Team Training Research Articles

QUALIDADE PARA GARANTIR A CONFIABILIDADE DOS RESULTADOS DOS TESTES DA COVID 19

Objective: To analyze and identify the main quality criteria essential to ensure the reliability of COVID-19 test results performed in clinical laboratories. Literature Review: Ensuring the quality of COVID-19 testing is vital for the effectiveness of pandemic control strategies. This involves meticulous care with the selection and implementation of tests, the formation and training of teams, and adherence to standards and good practices. Only with an ongoing commitment to quality and accuracy can we ensure that test results reflect the true situation of COVID-19 infection and aid in public health decision-making.Conclusion: To ensure the reliability of COVID-19 test results, it is essential to take a comprehensive approach that encompasses test accuracy, sample quality, rigorous validation, staff qualification, and transparency.

Crossing-Borders: Experiences With International Transports on Extracorporeal Membrane Oxygenation: Special Considerations and Challenges

Extracorporeal membrane oxygenation (ECMO) is a crucial support for patients with severe cardiac or respiratory failure, but its availability is limited, often requiring patient transport to specialized centers. Only a few centers provide mobile ECMO services, and international ECMO transports are rare. This study reviews a department’s experience with international ECMO transports from 1998 to 2022. Out of 1,277 ECMO transports, 357 (28%) were international. Most of these (52%) were directed to ECMO Center Karolinska, whereas others involved transfers due to a lack of beds or between foreign centers. The majority (79%) of patients were cannulated at the referring hospital, with 63% supported by venoarterial ECMO. Transport distances averaged 1,200 km, using fixed-wing aircraft 89% of the time. Hospital survival for those transported to Karolinska was 82%, and 36% of transports experienced complications, though no deaths occurred during transport. This study highlights the safety and effectiveness of international ECMO transport with highly trained teams.

Implementation of a Screening Program for High-Grade Anal Dysplasia in High-Risk Patients in a Tertiary Cancer Center.

The incidence of anal squamous cell carcinoma (SCC) has been increasing over the last decades. Human papillomavirus (HPV) infection accounts for more than 90% of anal cancers, and HIV co-infection increases the risk of invasive cancer. Men who have sex with men (MSM) with HIV are the highest risk group for developing anal high-grade squamous intraepithelial lesions (aHSILs), which can be found in 45%-50% of these patients and are precursor lesions for invasive cancer. Anal cytology is an effective screening tool, but it lacks sensitivity. High-resolution anoscopy (HRA) is the gold standard procedure for diagnosis and treatment of aHSILs. Recent data suggest that early detection and treatment of aHSILs could prevent the development of invasive cancer in this population. The objective of the study was to describe the implementation of an office-based screening program for anal cancer prevention in a Comprehensive Cancer Center in Brazil. Training included participation in the International Anal Neoplasia Society (IANS) HRA course at UCSF Medical Center Mount Zion in San Francisco, CA, USA, by three colorectal cancer surgeons. In-person and hands-on training was provided by a specialist through the AIDS Malignancy Consortium (AMC) of the US NIH. Equipment purchased and provided by the AMC included a colposcope with a digital camera, a hands-free mouse pedal, and a photo documentation imaging software program that allows images to be recorded for documentation and training purposes. The program was implemented in 2022 after a delay of more than two years due to the COVID-19 pandemic. An average of 24 exams are performed monthly. Patients with HIV aged 35 years or older who are undergoing antiretroviral therapy were recruited from the metropolitan area of Rio de Janeiro and referred by primary care providers for screening. Patients diagnosed with aHSILs are scheduled for in-office ablative treatment in the clinic. From March 2022 to June 2024, 324 exams were performed, and aHSIL was found in 38.2% of 220 high-risk patients, including 45 of 129 MSMs (34.9%), 6 of 19 transgender women (31.6%), and 33 of 72 women living with HIV (45.8%). A total of 69 treatments for aHSIL were performed in 62 patients. Patients are followed on a regular basis and long-term results are awaited, including the effectiveness of local therapy for aHSIL. The screening and treatment program was successfully implemented in a tertiary comprehensive Cancer Center. Team training and external proctorship were decisive for the achievement of benchmark standards. The program aims to permanently provide screening for the prevention of anal cancer through the detection and treatment of aHSIL within the National Cancer Institute of Brazil for populations considered at-risk for anal cancer.

Decision-making during training of a Swedish navy command and control team: a quantitative study of workload effects.

The study compared two simulation environments for training of Swedish naval Command and Control teams by using indirect measures, including workload, combat readiness, and situation awareness. The literature explains simulation-based training as providing a safe avenue to practice relevant scenarios. Fidelity, the degree of realism in the simulation, and workload, the equilibrium between demands and assigned tasks, are crucial factors examined in this study of low- and high-fidelity naval simulations. This study was conducted to better understand the effects of various training methods. An experimental design with repeated measures was used with three consecutive escalating parts. The subjective, multidimensional assessment tool, NASA-Task Load Index was used to rate perceived workload. Combat readiness of the ship and mental demand yielded significant results. For combat readiness of the ship, there was a difference between the low and the high-fidelity setting, for the initial part of the scenario p = 0.037 and for the second part p = 0.028. Mental demand was experienced as higher in the low-fidelity setting, p = 0.036. Notably, the simulated internal battle training for onboard command teams in a low-fidelity setting was found to induce a level of stress comparable with that experienced in a high-fidelity setting. The results indicate that low-fidelity training results in a workload not distinguishable from high-fidelity training and has practical implications for increased use of low-fidelity training as part of (naval) command team training programmes.

Interprofessional Team Training

Background: Interprofessional team training (IPTT) prepares students from health care professions for team-based care. Evaluating different learning environments to inform decisions about delivery format is timely and important. Purpose: To compare in-person and online IPTT learner outcomes. Method: Undergraduate and graduate students (n = 866) from 11 professions participated. Using retrospective pre-/post-methodology, 20 item Interprofessional Collaboration Competency Attainment Survey (ICCAS) scores were compared, and qualitative responses analyzed. Results: Mean ICCAS scores improved for in-person and online delivery (P < .0001) with large effect sizes (Cohen’s D = 0.94-1.86). In-person delivery resulted in greatest improvement (P = .038), offset by online logistical benefits. Qualitative themes highlighted impact on learning, importance of facilitator competence, and setting expectations. Conclusion: IPTT achieved learning consistent with competency development. Advantages from in-person delivery should be weighed against online logistical advantages.

VIOLÊNCIA DOMÉSTICA E O ACOLHIMENTO FEMININO: A IMPORTÂNCIA DAS CASAS DE APOIO PARA MULHERES VÍTIMAS

This study addresses the issue of domestic violence against women, highlighting the role of shelters in Amazonas as essential instruments in breaking the cycle of violence. The general objective is to analyse how these institutions contribute to the protection and recovery of victims, providing comprehensive support that promotes their autonomy and security. The methodology applied is based on a theoretical and practical analysis of the functioning of shelters, assessing legislative aspects and their application in the state of Amazonas. The research reveals that sheltering offers a safe and structured environment where women receive psychological, legal, and social support, significantly contributing to breaking the violence cycle and rebuilding self-esteem. The results indicate that, beyond providing shelter, these facilities offer multidimensional support that helps victims understand their rights and develop the confidence necessary to break ties with the aggressor. The conclusions reinforce the importance of these shelters within the women's protection system, suggesting the need to improve shelter policies to fully ensure victims’ rights to safety and dignity. Expanding resources and continuous team training are recommended to ensure shelters in Amazonas can provide even more effective assistance to women in vulnerable situations.

Interprofessional Team Training With Virtual Reality: Acceptance, Learning Outcome, and Feasibility Evaluation Study.

Effective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)-based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning. This study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case. This 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course. The data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65-80). The perception of usefulness (median 6, IQR 5.8-6.9) and ease of use (median 5.9, IQR 5.1-6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6-9) to posttraining (median 8, IQR 7-9; z=-2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2-3 and median 3.5, IQR 3-4, respectively; z=-3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely. The new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students.

Airway Management in Patients With Severe Traumatic Brain Injuries in the Emergency Unit: Integratva Review

Objective: The present study aims to analyze the best practices, risk factors, and challenges involved in airway management in patients with severe TBI, both in the prehospital and hospital settings, in order to identify interventions that optimize clinical outcomes. Method: An integrative literature review was conducted based on studies published between 2019 and 2024. The research was structured by the PICo (Population, Interest and Context) strategy, focusing on patients with severe TBI, airway management and ventilation. After screening 325 articles, 10 studies were selected for critical analysis, following the PRISMA guidelines. Results and Discussion: It was observed that early intubation, although crucial, presents significant variations in effectiveness depending on the training and experience of the team. Complications such as excessive hyperventilation, aspiration, and difficulties in airway management in patients with cervical spine injuries were recurrent in the studies. The implementation of standardized protocols and the use of advanced devices, such as videolaryngoscopy, have been identified as essential measures to reduce complications and improve outcomes. The need for a trained multidisciplinary team and the use of evidence-based guidelines was also highlighted as critical to treatment success. Conclusion: Airway management in patients with severe TBI is complex and requires a careful and well-trained approach. The review emphasizes the importance of well-defined protocols and continuous training of emergency responders to optimize survival and neurological outcomes for these patients.

Transforming learning for adult protective services caseworker certification training: program evaluation of simulation training

ABSTRACT This study assesses the first statewide program to provide simulation training conducted via videoconference to all new caseworkers. The simulation training in Illinois was conducted at a mock house. A mock family played by standardized clients is physically present, and trainees participate remotely. The program evaluation team implemented a survey that asks trainees to rate their confidence in different skills at multiple timepoints, to appraise the quality of feedback and debriefing of the training team, and to write text responses to the questions regarding their learning experience. Analysis of quantitative data over the course of the training showed statistically significant linear increases in trainees’ confidence for all the 14 skills. Their text responses indicated that they received feedback they appreciated and felt they gained ability on a range of different skills. The simulation training makes a valued and effective contribution to the certification training.

2022 AAHA Canine Vaccination Guidelines (2024 Update).

Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Applying integrated enhanced cognitive behaviour therapy (I-CBTE) to severe and longstanding eating disorders (SEED) Paper 2: An in-depth case study for clinicians

BackgroundThis case study examines the application of Integrated Enhanced Cognitive Behavioural Therapy (I-CBTE) for a patient with severe, longstanding anorexia nervosa and multiple comorbidities, including organic hallucinosis, complex post-traumatic stress disorder (CPTSD), and severe self-harm. Such complex presentations often result in patients falling between services, which can lead to high chronicity and increased mortality risk. Commentaries from two additional patients who have recovered from severe and longstanding anorexia nervosa are included.Case studyThe patient developed severe anorexia nervosa and hallucinosis after a traumatic brain injury in 2000. Despite numerous hospitalisations and various psychotropic medications in the UK and France, standard treatments were ineffective for 17 years. However, Integrated Enhanced Cognitive Behaviour Therapy (I-CBTE) using a whole-team approach and intensive, personalised psychological treatment alongside nutritional rehabilitation proved effective.MethodsIn this paper, we describe the application of the I-CBTE model for individuals with severe, longstanding, and complex anorexia nervosa, using lived experience perspectives from three patients to inform clinicians. We also outline the methodology for adapting the model to different presentations of the disorder.OutcomesThe patient achieved and maintained full remission from her eating disorder over the last 6 years, highlighting the benefit of the I-CBTE approach in patients with complex, longstanding eating disorder histories. Successful treatment also saved in excess of £360 k just by preventing further hospitalisations and not accounting for the improvement in her quality of life. This suggests that this method can improve outcomes and reduce healthcare costs.ConclusionThis case study, with commentaries from two patients with histories of severe and longstanding anorexia nervosa, provides a detailed description of the practical application of I-CBTE for patients with severe and longstanding eating disorders with complex comorbidities, and extensive treatment histories. This offers hope for patients and a framework for clinicians to enhance existing treatment frameworks, potentially transforming the trajectory of those traditionally deemed treatment resistant.RecommendationsWe advocate the broader integration of CBT for EDs into specialist services across the care pathway to help improve outcomes for patients with complex eating disorders. Systematic training and supervision for multidisciplinary teams in this specialised therapeutic approach is recommended. Future research should investigate the long-term effectiveness of I-CBTE through longitudinal studies. Patient feedback on experiences of integrated models of care such as I-CBTE is also needed. In addition, systematic health economics studies should be conducted.

Less is more: Overlapping communication in trauma resuscitation

BackgroundTimely management of trauma patients is crucial. Better team performance means faster care, but roles of specific communication practices remain unclear. We hypothesized that overlapping communication is associated with less efficient resuscitations. MethodsThis single-center prospective observational study included hypotensive trauma patients from June–September 2023. Data were collected using Trauma Video Review. The association between overlapping communication and resuscitation length was assessed using multivariable linear regression adjusting for demographics, injury mechanism, Injury Severity Score (ISS), vitals, and number of procedures performed. ResultsWe included 87 patients with median ISS 26.0 [interquartile range IQR: 14.0–34.0] and median systolic blood pressure 84.0 [70.0–90.5]. Median resuscitation length was 19.1 [15.4–23.1] minutes. Overlapping communication occurred for median 1.22 [0.7–2.1] minutes. Overlapping communication was associated with longer resuscitations (p ​< ​0.0001). ConclusionsOverlapping communication was associated with less efficient resuscitations in hypotensive trauma patients. Training for trauma teams should target “one voice at a time”.

Using kanban board for forming social time management skills of future IT specialists

For the professional development of students studying in information technology areas, it is important to develop social time management skills, i.e. skills in organizing well-coordinated teamwork and optimal distribution of responsibilities between team members with minimal time to achieve a common goal. The article aims to substantiate and elaborate methodological recommendations for developing social time management skills using kanban technology in organizing team activities of future IT specialists. Criteria for assessing the development of social time management skills are proposed. The article points out the necessity of including kanban project management technology not only as training content but also as a way to optimize time resources when performing team training projects.The article describes an experiment on teamwork organization of Nizhny Tagil State Socio-Pedagogical Institute (branch) of Russian State Vocational Pedagogical University students. At the initial stage, the determination of the level of formation of social time management skills among 2nd year students in the process of completing a project assignment on software product development was carried out within the discipline “High-level methods of informatics and programming” without the use of time management technologies. The results of this stage showed the need to develop time management skills of future IT specialists in the process of teamwork. Recommendations for organizing student teamwork when using project time management technologies using a kanban board were formulated, which will allow students to develop social time management skills.The next stage of the experiment was the organization of students’ teamwork using flexible project management methodology (kanban technology): taking into account the proposed recommendations in the experimental group, without the use of time management technologies in the control group. The results of the pedagogical experiment showed the expediency of following the proposed methodological recommendations.

Nursing Roles in Extracorporeal Membrane Oxygenation

ABSTRACT Extracorporeal membrane oxygenation (ECMO) is a type of mechanical circulatory support that is increasingly utilized in the United States for severe respiratory and/or cardiac failure refractory to conventional therapies. It is an expensive and complex life support modality. Moreover, patients on ECMO are critically ill and require a strong multidisciplinary care team. A successful ECMO program involves a trained team consisting of physicians, perfusionists, nurses, and respiratory therapists. This article discusses the multiple roles of ECMO nurses, the various ECMO delivery care models, and the potential cost savings of an RN ECMO specialist staffing model—and introduces the novel role of the ECMO lead.

Adult mental healthcare professionals' experiences of family centred conversations with patients who are parents: a qualitative study.

Many parents with a mental illness report a desire for both recognition of their parental role and support for themselves and their children. However, parents are often fearful of negative judgements from professionals about their ability to be a parent, which inhibits raising concerns about their children with clinical teams. Consequently, an essential first step to supporting families is for professionals to proactively identify which patients are parents, although evidence indicates this is not consistently part of services. Professionals could play a pivotal role in guiding parents about how to talk to their children about their mental illness; this in turn can facilitate family functioning and enable children to access evidence-based interventions. This approach is crucial for mitigating the well-documented intergenerational risk of poorer outcomes and mental illness in children of affected parents. This study aimed to explore adult mental healthcare professionals' beliefs and experiences of talking with patients about: i) their role as parents ii) communication with their children about mental illness. Semi-structured qualitative interviews were conducted with 19 adult mental healthcare professionals with 4-30 years' experience of working with adult patients under the care of NHS adult mental healthcare services in England. Audio recordings were transcribed verbatim and analysed using an inductive coding approach following the principles of thematic analysis. All participants recognised their responsibility to identify patients' children through routine safeguarding protocols, but supporting patients around telling their children the diagnosis was less common. Many participants expressed concerns that raising the topic of children with patients could conflict with other parts of their professional role or would not be welcomed. Obstacles to these conversations were identified, across individual, environmental and organisational factors. Potential facilitators included specific staff training and resources for clinical teams and families around how to tell children about mental illness. Adult mental healthcare professionals would benefit from enhanced training on the importance and methods of guiding parents to communicate with their children about mental illness. This should include routine identification of which patients are parents and recognition of the impact of an adult's mental illness on the wider family system.

Peran Patroli Perintis Presisi dalam Mencegah Terjadinya Tawuran di Wilayah Hukum Polda Metro Jaya

The phenomenon of brawls in the DKI Jakarta area is increasing due to environmental, economic, and population density factors in the region. The literature references that form the main basis of this research are situational crime prevention theory, iceberg theory, social conflict theory, youth identity theory, as well as the concepts of community policing, and precision inspector patrols. This research uses qualitative methods with data collection techniques of interviews and document studies. The results showed that the role of the Precision Inspector Patrol in preventing fighting in the jurisdiction of Polda Metro Jaya is to ensure that patrols and general guards can run smoothly, be responsible for each assignment, training, and supervision of patrol teams in other units, be the front guard to carry out various preventive and responsive efforts, conduct routine patrols, respond to reports from the public, and maintain the situation in the jurisdiction of Polda Metro Jaya to remain conducive and under control. Through this role, the strategies that can be carried out by the Metro Jaya Police Precision Inspector Patrol Team in preventing fighting crimes are preemptive, preventive, and repressive strategies that are investigative in nature. The community policing policy model in an effort to maximise the implementation of the Precision Pioneer Patrol to prevent horizontal conflicts in the Polda Metro Jaya jurisdiction can be realised through several management stages which include communication and synergy, cooperation, handling, and performance evaluation. Thanks to this, the Precision Pioneer Patrol has been able to reduce the number of horizontal conflicts that occur in the Polda Metro Jaya jurisdiction. The suggestions are for the Precision Pioneer Patrol Team to increase the frequency of patrols at night in the red and yellow zones, for future researchers to apply GIS as an early detection map of conflict-prone areas, and for cooperation partners to expand the scope of programme implementation P2TP2A Unit, PPA Unit, and FKDM to provide an understanding of the importance of Precision Pioneer Patrol in preventing horizontal conflicts.

Research on Teaching Reform and Practice Strategies for Vocational College E-commerce Major in the Era of "Internet+"

With the advent of the "Internet+" era, the rapid development of digital technology presents new challenges and opportunities for vocational education, particularly in the field of e-commerce. This study analyzes the current teaching situation of the e-commerce major and identifies issues such as curriculum design, teaching methods, teacher quality, and resource allocation that do not meet the requirements of the new era. Based on these findings, it proposes reform strategies, including the introduction of diversified teaching models, the development of information-based teaching resources, and the training and enhancement of the faculty team. Additionally, this research explores how to build and apply practical teaching platforms, deepen school-enterprise cooperation, innovate training models, and promote students' autonomous learning and skill improvement in practice. The study indicates that these strategies can effectively enhance teaching quality, improve students' practical skills and employability, and provide new ideas and practical guidance for the future development of vocational college e-commerce majors.

Cluster randomized trial of a team communication training implementation strategy for depression screening in a pediatric healthcare system: a study protocol

BackgroundPediatric depression is a global concern that has fueled efforts for enhanced detection and treatment engagement. As one example, the US Preventive Services Task Force recommends depression screening for adolescents ages 12–18 years. While many health systems have implemented components of depression screening protocols, there is limited evidence of effective follow-up for pediatric depression. A key barrier is timely team communication and coordination across clinicians and staff within and across service areas for prompt service linkage. However, team effectiveness interventions have been shown to improve team processes and outcomes and can be applied in healthcare settings.MethodsThis project aims to refine and test a team communication training implementation strategy to improve implementation of an existing pediatric depression screening protocol in a large pediatric healthcare system. The team will be defined as part of the study but is expected to include medical assistants, nurses, physicians, and behavioral health clinicians within and across departments. The implementation strategy will target team mechanisms at the team-level (i.e., intra-organizational alignment and implementation climate) and team member-level (i.e., communication, coordination, psychological safety, and shared cognition). First, the project will use mixed methods to refine the team training strategy to fit the organizational context and workflows. Next, a hybrid type 3 implementation-effectiveness pilot trial will assess the initial effectiveness of the team communication training (implementation strategy) paired with the current universal depression screening protocol (clinical intervention) on implementation outcomes (i.e., feasibility, acceptability, appropriateness, workflow efficiency) and clinical/services outcomes (increased frequency of needed screening and reduced time to service linkage). Finally, the study will assess mechanisms at the team and team member levels that may affect implementation outcomes.DiscussionTeam communication training is hypothesized to lead to improved, efficient, and effective decision-making to increase the compliance with depression screening and timely service linkage. Findings are expected to yield better understanding and examples of how to optimize team communication to improve efficiency and effectiveness in the pediatric depression screening-to-treatment cascade. This should also culminate in improved implementation outcomes including patient engagement critical to address the youth mental health crisis.Trial registrationNCT06527196.Trial Sponsor: University of California San Diego.

Clinical Simulation Program for the Training of Health Profession Residents in Confidentiality and the Use of Social Networks.

In the transition to a professional learning environment, healthcare professionals in their first year of specialized postgraduate clinical training (known as residents in Spain) are suddenly required to handle confidential information with little or no prior training in the safe and appropriate use of digital media with respect to confidentiality issues. The aims of this study were: (1) to explore the usefulness of an advanced clinical simulation program for educating residents from different healthcare disciplines about confidentiality and the dissemination of clinical data or patient images; (2) to explore the use of social networks in healthcare settings; and (3) to explore participants' knowledge and attitudes on current regulations regarding confidentiality, image dissemination, and the use of social networks; Methods: This was a cross-sectional study. Data were collected from all 49 first-year residents of different health professions at a Spanish hospital between June and August 2022. High-fidelity clinical simulation sessions designed to address confidentiality and health information dissemination issues in hospital settings, including the use of social networks, were developed and implemented. Data were assessed using a 12-item ad hoc questionnaire on confidentiality and the use of social media in the healthcare setting. Descriptive of general data and chi-square test or Fisher's exact test were performed using the SPSS 25.0 software; Results: All the participants reported using the messaging application WhatsApp regularly during their working day. A total of 20.4% of the participants stated that they had taken photos of clinical data (radiographs, analyses, etc.) without permission, with 40.8% claiming that they were unaware of the legal consequences of improper access to clinical records. After the course, the participants reported intending to modify their behavior when sharing patient data without their consent and with respect to how patients are informed; Conclusions: The use of advanced simulation in the training of interprofessional teams of residents is as an effective tool for initiating attitudinal change and increasing knowledge related to patient privacy and confidentiality. Further follow-up studies are needed to see how these attitudes are incorporated into clinical practice.

The Relationship of Preseason Upper Extremity Function, Pain and Training on Normalized DIII Collegiate Swimming Performance.

Shoulder injuries comprise the largest proportion of swimming injuries and there is a large percentage of swimmers participating with pain. Therefore, it is assumed that shoulder pain decreases performance, but studies have not compared collegiate swimmers' performance with and without pain. 1) Determine if individual swimmer's shoulder pain and function are associated with a change in normalized swimming performance over a season.2) Determine if differences in normalized swimming performance exist among 3 collegiate teams. 3) Qualitatively describe and compare team's training regimes. Cross sectional study. Swimmers completed pre-(T1) and post-season (T2) surveys including pain ratings and shoulder function using the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire. Swimming times were obtained from published meet results. Coaches reported training programs through interviews and tracking logs. 52 NCAA Division III swimmers from 3 teams. Stepwise linear regression was used to determine if pain and function related to performance. Team demographics and normalized swimming performance (reduction in time per lap from season's beginning to end) were compared with ANOVAs with post-hoc tests. Initial KJOC scores, but not pain, related to individual swimming performance. Differences in team performance were found (p=0.006), with Team 3 having greatest reduction in time (1.01 sec/lap), lower percentage of females, a more experienced coach and a periodization schedule with large increases and decreases in yardage. There was a main effect (p=0.043) for baseline demographics with Team 3's swimmers being taller and having longer competitive experience. The initial KJOC score predicting swimming performance improvement demonstrates the need for athletic trainers to prioritize enhancement of pre-season function. Endurance training induced hypoalgesia and motivation may explain the lack of effect of shoulder pain on performance. Further research is needed to elucidate optimal periodization and dryland training.