Development and validation of an instrument for measuring the quality of teamwork in teaching teams in postgraduate medical training (TeamQ)

Scoping Review to Inform the Future Development of a Measure for Team-Based Care in Oncology

PURPOSE

Team-based care is the delivery of health services to an individual by at least two health care providers working collaboratively to achieve optimal care. Participants on the National Cancer Institute and the ASCO Teams in the Cancer Care Delivery Project have defined 13 key principles to serve as the foundation for a successful team; however, it is unclear whether there exist measures of these key principles.

METHODS

A scoping literature search was conducted for each key principle on PubMed and Embase to identify existing measures for key principles. Articles of interest were exported to a citation manager, Sciwheel, cataloged by the key principle. Existing measures were extracted via a two-stage screening process, with an abstract review followed by a full-text review.

RESULTS

Fifteen unique measures were identified, with items extrapolated for 12 of the 13 key principles. Measures were not exclusive and could represent more than one key principle. The number of measures varied per principle from zero to five, with Team Composition and Diversity yielding no existing measure.

CONCLUSION

The long-term goal is to compile and edit these measures, to create a comprehensive measure to be used in various team-based oncology care settings, and to address areas for improvement, ultimately optimizing patient care.

A Practical Review for Implementing Peer Assessments Within Teams

Objective. The objective of this review is to maximize the benefit of peer assessments in teamwork settings in professional pharmacy curricula.Findings. Best practices do not exist for using peer assessments in academic settings. The studies on peer assessments that we reviewed applied various conditions: Some studies used peer assessments of teams for formative assessments, while others used them for summative assessments; some assessed teamwork at a limited number of time points, while some assessed multiple time points; some attached student names to the assessments, while some were anonymous; and some explained why the tool was being used, while others offered no explanation.Conclusion. To use peer assessments most beneficially, instructors must define the purpose for their use, explain the purpose of teamwork, orient students to the tool being used, assess teamwork over time, provide feedback, minimize grades associated with the assessment, and use partial anonymity when collecting feedback.

The Surgical Hazardous Attitudes Reflection Profile (SHARP) Instrument - A Prototype Study

OBJECTIVE

There is growing recognition that surgeons' non-technical skills are crucial in guaranteeing optimal quality and safety of patient care. However, insight in relevant attitudes underlying these behavioral skills is lacking. Hazardous attitudes potentially cause risky behavior, which can result in medical errors and adverse events. A questionnaire offering surgeons insight in their attitudinal profile is still missing and would be instrumental in risk reduction. Therefore, the aim of this study is to develop a prototype of a reliable and valid instrument to measure hazardous attitudes among surgeons.

DESIGN

To measure hazardous attitudes, a prototype of the Surgical Hazardous Attitudes Reflection Profile (SHARP) tool was designed using a mixed methods approach, consisting of (1) 2 focus group discussions, (2) a modified Delphi analysis, and (3) a survey followed by (4) statistical analysis of the psychometric properties. Statistical analysis included exploratory factor analysis with varimax rotation, calculation of internal consistency reliability coefficients, and interscale correlations.

SETTING

Fourteen hospitals across the Netherlands were recruited to guarantee demographic variety and the inclusion of academic, tertiary, and general hospitals.

PARTICIPANTS

Nineteen experts participated in the 2 focus groups, and 19 in the modified Delphi study. In total, 302 surgeons (54.1%) completed the SHARP.

RESULTS

In total, 302 surgeons (54.1%) completed the SHARP. Exploratory factor analysis resulted in 6 subscales measuring attitude towards (1) authority (α = 0.78), (2) self-performance (α = 0.69), (3) performance feedback (α = 0.61), (4) own fitness to perform (α = 0.54), (5) uncertainty (α = 0.51), and (6) planned procedures (α = 0.48).

CONCLUSIONS

This study resulted in a prototype instrument identifying 6 potential hazardous attitudes in surgeons. Attitudes towards "authority" and "self-performance" can now be validly and reliably measured. Further research is required to optimize the prototype version of the instrument and could usefully explore the plausible relations between hazardous attitudes and clinical outcomes.

Team up! Linking teamwork effectiveness of clinical teaching teams to residents' experienced learning climate

Background: Supportive learning climates are key to ensure high-quality residency training. Clinical teachers, collaborating as teaching team, have an important role in maintaining such climates since they are responsible for residency training. Successful residency training is dependent on effective teamwork within teaching teams. Still, it remains unclear whether this team effort benefits residents' perceptions of the learning climate. We, therefore, investigated to what extent teamwork effectiveness within teaching teams is associated with (1) the overall learning climate, and (2) its affective, cognitive and instrumental facets?Methods: This study used a web-based platform to collect data in clinical departments in the Netherlands from January 2014 to May 2017. Teamwork effectiveness was measured with the TeamQ questionnaire, administered amongst clinical teachers. The learning climate was measured with the D-RECT, applied amongst residents. Associations were analyzed using multilevel models and multivariate general linear models.Results: Teamwork effectiveness was positively associated with the overall learning climate as well as with the affective and the instrumental facets of the learning climate. No significant associations were found with the cognitive facet.Conclusion: Effective teamwork within teaching teams benefits learning climates in postgraduate medical education. Therefore, departments aiming to improve their learning climate should target teamwork within teaching teams.

Comprehensive assessment of health education and health promotion in five non-communicable disease demonstration districts in China: a cross-sectional study

OBJECTIVES

This study aims to develop assessment indicators of health education and promotion for non-communicable disease (NCD) demonstration districts in China and to identify significant factors associated with NCD health education and promotion work.

METHODS

Three complementary techniques were used to conduct this study in Hunan Province, China, between late 2013 and 2015. The Delphi technique was used to develop weighted assessment indicators, followed by the rank sum ratio (RSR) to normalise the weights through rank conversion. Lastly, the technique for order of preference by similarity to ideal solution was conducted to assess five randomly selected NCD demonstration districts representing five different orientations in the province.

RESULTS

A total of 24 assessment indicators were constructed covering the following sections: organisational management, fund support, personnel supplies, health education and promotion, people's awareness of NCDs, management and control of patients with NCD, satisfaction with health education and promotion and health literacy of residents. Five districts were selected as samples for evaluation (Furong District, Ziyang District, Shaodong County, Shuangfeng County and Luxi County). Performance varied among the sites, with Furong District greatly surpassing the other sites, especially in fund support, media promotion, technical support for publicity materials, community promotion and supportive environment supplies. The latter four factors were also much greater in the second-ranked Luxi County site than those in the other sites (except Furong District).

CONCLUSIONS

There were gaps in health education and promotion work in NCD demonstration districts in Hunan Province. The districts that performed better had obvious advantages in fund support, media promotion, technical support, community promotion and supportive environment supplies. Our study provided both a methodological reference and an assessment indicator framework for similar future studies.

Teamwork of clinical teachers in postgraduate medical training

Teamwork among clinical teachers is essential for continuous improvement of postgraduate medical training. This thesis deconstructs teamwork in four studies, mostly based on qualitative research approaches and one study utilizes mixed methods. We found that clinical teachers do train residents, but individually rather than as a team. The programme directors as leaders focus more on teaching activities than on the collective ambition and mutual engagement of clinical teachers. During the teaching meetings, mistakes and conflicts are mainly discussed in a general sense and are often neither directed at the individual, nor result-oriented. A valid evaluation instrument is constructed to improve teamwork.