age 81.8 years) in our hospital. Standard 1, time to the ward <4 hours, stands at 71% locally (national average 33%). Standard 2, time to theatre <48 hours, is an ongoing challenge and remains at 66% (national average 75%). Standard 3, pressure ulcer rate, was the same as the national average at 3%. Standards 4, 5 and 6 in our hospital stand at 87% (national averages of 82%, 91% and 85% respectively).In Q1, 56%, or over 1 in every 2 patients with hip fractures, met all of the Irish Hip Fracture Standards in our hospital. In Q2, only 18% of patients met all of the IHFS’s. Q3 saw improvements with 47% of all hip fracture patients achieving all IHFS’s. Q4 showed maintenance with 45% of all patients achieving all IHFS’s.ConclusionThese findings highlight the need for a dedicated Orthogeriatric Service and Orthopaedic ward at all times. Going forward with the risk of future waves and the emergence of new variants, every effort should be made to maintain a comprehensive orthogeriatric service to minimise a negative impact on patient care.

Large cell neuroendocrine carcinoma of hypopharynx: A distinct histopathological entity

Aim: To present a case of large cell neuroendocrine carcinoma (LCNEC) involving the hypopharynx focusing on the histopathological diagnosis, radiological investigations and oncology treatment. Methodology: A case report with relevant literature review Case report: A 71-year-old Caucasian male presented with a four-month history of right sided sore throat, a one-month history of feeling something stuck in his throat at the level of the larynx associated with a deeper voice and two weeks history of right referred otalgia. On examination his voice has a rough but there was no stridor. There was a 2 x 2 cm node palpable in the right neck level II. Flexible pharyngolaryngoscopy revealed an exophytic growth on the right aryepiglottic fold that was covering the whole of the glottis. However, panendoscopy showed a large exophytic mass filling up the right piriform fossa involving the adjacent aryepiglottic fold and the postcricoid region. The biopsy confirmed the LCNEC and the fine needle aspiration cytology showed metastasis in his neck. The scans did not show any widespread disease in the body. He was managed in the multidisciplinary team setting and was treated with chemoradiotherapy. Conclusion: LCNEC involving the hypopharynx is an extremely rare clinical entity with poor prognosis. Early diagnosis and radical treatment with chemoradiotherapy would appear to be an acceptable treatment option.

Leadership and knowledge sharing in teams: The effects of the leader's communicative framing of team goals

ABSTRACT Capitalizing on team members’ knowledge resources is one of the key determinants of the success of a work team, and team leaders play an important role in cultivating team members’ motivation to share their knowledge with each other. This study examined the effects of a leader’s communicative framing of team goals on individuals’ knowledge-sharing intention in a team setting. An experimental study with a 2 (leader’s regulatory focus: promotion vs. prevention) X 2 (leader’s reward focus: process vs. outcome) factorial design revealed that the leader’s process-based reward framing leads to a significantly higher level of knowledge sharing intention than the leader’s outcome-based reward framing. This result suggests that a leader’s communicative framing that emphasizes and incentivizes collaborative processes as opposed to the team’s end outcomes is more likely to encourage team knowledge sharing.

A Review of Legal, Ethical, and Governance Issues for Team Doctors.

To provide a review and discussion of a range of legal and ethical issues commonly faced by team physicians, with reference to high-profile international integrity crises in sport that have involved doctors. The article also presents some recommendations and guidance for team doctors and sporting organizations. Media reports, legal cases, and journal articles describing recent sporting integrity crises that have involved medical issues and governance reforms which are emerging in response. Many of the modern "integrity crises" in sport have a medical aspect (eg, doping cases, catastrophic injuries and illnesses, "Bloodgate" and other "medical cheating," sexual contact between doctors and athletes, harassment/bullying of doctors, concussion mismanagement, and management of the coronavirus pandemic in sport). A key issue is that while doctors bear ultimate responsibility for any perceived medical negligence, they do not always have ultimate power in decision-making. This is common in the traditional governance structure where the coach/manager "outranks" the doctor and can overrule medical decisions. There can be a blurring of the traditional doctor-patient relationship, especially on tour, and conflicts of interests occur when the needs of the employer/sporting organization differ from the player (patient). Further issues can arise in treating other staff members and players' family members. Doctors must be aware of range of important legal and ethical issues that arise in the team setting. Medical integrity crises have inspired governance reforms, such as policy development, appointment of chief medical officers, medical staff reporting to integrity departments, and sanctions of teams that breach medical integrity requirements. Sporting organizations must continue to implement and strengthen frameworks reinforcing doctors' seniority in the medical area.

Level Up: Strategies to Increase Student Engagement Using Gamification in Physical Education

The aim of this paper is to provide strategies for coaches to improve their ability to implement goal setting practices with groups or teams. First, an overview of effective goal setting practices is provided. Next, a three-step goal setting system is introduced to assist when setting goals with teams. Concrete examples from a variety of different team sports are included to aid coaches in better understanding what these practices and processes look like in a team setting when implemented properly.