Enhancing the Effectiveness of Work Groups and Teams

'Let's work together to pass medical school': a qualitative study of medical student attitudes to teamwork, competition and collaboration

Teamwork is vital to all types of work, and graduates of higher education programmes must be prepared to contribute to a wide variety of professional teams. This is especially true in healthcare, where graduates will work in multidisciplinary teams (MDTs) under considerable pressure. This study is a follow-up to a previous study, where we described how competition between students is a barrier to constructive teamwork. Since then, we have made considerable enhancements to our transferable skills curriculum, moved away from norm referencing, and there have been national changes to the way that graduate Foundation training places are allocated. Here we present findings from a qualitative study of students from all six stages of our medical degree programme (5 years plus predegree foundation year). We explored whether there had been changes in how students perceived the importance of teamwork, their own teamwork development and how they collaborated with their peers. Following analysis of in-depth, semi-structured interviews, five themes emerged: (a) competition between students; (b) importance of teamwork; (c) what makes effective teamwork; (d) preparing for work in MDTs; and (e) recommendations for teamwork education. Competition between students was perceived as both positive and negative, but there has been a shift since our last study towards collaboration, with students now more willing to help each other succeed. Students also show more insight into their teamwork development, and were able to discuss what aspects of the programme, and higher education more broadly, were most valuable in helping them develop.

Evolving Dynamics of Relational Coordination: A Study of Progression of Care Huddles in Hospital Observation Services

Health care organizations are increasingly using team huddles to enhance communication, improve patient experience, and deliver timely care. However, established practices, resource constraints, and hierarchical role dynamics can hinder the effectiveness of huddling. This study investigates the dynamics of care huddle implementation through interviews with care providers and managers of an observation unit in a U.S. hospital. Qualitative analysis of interview data reveals that huddle adoption enhances relational coordination (RC), thus highlighting the importance of both coaching interventions in fostering proactive behavior and the building of a work environment aligned toward shared goals. The findings affirm RC as a dynamic change model, examining its interplay with organizational processes and structure. The study underscores the significance of adaptations in work processes, the role of informal boundary spanners in facilitating cross-departmental coordination, and structural changes that increase autonomy for low-power actors. We offer actionable recommendations for health care organizations aiming to improve care coordination.

Advancing sustainable healthcare: a concept analysis of eco-conscious nursing practices

BACKGROUND

As the healthcare sector grapples with its environmental footprint, the concept of Eco-conscious Nursing emerges as a pivotal framework for integrating sustainability into nursing practice. This study aims to clarify and operationalize Eco-conscious Nursing, examining its attributes, antecedents, consequences, and providing operational definitions to guide future research and practice.

METHODS

Utilizing a systematic literature review across PubMed, Google Scholar, and CINAHL Ultimate, this study identifies and analyzes existing theories, frameworks, and practices related to eco-conscious nursing. Through conceptual analysis, key attributes, antecedents, and consequences of Eco-conscious Nursing are delineated, leading to the formulation of comprehensive operational definitions.

RESULTS

The study reveals Eco-conscious Nursing as a multifaceted concept characterized by environmental stewardship, sustainable healthcare practices, and a commitment to reducing the ecological impact of nursing care. Operational definitions highlight the role of education, awareness, and institutional support as antecedents, with improved environmental health and sustainable healthcare outcomes as key consequences.

CONCLUSION

Eco-conscious Nursing represents a crucial ethos for the nursing profession, emphasizing the necessity of sustainable practices within healthcare. The operational definitions provided serve as a foundation for embedding eco-conscious principles into nursing, addressing the urgent need for sustainability in healthcare settings. Future research should focus on the empirical application of these definitions and explore the economic and cross-cultural dimensions of eco-conscious nursing.

Team Factors in Ethical Decision Making: A Content Analysis of Interviews with Scientists and Engineers

The ethical decision making of researchers has historically been studied from an individualistic perspective. However, researchers rarely work alone, and they typically experience ethical dilemmas in a team context. In this mixed-methods study, 67 scientists and engineers working at a public R1 (very high research activity) university in the United States responded to a survey that asked whether they had experienced or observed an ethical dilemma while working in a research team. Among these, 30 respondents agreed to be interviewed about their experiences using a think-aloud protocol. A total of 40 unique ethical incidents were collected across these interviews. Qualitative data from interview transcripts were then systematically content-analyzed by multiple independent judges to quantify the overall ethicality of team decisions as well as several team characteristics, decision processes, and situational factors. The results demonstrated that team formalistic orientation, ethical championing, and the use of ethical decision strategies were all positively related to the overall ethicality of team decisions. Additionally, the relationship between ethical championing and overall team decision ethicality was moderated by psychological safety and moral intensity. Implications for future research and practice are discussed.

The effect of family physician team processes on chronic disease management performance from a structural network perspective

OBJECTIVE

The family physician team has become the core carrier for delivery primary health care in China. This study aimed to measure the effect of the network structural characteristics of family physician team processes on health performance. Strategic recommendations for optimizing the family physician team processes with a view to improving performance were presented.

METHODS

A cross-sectional survey was conducted from October to December 2021 in Qianjiang in Hubei Province and Changsha in Hunan Province. Task performance, contextual performance, social networks, and sociodemographic characteristics were collected. Social network analysis was conducted to calculate density and centralization, then hierarchical linear regression analysis was employed to explore the relationship between the network structural characteristics of family physician team processes and performance.

RESULTS

In total, 88 family physician teams attended in this investigation. The transition processes of family physician team showed a distinctive low density (0.272 ± 0.112), high centralization (0.866 ± 0.197) network structure. For family physician team, the density of action processes significantly and positively affected task performance (B = 0.600, P < 0.05); the centralization of action processes positively affected task performance (B = 0.604, P < 0.01); the density of action processes positively affected contextual performance (B = 0.545, P < 0.01); the density of interpersonal processes significantly and positively affected contextual performance (B = 0.326, P < 0.05).

CONCLUSION

The network density and centralization of family physician team processes have positive effects on chronic disease management performance. The results from this study help to enhance our conceptual understanding of social network and its implications for team-dynamics. Optimizing family physician team processes is an effective way to strengthen the construction of family physician team and promote the quality and efficiency of family physician-contracted service. It is recommended to strengthen the management of team processes, enhance the internal collaboration mechanism, and optimize the centralized network structure of family physician team.

Exploring the Potential of a Serious Game Framework in Developing Systems-Thinking Skills

Effective decision-making within veterinary practice demands a comprehensive understanding of interconnected animal, public, and environmental health systems. To foster systems thinking, participatory modeling and serious games are gaining prominence. Serious games combine play, instruction, and problem-based learning to facilitate skill acquisition. This study investigates the potential of a multiplayer serious game framework as a participatory method to cultivate systems thinking skills in a Master of Veterinary Medicine program. The research focuses on the Territory Game, designed to encourage engagement and creativity, assessing its role in fostering systems thinking among veterinary students. Integrated into a master's course, the game immerses students in complex decision-making scenarios, aiding their navigation of real-world intricacies. Qualitative analysis of discussions and responses provides insights. Results indicate that serious game-based learning within a participatory structure enhances participants' grasp of decision-making complexities. The game's simulated environment promotes a broader perspective and consideration of diverse factors in choices. Additionally, the game framework exhibits potential to enhance group participation, autonomy, time management, and inclusivity for reserved individuals. However, the study acknowledges that teaching methods like participatory modeling might not universally fit all contexts and could require instructor support. The framework's effectiveness is influenced by educational constraints, engagement levels, learning styles, and expertise. Nonetheless, the Territory Game framework shows promise in deepening understanding of complex veterinary decisions and fostering critical systems thinking skills essential for effective decision-making. Future research should explore its adaptability, scalability, and long-term impact across diverse educational settings.

Teamwork and implementation of innovations in healthcare and human service settings: a systematic review

BACKGROUND

Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations. However, team constructs and team-based implementation approaches have received little attention in the implementation science literature. This systematic review summarizes empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings.

METHODS

We searched MEDLINE, CINAHL, APA PsycINFO and ERIC for peer-reviewed empirical articles published from January 2000 to March 2022. Additional articles were identified by searches of reference lists and a cited reference search for included articles (completed in February 2023). We selected studies using quantitative, qualitative, or mixed methods to examine associations between team constructs and implementation outcomes in healthcare and human service settings. We used the Mixed Methods Appraisal Tool to assess methodological quality/risk of bias and conducted a narrative synthesis of included studies. GRADE and GRADE-CERQual were used to assess the strength of the body of evidence.

RESULTS

Searches identified 10,489 results. After review, 58 articles representing 55 studies were included. Relevant studies increased over time; 71% of articles were published after 2016. We were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. Qualitative findings with high confidence were: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier.

CONCLUSIONS

Teamwork matters for implementation. However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies. Greater specificity and rigor are needed to understand how teamwork influences implementation processes and outcomes. We provide recommendations for improving the conceptualization, description, assessment, analysis, and interpretation of research on teams implementing innovations.

TRIAL REGISTRATION

This systematic review was registered in PROSPERO, the international prospective register of systematic reviews.

REGISTRATION NUMBER

CRD42020220168.

Team functioning in Neurorehabilitation: a mixed methods study

The objective of this study was to enhance understanding of team functioning in a neurorehabilitation team by identifying the factors that impede and facilitate effective interprofessional team collaboration. We focused on team identification, psychological safety, and team learning, and conducted the research at a neurorehabilitation center treating young patients with severe acquired brain injury in the Netherlands. A mixed-methods approach was employed, integrating quantitative data from questionnaires (N = 40) with qualitative insights from a focus group (n = 6) and in-depth interviews (n = 5) to provide a comprehensive perspective on team dynamics. Findings revealed strong team identification among participants, denoting a shared sense of belonging and commitment. However, limited psychological safety was observed, which negatively affected constructive conflict and team learning. Qualitative analysis further identified deficiencies in shared mental models, especially in shared decision-making and integrated care. These results highlight the crucial role of psychological safety in team learning and the development of shared mental models in neurorehabilitation settings. Although specific to neurorehabilitation, the insights gained may be applicable to enhancing team collaboration in various healthcare environments. The study forms a basis for future research to investigate the impact of improvements in team functioning on patient outcomes in similar settings.

Advancing vascularized composite allotransplantation: essential factors for upper extremity transplant program development

Vascularized Composite Allotransplantation (VCA) offers a unique option to restore form and function after limb loss or facial trauma that cannot be satisfactorily accomplished through traditional prosthetics or reconstructions. Establishing a successful Upper Extremity Transplantation (UET) program requires strong leadership and a structured surgical team, and extensive interdisciplinary collaboration. We conducted a qualitative study among 12 health care professionals and patients. Informed consent was obtained per protocol, and semi-structured interviews were conducted online and recorded. Participants reported their perceptions of factors that either favored or hindered a successful outcome, including functional status before and after surgery, preparation for transplant, shared decision-making, rehabilitation, and psychosocial support. Thematic analysis revealed that it is essential to establish a team comprising various disciplines well before performing VCA procedures. Defining a common goal and choosing a defined leader is a key factor in procedural success and requires open collaboration beyond what is typical. Primary described categories are interdisciplinary collaboration and skills of the VCA team, building and leading a VCA team, pre-transplant procedures, post-transplant course, and factors to consider when establishing a program. The basic roles of team science play an outsized role in establishing a VCA program. Transplantation medicine involves various overlapping scientific and medical categories requiring health professionals to consciously work together to establish complex vertical and horizontal communication webs between teams to obtain positive outcomes. In addition to medical considerations, patient-specific factors such as transparent communication, therapy plan establishment, plan adherence, and continual follow-up are significant factors to overall success.

Group-based exercise for Parkinson's: a qualitative study of participants and partners' perceptions of an exercise class delivered through a community-university collaboration

BACKGROUND

Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an ancillary therapeutic benefit to pharmacological management. This study explores the perceptions of exercising participants (PwP) and non-participating partners involved in an exercise class delivered through a community-university partnership.

METHODS

Two separate focus group discussions were conducted: one with class participants (PwP: n = 7, H&Y scale I to III), and the other with non-participating partners of PwP (n = 4).

RESULTS

Thematic analysis of the data identified that a range of physical, psychological and social factors were perceived to influence engagement: (1) actively taking control, (2) exercise is medicine for the mind and body, and (3) a community working together to promote exercise for parkinson's. Participants and partners felt that the support from the group, including the instructors and student volunteers, empowered and supported PwP to proactively self-manage their health, enjoy exercise in an inclusive group setting, and develop strong social connections with others in the local Parkinson's community. Support to exercise from healthcare professionals was identified as both an enabler and barrier to participation.

CONCLUSIONS

This study underscores the significance of a community-university partnership as a complementary therapeutic approach for PwP. It also provides critical reflections on its sustainability, including implications for how exercise is considered as medicine for PwP. Additionally, it offers practical recommendations to galvanise community participation and provide inclusive and viable exercise opportunities for PwP.

NICU Graduates and Psychosocial Problems in Childhood: A Systematic Review

This systematic review analyzes the research evidence on the psychosocial risks faced by graduates of Neonatal Intensive Care Units (NICUs) during childhood. NICUs hold enormous value in uniting preterm or critically ill infants and their families; however, excess NICU exposure affects infants in numerous negative psychosocial ways. Developmental, behavioral, emotional, and social issues faced by NICU graduates are the focus of this systematic review, which aims to summarize the available evidence from published literature. It points to the incidence of such problems and how they emerged, and it insists on the importance of early detection, complex interference, and constant assistance to children and their families dealing with such issues. The review uses the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to assess methodological quality and includes data from various electronic databases. This review emphasizes the concurrent applications of family-centered care, early neurodevelopmental screens, and specialized intervention strategies and also, explains the different types of childhood psychosocial problems in NICU graduates.

Patient care in complex Sociotechnological ecosystems and learning health systems

The learning health system (LHS) model was proposed to provide real-time, bi-directional flow of learning using data captured in health information technology systems to deliver rapid learning in healthcare delivery. As highlighted by the landmark National Academy of Medicine report "Crossing the Quality Chasm," the U.S. healthcare delivery industry represents complex adaptive systems, and there is an urgent need to develop innovative methods to identify efficient team structures by harnessing real-world care delivery data found in the electronic health record (EHR). We offer a discussion surrounding the complexities of team communication and how solutions may be guided by theories such as the Multiteam System (MTS) framework and the Multitheoretical Multilevel Framework of Communication Networks. To advance healthcare delivery science and promote LHSs, our team has been building a new line of research using EHR data to study MTS in the complex real world of cancer care delivery. We are developing new network metrics to study MTSs and will be analyzing the impact of EHR communication network structures on patient outcomes. As this research leads to patient care delivery interventions/tools, healthcare leaders and healthcare professionals can effectively use health IT data to implement the most evidence-based collaboration approaches in order to achieve the optimal LHS and patient outcomes.

Human Capital Creation: A Collective Psychological, Social, Organizational and Religious Perspective

Psychological, social, cultural, emotional, and organizational perspectives consistently highlight human capital's importance in the literature. We argue that the collective view of different capitals with self-notion is essential for establishing impression, image, and self-esteem. According to the review findings, religious capital could predict context-specific psychological, cultural, social, emotional, and organizational capital. This acknowledgment can assist academics in better understanding how religion, social psychology, and other capitals co-create value in human capital development. This study includes several possible future paths and notes remarkable qualities that can enhance human capital value development research.

Simulation-based team training for healthcare professionals in pediatric departments: study protocol for a nonrandomized controlled trial

BACKGROUND

Healthcare systems worldwide face challenges related to patient safety, quality of care, and interprofessional collaboration. Simulation-based team training has emerged as a promising approach to address some of these challenges by providing healthcare professionals with a controlled and safe environment to enhance their teamwork and communication skills. The purpose of this study protocol is to describe an intervention using simulation-based team training in pediatric departments.

METHODS

Using a parallel-group, non-randomized controlled trial design, a simulation-based team training intervention will be implemented across four pediatric departments in Denmark. Another four pediatric departments will serve as controls. The intervention implies that healthcare professionals engage in simulation-based team training at a higher quantity and frequency than they did previously. Development of the intervention occurred from April 2022 to April 2023. Implementation of the intervention occurs from April 2023 to April 2024. Evaluation of the intervention is planned from April 2024 to April 2025. All simulation activity both before and during the intervention will be registered, making it possible to compare outcomes across time periods (before versus after) and across groups (intervention versus control). To evaluate the effects of the intervention, we will conduct four analyses. Analysis 1 investigates if simulation-based team training is related to sick leave among healthcare professionals. Analysis 2 explores if the simulation intervention has an impact on patient safety culture. Analysis 3 examines if simulation-based team training is associated with the treatment of critically ill newborns. Finally, Analysis 4 conducts a cost-benefit analysis, highlighting the potential return on investment.

DISCUSSION

The implemented simulation-based team training intervention can be defined as a complex intervention. Following the Medical Research Council framework and guidelines, the intervention in this project encompasses feasibility assessment, planning of intervention, implementation of intervention, and rigorous data analysis. Furthermore, the project emphasizes practical considerations such as stakeholder collaboration, facilitator training, and equipment management.

TRIAL REGISTRATION

Registered as a clinical trial on clinicaltrials.gov, with the identifier NCT06064045.

Using interbrain synchrony to study teamwork: A systematic review and meta-analysis

It has been proposed that interbrain synchrony (IBS) may help to elucidate the neural mechanisms underpinning teamwork. As hyperscanning studies have provided abundant findings on IBS in team environments, the current review aims to synthesize the findings of hyperscanning studies in a way that is relevant to the teamwork research. A systematic review was conducted. Included studies were classified according to the IPO (i.e. input, process, output) model of teamwork. Three multi-level meta-analyses were performed to quantify the associations between IBS and the three IPO variables. The methodology followed PRISMA guidelines and the protocol was pre-registered (https://osf.io/7h8sa/). Of the 229 studies, 41 were included, representing 1326 teams. The three meta-analyses found statistically significant positive effects, indicating a positive association between IBS and the three IPO teamwork variables. This study provides evidence that IBS is a relevant measure of the teamwork process and argues for the continued use of IBS to study teamwork.

Comparative Analysis of the Functions Work Groups and Informal Subgroups Carry out in Relation to their Members: The Essence, Conditions of Implementation, Effects, and Dysfunctions

In this article, we attempt to integrate and further develop conceptual ideas about functions of small groups and the informal subgroups that arise within them in relation to their respective members, namely, the functions of: (1) creating possibilities for realizing individual goals and meeting individual needs; (2) providing protection from external and intragroup social threats; (3) providing information to members; (4) educating members; (5) providing adaptive capacities to members; and (6) providing control and regulation. First, drawing on a functional analysis, we defined the concept of "function." Next, we touched upon such issues as: the essence of each function; conditions for implementing the functions; the difference between an informal subgroup and a small group in how they implement the functions for their respective members; the effects of implementing the functions; and the related dysfunctions. This versatile account of the functions that small groups and informal subgroups implement in relation to their members allowed us to expand our understanding of these functions and their effects on attitudes, activities and the development of group (subgroup) members, as well as of some aspects of group and subgroup processes and performance. We conclude by presenting both theoretical and practical applications of the analysis of the functions of groups and subgroups and, accordingly, posed some important questions for further research and discussion.

Organization of care of infants with congenital diaphragmatic hernia-Building a high-functioning CDH program

Infants born with congenital diaphragmatic hernia have high mortality and morbidity and require coordinated multidisciplinary care for optimal outcomes. Over the past several decades numerous articles have been published on the technical aspects of the care of these patients demonstrating both the variation in management across institutions as well as the desirability and need for standardization of care. Unfortunately, none have focused on the organization of care for CDH patients encompassing the range from early prenatal diagnosis to long-term postnatal care. However, to achieve optimal care and optimal outcomes, it is important to not only have excellent technical surgical and medical care but also to have an organized, systematic, and purposefully designed program for the delivery of healthcare to infants with this condition. In this article, based on our experience and drawing on general principles of building clinical programs, we describe the important elements of an ideal CDH program.

Organizational and Policy Challenges and Priorities for Integrating Family Care Partners Into the Healthcare Team

Family care partners are significantly involved in healthcare tasks in order to support adult relatives. Yet, unlike pediatric models of care where caregivers of children are formally integrated into healthcare teams, care partners of adults are rarely engaged in a formal, structured, or consistent manner. Their inclusion in the healthcare team is critical to their capacity to continue supporting their relative. A meaningful dialogue between policy and healthcare management is required to identify feasible and effective ways of engaging family care partners in healthcare teams.

Team Functioning and Performance in Child Advocacy Center Multidisciplinary Teams

The quality of teamwork in Child Advocacy Center (CAC) multidisciplinary teams is likely to affect the extent to which the CAC model improves outcomes for children and families. This study examines associations between team functioning and performance in a statewide sample of CAC teams. Multidisciplinary team members (N = 433) from 21 CACs completed measures of affective, behavioral, and cognitive team functioning. Team performance was assessed with three measures: team member ratings of overall performance, ratings of mental health screening/referral frequency, and caregiver satisfaction surveys. Linear mixed models and regression analyses tested associations between team functioning and performance. Affective team functioning (i.e., liking, trust, and respect; psychological safety) and cognitive team functioning (i.e., clear direction) were significantly associated with team members' ratings of overall performance. Behavioral team functioning (i.e., coordination) and cognitive team functioning were significantly associated with mental health screening/referral frequency. Team functioning was not associated with caregiver satisfaction with CAC services. Aspects of team functioning were associated with team members' perceptions of overall performance and mental health screening/referral frequency, but not caregiver satisfaction. Understanding associations between team functioning and performance in multidisciplinary teams can inform efforts to improve service quality in CACs and other team-based service settings.

The Power of Peer Leaders: Exploring the Link between Peer Leadership Behaviors and Sustainable Work Outcomes

Most leadership studies primarily focus on formal leaders, often overlooking the influence of leaders within the team. While prior research has shown that peer leaders can have a beneficial impact on various team outcomes, it is yet unclear which peer leadership behaviors precisely foster a supportive and sustainable work environment. Building upon the recent identification of 10 peer leadership roles and 37 underlying functions, the current study aims to investigate the relationships between these peer leadership roles and functions and key outcomes (i.e., job satisfaction, team cohesion, team effectiveness, and OCB). A total of 31 organizational teams, comprising 182 employees from diverse sectors, participated in a quantitative survey. Employing multilevel modeling analysis, the findings demonstrated that each leadership role and nearly every function predicted at least one outcome, highlighting their significance within organizational teams. Additionally, Necessary Condition Analysis revealed that specific roles and functions were necessary for generating one or more outcomes. Finally, we found that most of the significant relationships remained consistent across teams, regardless of their size, tenure, or level of team identification. These findings refine our understanding of shared leadership and how peer leaders can create a sustainable workplace by fostering employee well-being and productivity in organizational teams.

Individual characteristics on multicultural team performance: does the role played by leaders and team members matter?

The main purpose of this study was to analyze the impact of individual characteristics of cultural sensitivity, adaptability, cohesion, and cultural diversity on the multicultural team performance. Also, we analyzed the moderating effect of being a team member or a team leader on the relationships mentioned above. To test out hipotheses, data were collected from 415 members of multicultural teams specifically, from 304 team members and 111 leaders. The findings provided evidence to support a positive relationship between cultural sensitivity, adaptability, cohesion, and team performance. Cultural diversity did not show a significant impact on team performance. The study also showed that the leaders and members had different perceptions about the factors that influence team performance. For instance, team members consider that cohesion influences team performance, while leaders consider adaptability as the key factor to achieve performance. Main implications from findings are discussed.

Emotional labor among team members: do employees follow emotional display norms for teams, not for customers?

Emotional labor is typically conceptualized as a process in which individuals regulate their emotions in response to display rules. Most research on emotional labor has focused on the influence of display rules at individual-level perceptions but is rarely examined at the team level. We examine the influence of the shared display rules in teams as emotional display norms. This study considers emotional dissonance as the difference between the positive emotional display norm at the team level and positive emotion at the individual level. To examine the purpose of this study, data were collected from leader-follower pairs within teams and based on a three-wave design. Thus, this study conducted a multi-level polynomial regression analysis and used the response surface methodology to interpret the incongruence effect. The results show that the incongruence effect of emotional dissonance is positively related to surface acting. In addition, the moderating effect of regulatory focus significantly strengthens the positive relationship between emotional dissonance and emotion regulation strategies. The results also show that surface acting strategy is negatively related to selfless Organizational citizenship behaviors (OCB). These findings highlight that emotional display norms play an important role as the standard for emotional experience in teams, and especially with the moderating effect of self-regulatory focus, emotion regulation strategies affect the selfless OCB rating of observers.

Psychological constraint on unethical behavior in team-based competition

A growing body of research contributes to our knowledge about unethical behavior. However, very little is known about how group-based competition shape members' unethical behavior. Building on social learning theory, we conducted three studies to reveal how group-based competition may affect individual's unethical behavior for their team. Study 1 and 2 are laboratory experiments in which participants were randomly assigned into groups of three members and engaged in group-based competition (or engaged in individual-based competition in an individual context) with monetary incentives. Different from individual-based competition where mean number of unethical behaviors for the self in the losing condition was larger than that in the winning condition, in group-based competition mean number of unethical behaviors in favor of group between the winning and the losing condition was not significantly different. Both studies also showed that there are less unethical behaviors in the group-based competition than in the individual-based competition. Study 2 further revealed that collective efficacy negatively associated with mean number of unethical behaviors in group-based competition. Study 3 was a field study with employees from bank subsidiaries working as teams, and results from their self-reported data confirm the relationship between collective efficacy and unethical behaviors observed in Study 2. Together, these results suggest that collective efficacy has the effect of curbing unethical behavior in group-based competition, thus contributing to the understanding of group-based experience on unethical behaviors.

Developing public health competency statements and frameworks: a scoping review and thematic analysis of approaches

Competencies ensure public health students and professionals have the necessary knowledge, skills, values, and behaviours to do their jobs effectively. Public health is a dynamic and complex field requiring robust competency statements and frameworks that are regularly renewed. Many countries have public health competencies, but there has been no evidence synthesis on how these are developed. Our research aim was to synthesize the extent and nature of the literature on approaches and best practices for competencies statement and framework development in the context of public health, including identifying the relevant literature on approaches for developing competency statements and frameworks for public health students and professionals using a scoping review; and, synthesizing and describing approaches and best practices for developing public health competency statements and frameworks using a thematic analysis of the literature identified by the scoping review. We conducted a scoping review and thematic analysis of the academic and grey literature to synthesize and describe approaches and best practices for developing public health competency statements and frameworks. A systematic search of six databases uncovered 13 articles for inclusion. To scope the literature, articles were assessed for characteristics including study aim, design, methods, key results, gaps, and future research recommendations. Most included articles were peer-reviewed journal articles, used qualitative or mixed method design, and were focused on general, rather than specialist, public health practitioners. Thematic analysis resulted in the generation of six analytical themes that describe the multi-method approaches utilized in developing competency statements and frameworks including literature reviews, expert consultation, and consensus-building. There was variability in the transparency of competency framework development, with challenges balancing foundational and discipline-specific competencies. Governance, and intersectoral and interdisciplinary competency, are needed to address complex public health issues. Understanding approaches and best practices for competency statement and framework development will support future evidence-informed iterations of public health competencies.

Interprofessional care in a retirement and assisted living community: the complexity of teamwork

Teamwork is an aspiration in the delivery of interprofessional care to older adults, but how does it play out in residential settings that combine independent living, assisted living, and skilled nursing care? This study investigated teamwork as an organic part of a retirement and assisted living community immersed in mission-driven care. Drawing on 44 in-depth interviews, 62 meeting observations, and five years of immersion in the setting by the first author, we explored the complex dynamics of teamwork. Our overarching findings showed that co-location aided by physical design and a mission-driven investment in care may not be sufficient to effect teamwork in a complex care environment, and that the organizational context was potentially damaging to teamwork. Our study highlights opportunities to improve teamwork and interprofessional collaboration in organizational settings that combine the provision of health and social care. Increasing expectations for teamwork outcomes may prove essential as retirement and assisted living care settings offer supportive and therapeutic environments for older adults who move between different levels of care.

When team members retaliate: The effect of LMX differentiation on team CWB

Leader-member exchange (LMX) differentiation, or a leader's differentiated treatments among team members, is a prevalent phenomenon in any type of organization due to constraints of personal, social, and organizational resources. Despite numerous empirical examinations of such phenomenon, the impact of LMX differentiation on group outcomes is inconsistent and inconclusive. Based on team diversity framework, we approach LMX differentiation as disparity and draw on social comparison theory and social exchange theory to examine the positive effect of LMX differentiation on team counterproductive work behavior (CWB) through a supervisory justice climate. In addition, we investigate leader competence as an essential boundary condition that influences the impact of LMX differentiation on supervisory justice climate and subsequent team CWB. Using a sample of 94 teams in South Korea, we found that LMX differentiation negatively impacts supervisory justice climate, subsequently promoting team CWB. Furthermore, when team members perceive their leader as incompetent, the positive impact of LMX differentiation on team CWB is strengthened. Theoretical and practical implications and directions for future research are discussed.

Towards diagnostic excellence on academic ward teams: building a conceptual model of team dynamics in the diagnostic process

OBJECTIVES

Achieving diagnostic excellence on medical wards requires teamwork and effective team dynamics. However, the study of ward team dynamics in teaching hospitals is relatively underdeveloped. We aim to enhance understanding of how ward team members interact in the diagnostic process and of the underlying behavioral, psychological, and cognitive mechanisms driving team interactions.

METHODS

We used mixed-methods to develop and refine a conceptual model of how ward team dynamics in an academic medical center influence the diagnostic process. First, we systematically searched existing literature for conceptual models and empirical studies of team dynamics. Then, we conducted field observations with thematic analysis to refine our model.

RESULTS

We present a conceptual model of how medical ward team dynamics influence the diagnostic process, which serves as a roadmap for future research and interventions in this area. We identified three underexplored areas of team dynamics that are relevant to diagnostic excellence and that merit future investigation (1): ward team structures (e.g., team roles, responsibilities) (2); contextual factors (e.g., time constraints, location of team members, culture, diversity); and (3) emergent states (shared mental models, psychological safety, team trust, and team emotions).

CONCLUSIONS

Optimizing the diagnostic process to achieve diagnostic excellence is likely to depend on addressing all of the potential barriers and facilitators to ward team dynamics presented in our model.

Organizational system thinking as a cognitive framework to meet climate targets

System thinking is a crucial cognitive framework to enable individual pro-environmental behavioral changes. Indeed, a large body of literature has shown a significant and positive association between individuals' system thinking capacities and perceptions of the threat posed by climate change. However, individual behavioral changes play a limited role in addressing climate change compared to large organizations involved in a significantly larger share of economic activities. Do organizations exhibit system thinking capacities? Here, we conjecture that system thinking is a cognitive framework observable at an aggregated group level and, therefore, organizations, not just individuals, can exhibit characteristic levels of system thinking. We conceptualize a definition of organizational system thinking and develop an empirical method to estimate it using a large body of textual data from business organizations. Then, we show that system thinking organizations are more likely to lower emissions and align them with the pathways required to meet the climate targets set by the Paris Agreement. Finally, we discussed the theoretical and policy implication of our study. Overall, our results suggest that system thinking is a relevant organization-level cognitive framework that can help organizations align their emissions with global climate targets.

Leader airtime management and team effectiveness in emergency management command and control (EMCC) teams

We investigated the relation between leader airtime management and team effectiveness in Emergency Management Command and Control (EMCC) teams. Leader airtime management concerns leaders' interventions to structure who shares information when using opening and closing statements to respectively stimulate or reduce information sharing. We coded leaders' airtime management statements across different meeting phases (structuring, information sharing, decision making) using video-recordings of 12 EMCC exercises involving two consecutive meetings each. Experts rated two components of team effectiveness: Team Situation Awareness (TSA) and Team Decision Making (TDM). We found that closing statements were more frequently used in the decision-making phase than in any other meeting phase. Also, leaders of teams with lower TSA used more opening statements in the decision-making phase of the first team meeting than leaders of teams with higher TSA. These results confirm the importance of the timing of leader airtime management for EMCC team effectiveness. Practitioner summary: We investigated leader airtime management and team effectiveness in EMCC teams. We video-coded 12 exercises; experts rated team effectiveness. In the decision-making phase, leaders use more closing statements, and leaders of less effective teams use more opening statements. Leaders are advised to adjust their airtime management to meeting phases.

Improving teamwork in multidisciplinary cross-sector teams: Adaption and pilot testing of a team training for Child Advocacy Center teams

Background

Effective teamwork is critical to the mission of Child Advocacy Center (CAC) multidisciplinary teams. Team interventions designed to fit the unique cross-organizational context of CAC teams may improve teamwork in CACs.

Methods

A collaborative, community-engaged approach was used to adapt TeamSTEPPS, an evidence-based team training for healthcare, for CAC multidisciplinary teams. The adapted training was piloted with one team and evaluated using mixed methods. Team members completed pre-training (n = 26) and follow-up surveys (n = 22) and participated in qualitative interviews (n = 9).

Results

The adaptation process resulted in the creation of TeamTRACS (Team Training in Roles, Awareness, Communication, and Support). Participants rated TeamTRACS as highly acceptable, appropriate, feasible, relevant, and useful for CAC teams. They identified positive and negative aspects of the training, ideas for improvement, and future uses for TeamTRACS.

Conclusions

TeamTRACS is a feasible approach to team training in CACs, and team members find the content and skills relevant and useful. Additional research is needed to test the effectiveness of TeamTRACS and identify appropriate implementation strategies to support its use.

The Dynamics of Team Learning: Harmony and Rhythm in Teamwork Arrangements for Innovation

Innovation teams must navigate inherent tensions between different learning activities to produce high levels of performance. Yet, we know little about how teams combine these activities-notably reflexive, experimental, vicarious, and contextual learning-most effectively over time. In this article, we integrate research on teamwork episodes with insights from music theory to develop a new theoretical perspective on team dynamics, which explains how team activities can produce harmony, dissonance, or rhythm in teamwork arrangements that lead to either positive or negative effects on overall performance. We first tested our theory in a field study using longitudinal data from 102 innovation teams at a Fortune Global 500 company; then, we replicated and elaborated our theory in a study of 61 MBA project teams at an elite North American university. Results show that some learning activities can occur within the same teamwork episode to have harmonious positive effects on team performance, while other activities combine to have dissonant negative effects when occurring in the same episode. We argue that dissonant activities must be spread across teamwork episodes to help teams achieve a positive rhythm of team learning over time. Our findings contribute to theory on team dynamics, team learning, and ambidexterity.

Organizing for Mars: A Task Management Perspective on Work within Spaceflight Multiteam Systems

OBJECTIVE

The aim of this study was to examine how task, social, and situational factors shape work patterns, information networks, and performance in spaceflight multiteam systems (MTSs).

BACKGROUND

Human factors research has explored the task and individual characteristics that affect decisions regarding when and in what order people complete tasks. We extend this work to understand how the social and situational factors that arise when working in MTSs affect individual work patterns.

METHODS

We conducted a complex multi-site space analog simulation with NASA over the course of 3 years. The MTS task required participants from four teams (Geology, Robotics, Engineering, and Human Factors) to collaborate to design a well on Mars. We manipulated the one-way communication delay between the crew and mission support: no time lag, 60-second lag, and 180-second lag.

RESULTS

The study revealed that team and situational factors exert strong effects: members whose teams have less similar mental models, those whose teams prioritize their team goal over the MTS goal, and those working in social isolation and/or under communication delay engage longer on tasks. Time-on-task positively predicts MTS information networks, which in turn positively predict MTS performance when communication occurs with a delay, but not when it occurs in real-time.

CONCLUSION

Our findings contribute to research on task management in the context of working in teams and multiteam systems. Team and situational factors, along with task factors, shape task management behavior.

APPLICATION

Social and situational factors are important predictors of task management in team contexts such as spaceflight MTSs.

Human-AI teaming: leveraging transactive memory and speaking up for enhanced team effectiveness

In this prospective observational study, we investigate the role of transactive memory and speaking up in human-AI teams comprising 180 intensive care (ICU) physicians and nurses working with AI in a simulated clinical environment. Our findings indicate that interactions with AI agents differ significantly from human interactions, as accessing information from AI agents is positively linked to a team's ability to generate novel hypotheses and demonstrate speaking-up behavior, but only in higher-performing teams. Conversely, accessing information from human team members is negatively associated with these aspects, regardless of team performance. This study is a valuable contribution to the expanding field of research on human-AI teams and team science in general, as it emphasizes the necessity of incorporating AI agents as knowledge sources in a team's transactive memory system, as well as highlighting their role as catalysts for speaking up. Practical implications include suggestions for the design of future AI systems and human-AI team training in healthcare and beyond.

Team principles for successful interdisciplinary research teams

Interdisciplinary research teams can be extremely beneficial when addressing difficult clinical problems. The incorporation of conceptual and methodological strategies from a variety of research disciplines and health professions yields transformative results. In this setting, the long-term goal of team science is to improve patient care, with emphasis on population health outcomes. However, team principles necessary for effective research teams are rarely taught in health professional schools. To form successful interdisciplinary research teams in cardio-oncology and beyond, guiding principles and organizational recommendations are necessary. Cardiovascular disease results in annual direct costs of $220 billion (about $680 per person in the US) and is the leading cause of death for cancer survivors, including adult survivors of childhood cancers. Optimizing cardio-oncology research in interdisciplinary research teams has the potential to aid in the investigation of strategies for saving hundreds of thousands of lives each year in the United States and mitigating the annual cost of cardiovascular disease. Despite published reports on experiences developing research teams across organizations, specialties and settings, there is no single journal article that compiles principles for cardiology or cardio-oncology research teams. In this review, recurring threads linked to working as a team, as well as optimal methods, advantages, and problems that arise when managing teams are described in the context of career development and research. The worth and hurdles of a team approach, based on practical lessons learned from establishing our multidisciplinary research team and information gleaned from relevant specialties in the development of a successful team are presented.

A leadership model supporting maturation of high-performance translational teams

Despite understanding its impact on organizational effectiveness, practical guidance on how to train translational team (TT) leaders is lacking. Previously, we developed an evolutionary learning model of TT maturation consisting of three goal-directed phases: (1). team assembly (Formation); (2). conducting research (Knowledge Generation); and (3). dissemination and implementation (Translation). At each phase, the team acquires group-level knowledge, skills, and attitudes (KSAs) that enhance its performance. Noting that the majority of team-emergent KSAs are promoted by leadership behaviors, we examine the SciTS literature to identify the relevant behaviors for each phase. We propose that effective team leadership evolves from a hierarchical, transformational model early in team Formation to a shared, functional leadership model during Translation. We synthesized an integrated model of TT leadership, mapping a generic "functional leadership" taxonomy to relevant leadership behaviors linked to TT performance, creating an evidence-informed Leadership and Skills Enhancement for Research (LASER) training program. Empirical studies indicate that leadership behaviors are stable across time; to enhance leadership skills, ongoing reflection, evaluation, and practice are needed. We provide a comprehensive multi-level evaluation framework for tracking the growth of TT leadership skills. This work provides a framework for assessing and training relevant leadership behaviors for high-performance TTs.

Team behaviors as antecedents for team members' work engagement in interdisciplinary health care teams

Introduction

Due to the increasing complexity and diversity of work tasks in teams, teams need team members who are dedicated and energetic, both characteristics attributed to team members' work engagement. Especially in the domain of health care, high demands at work impact professionals' work engagement. Despite teams being the main work unit in this domain, team research on antecedents of work engagement has been neglected. The present study examines the role of team behaviors such as reflection activities in the relationships between demands at work and team members' work engagement. In doing so, the study aims to extend findings on team behaviors by considering cognitive and work-task related team behaviors as well as team behaviors that focus on emotional aspects.

Methods

Data of 298 team members of 52 interdisciplinary teams of health and social care organizations which provide care and assistance were collected in this cross-sectional survey study. Relationships between team demands at work, team learning behaviors, dealing with emotions in the team and team members' work engagement were estimated in a mediation model using structural equation modeling (SEM).

Results

The results indicate that team members' work engagement is positively related to team learning behaviors and dealing with emotions in the team. Cognitive team demands at work such as the complexity of work tasks, were found to relate positively to team members' work engagement, while emotional team demands such as the amount of emotional labor at work had a negative relationship. Team learning behaviors and dealing with emotions in the team were found to mediate the relationship between team demands at work and team members' work engagement.

Discussion

Our results provide insights into the actual behavior of teams in the domain of health care, both on cognitive and emotional aspects, and the capability of team learning behaviors and dealing with emotions in the team to mediate the relationship between team demands at work and team members' work engagement. The findings encourage future researchers and practitioners to address cognitive, emotional and motivational components in team research to provide a better understanding of team conditions, team behavior and team outcomes.

Team-focused implementation strategies to improve implementation of mental health screening and referral in rural Children's Advocacy Centers: study protocol for a pilot cluster randomized hybrid type 2 trial

BACKGROUND

Children's Advocacy Centers (CACs) use multidisciplinary teams to investigate and respond to maltreatment allegations. CACs play a critical role in connecting children with mental health needs to evidence-based mental health treatment, especially in low-resourced rural areas. Standardized mental health screening and referral protocols can improve CACs' capacity to identify children with mental health needs and encourage treatment engagement. In the team-based context of CACs, teamwork quality is likely to influence implementation processes and outcomes. Implementation strategies that target teams and apply the science of team effectiveness may enhance implementation outcomes in team-based settings.

METHODS

We will use Implementation Mapping to develop team-focused implementation strategies to support the implementation of the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), a standardized screening and referral protocol. Team-focused strategies will integrate activities from effective team development interventions. We will pilot team-focused implementation in a cluster-randomized hybrid type 2 effectiveness-implementation trial. Four rural CACs will implement the CPM-PTS after being randomized to either team-focused implementation (n = 2 CACs) or standard implementation (n = 2 CACs). We will assess the feasibility of team-focused implementation and explore between-group differences in hypothesized team-level mechanisms of change and implementation outcomes (implementation aim). We will use a within-group pre-post design to test the effectiveness of the CPM-PTS in increasing caregivers' understanding of their child's mental health needs and caregivers' intentions to initiate mental health services (effectiveness aim).

CONCLUSIONS

Targeting multidisciplinary teams is an innovative approach to improving implementation outcomes. This study will be one of the first to test team-focused implementation strategies that integrate effective team development interventions. Results will inform efforts to implement evidence-based practices in team-based service settings.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT05679154 . Registered on January 10, 2023.

Temporal development of high-performance translational teams

Successful translation involves the coupled application of knowledge-generating research with product development to advance a device, drug, diagnostic, or evidence-based intervention for clinical adoption to improve human health. Critical to the success of the CTSA consortium, translation can be more effectively accomplished by training approaches that focus on improving team-emergent knowledge skills and attitudes (KSAs) linked to performance. We earlier identified 15 specific evidence-informed, team-emergent competencies that facilitate translational team (TT) performance. Here, we examine the SciTS literature describing developmental, temporal dynamics, and adaptive learning stages of interdisciplinary teams and integrate these with real-world observations on TT maturation pathways. We propose that TTs undergo ordered developmental phases, each representing a learning cycle that we call Formation, Knowledge Generation, and Translation. We identify major activities of each phase linked to development goals. Transition to subsequent phases is associated with a team learning cycle, resulting in adaptations that enabling progression towards clinical translation. We present known antecedents of stage-dependent competencies and rubrics for their assessment. Application of this model will ease assessment, facilitate goal identification and align relevant training interventions to improve performance of TTs in the CTSA context.

Conceptual Framework for Integrating Family Caregivers Into the Health Care Team: A Scoping Review

More than 80% of family care partners of older adults are responsible for coordinating care between and among providers; yet, their inclusion in the health care delivery process lacks recognition, coordination, and standardization. Despite efforts to include care partners (e.g., through informal or formal proxy access to their care recipient's patient portal), policies and procedures around care partner inclusion are complex and inconsistently implemented. We conducted a scoping review of peer-reviewed articles published from 2015 to 2021 and reviewed a final sample of 45 U.S.-based studies. Few articles specifically examine the inclusion of care partners in health care teams; those that do, do not define or measure care partner inclusion in a standardized way. Efforts to consider care partners as "partners" rather than "visitors" require further consideration of how to build health care teams inclusive of care partners. Incentives for health care organizations and providers to practice inclusive team-building may be required.

A comparison of physiological intensity and psychological perceptions during three different group exercise formats

Introduction

Past research highlighted that group fitness is an ideal format to meet exercise prescription guidelines. To add, a group enhances exertion, enjoyment, and satisfaction. In the last five years, streaming (live classes on screen with other participants visible) and on demand (pre-recorded classes on screen without other participants visible) formats have grown in popularity. Our goal is to compare the physiological intensity and psychological perceptions of live group, live streaming, and non-live on demand classes. We hypothesize that live classes will have the greatest cardiovascular intensity, enjoyment, and satisfaction followed by streaming and finally on demand.

Methods

Fifty-four adults between 18–63 years, who regularly participate in group fitness classes, recorded their heart rate with a chest transmitter during a mixed-martial arts cardiovascular class on consecutive weeks in random order. We calculated the mean, identified the max, and extracted the top 300 values (5 min) for comparison between conditions.

Results

Following each class, the participants completed an online survey to evaluate their rate of perceived exertion, enjoyment, and satisfaction. Confirming our hypothesis, mean class heart rate and mean heart rate for the five minutes at the highest intensity were 9% greater during the live group format compared to both live streaming and non-live on demand (all values, p &lt; 0.01). However, there was no difference in any heart rate variables between the streaming and on demand formats. Also, rate of perceived exertion, enjoyment, and satisfaction were all significantly greater during the live session compared to the home collections (all values, p &lt; 0.05).

Discussion

Streaming and on demand group fitness formats are viable options for meeting exercise prescription guidelines. But physiological intensity and psychological perceptions were greater during the live class format.

Competencies supporting high-performance translational teams: A review of the SciTS evidence base

A translational team (TT) is a specific type of interdisciplinary team that seeks to improve human health. Because high-performing TTs are critical to accomplishing CTSA goals, a greater understanding of how to promote TT performance is needed. Previous work by a CTSA Workgroup formulated a taxonomy of 5 interrelated team-emergent competency "domains" for successful translation: 1). affect, 2). communication, 3). management, 4). collaborative problem-solving, and 5). leadership. These Knowledge Skills and Attitudes (KSAs) develop within teams from the team's interactions. However, understanding how practice in these domains enhance team performance was unaddressed. To fill this gap, we conducted a scoping literature review of empirical team studies from the broader Science of Team Science literature domains. We identified specific team-emergent KSAs that enhance TT performance, mapped these to the earlier "domain" taxonomy, and developed a rubric for their assessment. This work identifies important areas of intersection of practices in specific competencies across other competency domains. We find that inclusive environment, openness to transdisciplinary knowledge sharing, and situational leadership are a core triad of team-emergent competencies that reinforce each other and are highly linked to team performance. Finally, we identify strategies for enhancing these competencies. This work provides a grounded approach for training interventions in the CTSA context.

Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol

PURPOSE

Teams play a central role in the implementation of new practices in settings providing team-based care. However, the implementation science literature has paid little attention to potentially important team-level constructs. Aspects of teamwork, including team interdependence, team functioning, and team performance, may affect implementation processes and outcomes. This cross-sectional study tests associations between teamwork and implementation antecedents and outcomes in a statewide initiative to implement a standardized mental health screening/referral protocol in Child Advocacy Centers (CACs).

METHODS

Multidisciplinary team members (N = 433) from 21 CACs completed measures of team interdependence; affective, behavioral, and cognitive team functioning; and team performance. Team members also rated the acceptability, appropriateness, and feasibility of the screening/referral protocol and implementation climate. The implementation outcomes of days to adoption and reach were independently assessed with administrative data. Associations between team constructs and implementation antecedents and outcomes were tested with linear mixed models and regression analyses.

RESULTS

Team task interdependence was positively associated with implementation climate and reach, and outcome interdependence was negatively correlated with days to adoption. Task and outcome interdependence were not associated with acceptability, appropriateness, or feasibility of the screening/referral protocol. Affective team functioning (i.e., greater liking, trust, and respect) was associated with greater acceptability, appropriateness, and feasibility. Behavioral and cognitive team functioning were not associated with any implementation outcomes in multivariable models. Team performance was positively associated with acceptability, appropriateness, feasibility, and implementation climate; performance was not associated with days to adoption or reach.

CONCLUSIONS

We found associations of team interdependence, functioning, and performance with both individual- and center-level implementation outcomes. Implementation strategies targeting teamwork, especially task interdependence, affective functioning, and performance, may contribute to improving implementation outcomes in team-based service settings.

Qualitative examination of collaboration in team-based primary care during the COVID-19 pandemic

OBJECTIVE

The objective of this study was to describe Ontario primary care teams' experiences with collaboration during the COVID-19 pandemic. Descriptive qualitative methods using focus groups conducted virtually for data collection.

SETTING

Primary care teams located in Ontario, Canada.

PARTICIPANTS

Our study conducted 11 focus groups with 10 primary care teams, with a total of 48 participants reflecting a diverse range of interprofessional healthcare providers and administrators working in primary care.

RESULTS

Three themes were identified using thematic analysis: (1) prepandemic team functioning facilitated adaptation, (2) new processes of team interactions and collaboration, and (3) team as a foundation of support.

CONCLUSIONS

Results revealed the importance of collaboration for provider well-being, and the challenges of providing collaborative team-based primary care in the pandemic context. Caution against converting primary care collaboration to predominantly virtual modalities postpandemic is recommended. Further research on team functioning during the COVID-19 pandemic in other healthcare organisations will offer additional insight regarding how primary care teams can work collaboratively in a postpandemic environment.

Measuring the impact of simulation debriefing on the practices of interprofessional trauma teams using natural language processing

BACKGROUND

Natural language processing (NLP) may be a tool for automating trauma teamwork assessment in simulated scenarios.

METHODS

Using the Trauma Nontechnical Skills Assessment (T-NOTECHS), raters assessed video recordings of trauma teams in simulated pre-debrief (Sim1) and post-debrief (Sim2) trauma resuscitations. We developed codes through directed content analysis and created algorithms capturing teamwork-related discourse through NLP. Using a within subjects pre-post design (n = 150), we compared changes in teams' Sim1 versus Sim2 T-NOTECHS scores and automatically coded discourse to identify which NLP algorithms could identify skills assessed by the T-NOTECHS.

RESULTS

Automatically coded behaviors revealed significant post-debrief increases in teams' simulation discourse: Verbalizing Findings, Acknowledging Communication, Directed Communication, Directing Assessment and Role Assignment, and Leader as Hub for Information.

CONCLUSIONS

Our results suggest NLP can capture changes in trauma team discourse. These findings have implications for the expedition of team assessment and innovations in real-time feedback when paired with speech-to-text technology.

Exceeding the Ordinary: A Framework for Examining Teams Across the Extremeness Continuum and Its Impact on Future Research

Work teams increasingly face unprecedented challenges in volatile, uncertain, complex, and often ambiguous environments. In response, team researchers have begun to focus more on teams whose work revolves around mitigating risks in these dynamic environments. Some highly insightful contributions to team research and organizational studies have originated from investigating teams that face unconventional or extreme events. Despite this increased attention to extreme teams, however, a comprehensive theoretical framework is missing. We introduce such a framework that envisions team extremeness as a continuous, multidimensional variable consisting of environmental extremeness (i.e., external team context) and task extremeness (i.e., internal team context). The proposed framework allows every team to be placed on the team extremeness continuum, bridging the gap between literature on extreme and more traditional teams. Furthermore, we present six propositions addressing how team extremeness may interact with team processes, emergent states, and outcomes using core variables for team effectiveness and the well-established input–mediator–output–input model to structure our theorizing. Finally, we outline some potential directions for future research by elaborating on temporal considerations (i.e., patterns and trajectories), measurement approaches, and consideration of multilevel relationships involving team extremeness. We hope that our theoretical framework and theorizing can create a path forward, stimulating future research within the organizational team literature to further examine the impact of team extremeness on team dynamics and effectiveness.

Bringing Together a Transdisciplinary Team to Create and Advance a Shared Vision for Research and Support for Siblings of Youth With Cancer

Background: Siblings of youth with cancer are at risk for psychosocial difficulties and report unmet needs. Supporting siblings is a psychosocial standard of care; however, many barriers prevent this standard from being fully achieved. Transdisciplinary team science has potential to generate novel, real-world solutions to complex research problems and can be beneficial to addressing sibling needs within pediatric hematology/oncology nursing. This process paper aims to present a guiding framework for transdisciplinary team science using the experiences of the Sibling Partnership for Advocacy, Research, and Care in Childhood Cancer (SPARCCC) as an exemplar. Methods: SPARCCC employed an established model of transdisciplinary team-based research, which consisted of four phases: development, consultation, implementation, and translation. This transdisciplinary team was comprised of international experts from a variety of disciplines, as well as siblings and families impacted by cancer. Results: SPARCCC held two summits, and team members developed ongoing collaborative efforts to advance advocacy, research, and support for siblings of youth with cancer. The team implemented the four phases of the transdisciplinary team-based framework and used an iterative process to build a shared perspective of the needs of siblings and take action. For instance, we completed a grant application, several manuscripts, and conference presentations to disseminate our findings and begin to advance a focused research agenda for sibling supportive care. Discussion: Transdisciplinary team science holds promise for tackling complex issues within pediatric hematology/oncology nursing research, particularly areas that are not well aligned with more traditional models and can be used to generate novel solutions.