Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

Competencies related to generalism for Japanese medical undergraduates: Essential skills for comprehensive care

OBJECTIVE

To identify generalism-related competencies that medical students in Japan should acquire in order to provide comprehensive care for patients.

METHODS

The team responsible for developing the new 'Generalism' section of the 2022 revision of the Model Core Curriculum for Medical Education in Japan (MCC) consisted of nine members from diverse medical backgrounds across Japan. We adopted pragmatism paradigm and analyzed to identify decision-making processes using a qualitative document analysis.

RESULTS

The competency list was presented as a four-tier structure. The first tier of generalism was defined as 'take a multi-systemic view of the patient's problems and consider the patient's psychosocial background in order to provide comprehensive, flexible medical care that responds to the needs of the patient and is not limited to one's own specialty, supporting the achievement of individual and societal well-being.' The second tier was framed in terms of 'perspectives' and constructed of four different domains: 'holistic,' 'community,' 'life,' and 'social.'

CONCLUSION

We identified and defined the competencies required by medical students in Japan to provide comprehensive care for patients. By including these competencies in the MCC, undergraduate medical education will be better placed to respond to anticipated changes in the demand for medical care in Japan. Success factors in our guideline development process include facilitating a collaborative and iterative development process, ensuring that diverse perspectives are integrated, and using practical examples and feedback to refine competencies based on a pragmatic approach.

Development and validation of a questionnaire, the REST-Q Fire, to identify teamwork-related resources and stressors in firefighting operations

In the complex work environments of firefighting teams, it is often human error or difficulties in teamwork that lead to dangerous situations. To prevent these, it is essential to know the teamwork-related stressors and resources in firefighting operations. A measurement tool is needed to evaluate these stressors and resources. A successive instrument development process was conducted to identify the relevant teamwork-related stressors and resources in firefighting operations. First, interviews with experienced firefighters, and second, a document analysis were conducted and evaluated to provide an overview of the teamwork-related stressors and resources. Thereupon, a questionnaire, the REST-Q Fire, was developed asking about the experienced frequency and intensity of the identified teamwork-related stressors and resources in firefighting operations. Afterwards, an online study with firefighters was conducted (N = 491). CFAs confirmed the assumed structure of the REST-Q Fire and a positive correlation of the intensity of stressors with stress was shown (r = .19 - .27). Further, the resources were overall more frequently and intensively perceived than the stressors. The most important stressors were 'behavior of leaders' (M (SD)frequency = 2.80 (0.83), M (SD)intensity = 3.59 (1.12)), and 'behavior of team members' (M (SD)frequency = 2.77 (0.75), M (SD)intensity = 3.59 (1.05)). The most important resources, on the other hand, were 'knowledge about skills and behavior of team members' (M (SD)frequency = 3.96 (0.63), M (SD)intensity = 4.24 (0.78)), 'watch out for/ check on each other' (M (SD)frequency = 3.96 (0.70), M (SD)intensity = 4.20 (0.80)), and 'reliability of team members' (M (SD)frequency = 3.96 (0.51), M (SD)intensity = 4.16 (0.73)). As a result, training needs for trainees in the fire service and experienced firefighters were derived.

Joint problem-solving orientation, mutual value recognition, and performance in fluid teamwork environments

Introduction

Joint problem-solving orientation (JPS) has been identified as a factor that promotes performance in fluid teamwork, but research on this factor remains nascent. This study pushes the frontier of understanding about JPS in fluid teamwork environments by applying the concept to within-organization work and exploring its relationships with performance, mutual value recognition (MVR), and expertise variety (EV).

Methods

This is a longitudinal, survey-based field study within a large United States healthcare organization n = 26,319 (2019 response rate = 87%, 2021 response rate = 80%). The analytic sample represents 1,608 departmental units in both years (e.g., intensive care units and emergency departments). We focus on departmental units in distinct locations as the units within which fluid teamwork occurs in the hospital system setting. Within these units, we measure JPS in 2019 and MVR in 2021, and we capture EV by unit using a count of the number of disciplines present. For a performance measure, we draw on the industry-used measurement of perceived care quality and safety. We conduct moderated mediation analysis testing (1) the main effect of JPS on performance, (2) mediation through MVR, and (3) EV as a moderator.

Results

Our results affirm a moderated mediation model wherein JPS enhances performance, both directly and through MVR; EV serves as a moderator in the JPS-MVR relationship. JPS positively influences MVR, irrespective of whether EV is high or low. When JPS is lower, greater EV is associated with lower MVR, whereas amid high JPS, greater EV is associated with higher MVR, as compared to lower EV.

Discussion

Our findings lend further evidence to the value of JPS in fluid teamwork environments for enabling performance, and we document for the first time its relevance for within-organization work. Our results suggest that one vital pathway for JPS to improve performance is through enhancing recognition of the value that others offer, especially in environments where expertise variety is high.

Human-AI teams-Challenges for a team-centered AI at work

As part of the Special Issue topic "Human-Centered AI at Work: Common Ground in Theories and Methods," we present a perspective article that looks at human-AI teamwork from a team-centered AI perspective, i. e., we highlight important design aspects that the technology needs to fulfill in order to be accepted by humans and to be fully utilized in the role of a team member in teamwork. Drawing from the model of an idealized teamwork process, we discuss the teamwork requirements for successful human-AI teaming in interdependent and complex work domains, including e.g., responsiveness, situation awareness, and flexible decision-making. We emphasize the need for team-centered AI that aligns goals, communication, and decision making with humans, and outline the requirements for such team-centered AI from a technical perspective, such as cognitive competence, reinforcement learning, and semantic communication. In doing so, we highlight the challenges and open questions associated with its implementation that need to be solved in order to enable effective human-AI teaming.

Leader Trait Self-control and Follower Trust in High-Reliability Contexts: The Mediating Role of Met Expectations in Firefighting

Drawing from the theory of met expectations, this study aims to create new knowledge on the antecedents of follower trust in leaders in the context of high-reliability organizations. We hypothesize that highly self-controlled leaders instill more trust than leaders with less self-control, as the former tend to meet follower expectations. This work combines data from a field survey ( N = 256) and a multi-wave field study ( N = 106), using samples of professional firefighters to support our hypotheses that met follower expectations mediate the relationship between leader trait self-control and follower trust in the leader. Our research highlights the importance of met expectations in high-reliability contexts and demonstrates the value of leader trait self-control in building trustful relationships.

Factors Influencing Attenuating Skill Decay in High-Risk Industries: A Scoping Review

The infrequent use of skills relevant in non-routine situations in highly automated and high-risk industries is a major safety issue. The infrequent use of skills can lead to skill decay. Research on skill decay has a long history, but not much is known about the relevant factors and refresher interventions to attenuate skill decay in highly automated environments. In the present study, a scoping review was conducted to determine whether the well-known factors in skill decay research are also relevant for complex cognitive skill decay and to identify refresher interventions that are deemed effective for attenuating decay. A scoping review aims at identifying, summarizing, and mapping the body of literature on a given topic. Searches in electronic databases, including PsycArticles, PsyINFO, and Psyndex, via EBSCOhost and Web of Science and Google Scholar were conducted, and documents were analyzed regarding the research question, which resulted in n = 58 studies. The findings demonstrate the relevance of task characteristics and method-related (cognitive-based, behavioral-based training) and person-related factors (e.g., cognitive ability, experience, motivation) to mitigate decay. Additionally, the results demonstrate that minor refresher interventions are effective at attenuating complex cognitive skill decay. Implications for industry and training providers that aim to implement training and refresher interventions to attenuate skill decay in high-risk industries are provided. Researchers may use the information about the influences of person- and method-related factors, task characteristics, and refresher interventions presented in this scoping review as a starting point to conduct further empirical research by taking skill acquisition, retention, and transfer into account.

A novel agent-based, evolutionary model for expressing the dynamics of creative open-problem solving in small groups

Understanding the process of producing creative responses to open-ended problems solved in small groups is important for many modern domains, like health care, manufacturing, education, banking, and investment. Some of the main theoretical challenges include characterizing and measuring the dynamics of responses, relating social and individual aspects in group problem solving, incorporating soft skills (e.g., experience, social aspects, and emotions) to the theory of decision making in groups, and understanding the evolution of processes guided by soft utilities (hard-to-quantify utilities), e.g., social interactions and emotional rewards. This paper presents a novel theoretical model (TM) that describes the process of solving open-ended problems in small groups. It mathematically presents the connection between group member characteristics, interactions in a group, group knowledge evolution, and overall novelty of the responses created by a group as a whole. Each member is modeled as an agent with local knowledge, a way of interpreting the knowledge, resources, social skills, and emotional levels associated to problem goals and concepts. Five solving strategies can be employed by an agent to generate new knowledge. Group responses form a solution space, in which responses are grouped into categories based on their similarity and organized in abstraction levels. The solution space includes concrete features and samples, as well as the causal sequences that logically connect concepts with each other. The model was used to explain how member characteristics, e.g., the degree to which their knowledge is similar, relate to the solution novelty of the group. Model validation compared model simulations against results obtained through behavioral experiments with teams of human subjects, and suggests that TMs are a useful tool in improving the effectiveness of small teams.

Something Old or Something New?

Abstract. In 2020, the COVID-19 pandemic forced organizations to adjust co-located teams to virtual teams instantly. The applicability of known success factors for virtual teamwork to this situation is uncertain. Therefore, this study addresses the following research question: what factors relate to successful team adjustment to the new virtual work context? We hypothesize that perceived team success is influenced by individual and team factors and that these effects of team-related factors on perceived team success are moderated by team processes and team-/task-technology fit. A time-lagged online study was conducted at two timepoints during the initial lockdown in Germany with N = 110 employees working in teams. We found trust, task-technology fit, and communication to be significantly associated with perceived team performance. The results suggest that the instant adjustment might have led to a new phase related to team cycle episodes. We propose guidelines to prepare teams for future instant adjustments.

Characterizing Team Orientations and Academic Performance in Cooperative Project-Based Learning Environments

Information technology professionals are required to possess both technical and professional skills while functioning in teams. Higher education institutions are promoting teamwork by engaging students in cooperative and project-based learning environments. We characterized teams based on their collective orientations and evaluated their team performance in a cooperative project-based learning environment situated in a sophomore-level systems analysis and design course. We explored the orientation patterns in terms of goals, roles, processes, and interpersonal relations (GRPI). Specifically, we analyzed team retrospectives of 23 teams using a mixed-method approach. Findings characterized teams into balanced and unbalanced orientations. Teams with balanced orientations demonstrated a higher level of team performance in terms of academic achievement than the unbalanced category.

Kaizen event process quality: towards a phase-based understanding of high-quality group problem-solving

Purpose

As a problem-solving tool, the kaizen event (KE) is underutilised in practice. Assuming this is due to a lack of group process quality during those events, the authors aimed to grasp what is needed during high-quality KE meetings. Guided by the phased approach for structured problem-solving, the authors built and explored a measure for enriching future KE research.

Design/methodology/approach

Six phases were used to code all verbal contributions (N = 5,442) in 21 diverse, videotaped KE meetings. Resembling state space grids, the authors visualised the course of each meeting with line graphs which were shown to ten individual kaizen experts as well as to the filmed kaizen groups.

Findings

From their reactions to the graphs the authors extracted high-quality KE process characteristics. At the end of each phase, that should be enacted sequentially, explicit group consensus appeared to be crucial. Some of the groups spent too little time on a group-shared understanding of the problem and its root causes. Surprisingly, the mixed-methods data suggested that small and infrequent deviations (“jumps”) to another phase might be necessary for a high-quality process. According to the newly developed quantitative process measure, when groups often jump from one phase to a distant, previous or next phase, this relates to low KE process quality.

Originality/value

A refined conceptual model and research agenda are offered for generating better solutions during KEs, and the authors urge examinations of the effects of well-crafted KE training.

Change of collective orientation through an interprofessional training with medical students and student nurses depending on presence and professional group

BACKGROUND

Teamwork is an important success factors for patient treatment. The willingness of a healthcare provider to work in a team can be descripted with the construct of "Collective Orientation" (CO). The level of CO can be trained and is related to team performance. In this study, we investigated the effect of a simulator-based interprofessional training on the subject of patient fall in a hospital setting upon participations CO. To evaluate whether the course could be integrated into a longitudinal education concept, the participants were medical students and student nurses. Since effects of simulations can be influenced by the perceived reality, the results were measured as a function of Presence.

METHOD

In this observation study, 62 medical students and student nurses took part in six one-day interprofessional simulation trainings with the topic patient fall. The primary outcome was the mean difference between the CO measured immediately before (T1) and after the training (T2). The Presence of the participants was measured by questionnaire immediately after the course (T2).

RESULTS

Cronbach´s alpha for all scales and measurement points was higher than 0.69. CO increases over all professional groups from M = 3.42 (SD = 0.39) to M = 3.68 (SD = 0.54) significantly (p < .00; r = .5). Only the subscale "Dominance" in the professional group of the student nurses did not increase significantly. There was no correlation between Presence and the change in CO.

CONCLUSION

The questionnaires of CO and Presence can be applied to medical students and student nurses. The simulation course with the topic patient fall influences the CO and can be integrated in a longitudinal curriculum of teamwork training. The subscale "Dominance" of student nurses did not change. Preparatory learning units may increase the effects. The perceived reality of the scenario is not a main success factor.

Understanding how team process-sequences emerge over time and their relationship to team performance

Purpose

The purpose of this study was to explore the team process-sequences executed within and across performance episodes and their relation to team performance. In doing so, this effort responds to the call for examining the temporal and dynamic aspects of teams.

Design/methodology/approach

Data (i.e. observations and audio recordings) was collected from the stand-up meetings of three high-performing Scrum teams across six points in time during two consecutive performance episodes (i.e. beginning, midpoint, end). After content coding the data, lag sequential analyses was used to examine patterns of executed team processes to determine whether particular process-sequences occurred significantly different from others.

Findings

Teams shifted between transition and action phase processes during performance episodes. During and across performance episodes, process-sequences primarily consisted of transition processes. When teams executed process-sequences consisting solely of action phase processes, their focus was on monitoring processes.

Research limitations/implications

This study hopes that the findings here will serve to spur researchers to more fully investigate the relationship between process-sequences and team performance across various team types. However, limitations (e.g. small sample size, unknown point of teams’ life cycle and focus on explicit team processes) should be taken into account when building on the present findings.

Originality/value

This study contributes to a better understanding of the temporal and dynamic nature of team processes by analyzing how the team process and process-sequences occur across time. In addition, this study moves beyond most studies that assess team processes as static retrospective perceptions and consider their natural ordering.

"Let's Get Out of Here!": Cognitive Motivation and Maximizing Help Teams Solving an Escape Room

Contemporary teams often face complex problem-solving tasks. We theorized that two individual differences previously neglected in team research (cognitive motivation and maximizing) would be helpful for teams facing such situations. We tested this assertion on 81 teams participating in an escape-room simulation in which teams were locked into a pre-arranged room and had to solve various complex problems to escape the room as quickly as possible. The findings show that the average of the team members' cognitive motivation had a positive direct relation to team performance, while maximizing had a positive indirect relation to team performance via cooperation.

Impact of Simulator-Based Crisis Resource Management Training on Collective Orientation in Anaesthesia: Pre-Post Survey Study With Interprofessional Anaesthesia Teams

THEORY

Individuals have different qualities, levels of willingness, and degrees of engagement for working in teams. This behaviour is termed 'Collective Orientation' (CO). Collective orientation can be trained and has a positive influence on team processes. Here, we investigated the effect of a simulator-based, Crisis Resource Management team training upon the participants' CO.

HYPOTHESES

We hypothesized (1) the scales of CO and Presence for lab-based microworld research (PLBMR) are applicable to the German anaesthesia teams, (2) the CO can be influenced by means of simulation training, (3) the training effect is dependent on sex and/or profession, and (4) the change of CO depends on the perceived presence of the participants in the scenario.

METHOD

In a pre-post study, 66 nurses and doctors from various anaesthetic departments took part in a 1-day training course to improve non-technical skills. The primary outcome was the mean difference between the CO measured (via questionnaires) immediately before (T1) and after (T2) training. The change was then tested for dependence upon other variables, such as sex, professional group, and immersion into the simulation scenarios.

RESULTS

Collective orientation improved significantly after training (mean difference: 0.2; P < .001; dz = 0.53). Considering the subscales, affiliation increased significantly (P < .001; dz = 0.59), whereas dominance remained unchanged. Furthermore, no correlation was found regarding sex, professional group, or immersion into the simulation scenarios.

CONCLUSIONS

Our study demonstrated that simulation-based training improves the participants' COs, primarily by increasing affiliation. Subjective scenario reality did not significantly influence this. Nonetheless, it remains unclear as to what factors categorically resulted in this benefit. The shared experience in the course by all team members might trigger the effects. However, further studies are needed to identify the modifiable factors that can improve teamwork attitudes.

Changes of collective orientation through a medical student's anaesthesia simulation course - simulation-based training study with non-technical skills debriefing versus medical debriefing

BACKGROUND

Non-technical skills (NTS) are known to have a positive impact on quality of medical care. The team performance enhancing behaviour, as an example for NTS, is termed "Collective Orientation" (CO). In this study, we investigated the effect of a simulator-based anaesthesia training upon student's CO in relation to medical and TeamGAINS (guided team self-correction, advocacy-inquiry and systemic-constructivist techniques) debriefing. We hypothesized (a) the scale collective orientation, as demonstrated in other team setting, is applicable to fourth year German medical students, (b) collective orientation increases by a four-hour anaesthesia simulation course, (c) the change in collective orientation can be influenced by type of debriefing.

METHOD

All classes of an anaesthesia module (4th year medical students) were randomized into two groups. Students took part in a four-hour simulation course with team scenarios, supported by a simulated nurse. In group one the trainer focused on a debriefing on medical problems and in group two, a debriefing according to the specifications of the TeamGAINS concept was conducted. The primary outcome was the mean difference between the collective orientation measured (via questionnaires) immediately before (T1) and after (T2) training.

RESULTS

Cronbach's alpha for all scales and measurement points was higher than 0.72. The scale "affiliation" decreases in the group medical debriefing MD = 0.1 (p = 0.008; r = 0.31) and was unchanged in the group TeamGAINS. "Dominance" increases in both groups. The values were MD = 0.19 (p = 0.003; r = 0.25) for medical debriefing and MD = 0.22 (p = 0.01; r = 0.40) for TeamGAINS debriefing.

CONCLUSION

The collective orientation questionnaire can be applied to fourth year medical students. Simulation courses influence the attitude towards teamwork. The influence is negatively to the subscale "affiliation" by a "medical debriefing" and independently regardless of the nature of the debriefing for the subscale "dominance". We recommend a debriefing for medical students using the TeamGAINS approach to clarify the connection between the individual performance and non-technical skills. Anaesthesia simulation courses have the potential being a part of a longitudinal education curriculum for teaching non-technical skills.

Advancing Teams Research: What, When, and How to Measure Team Dynamics Over Time

Teams are complex and dynamic entities that face constant changes to their team structures and must simultaneously work to meet and adapt to the varying situational demands of their environment (Kozlowski and Ilgen, 2006). Agencies, industries, and government institutions are currently placing greater attention to the influence on team dynamics and teamwork as they are important to key organizational outcomes. Due to increased emphasis being placed upon the understanding the maturation of team dynamics, the incorporation of efficient methodological tools to understand how teams are being measured over time becomes critical. Thus, the purpose of this paper is to present a review of relevant academic articles detailing the science behind methodological tools and general approaches to study team dynamics over time. We provide an overview of the methodological tools used to understand team dynamics with accordance to specific temporal elements. Drawing from Kozlowski et al. (1999) process model of team development, we highlight relevant emergent team constructs within each stage. As well, for each stage, we discuss the what and how to measure team dynamics. Our analyses bring to light relevant, novel and complex approaches being used by researchers to examine specific constructs within different team developmental phases (e.g., agent-based simulations, computational modeling) and the importance of transitioning from a single source methodology approach. Implications and future research are also discussed.

[Measurement of attitudes toward interprofessional collaboration in an operating theatre - a cross-sectional study]

Measurement of attitudes toward interprofessional collaboration in an operating theatre - a cross-sectional study Abstract.Background: Interprofessional cooperation (IC) between healthcare professionals is essential for good treatment outcomes. Surgical departments place special demands on interprofessional cooperation (situational team formation, alterning work environment, coordinative overcrowding of work) within a health organisation. In order to achieve common goals in a team, it is important that those involved have a comparable understanding of and attitude towards interprofessional cooperation, regardless of their profession. Research Question: What is the internal consistency of the German version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC) when applied to personnel in an operating theatre? What is the attitude towards interprofessional cooperation between the various occupational groups in a surgical department of an acute care hospital functioning as a centre and a training establishment? Are there differences between the individual occupational groups and the sexes? Method: The validated JeffSATIC questionnaire was translated back into German and sent to 283 people in a surgical department with eleven operating theatres. The internal consistency of the questionnaire and differences in attitude towards interprofessional cooperation were examined. Findings: The German version of the JeffSATIC questionnaire is a reliable instrument for measuring the attitude of individuals towards interprofessional cooperation. It was used for the first time in the context of a surgical department. In the institution examined, there are no statistically significant differences between the different occupational groups and sexes in relation to the attitude to IC in the dimensions 'work relationship' and 'responsibility' determined by the questionnaire. The medical service anaesthesia shows the greatest divergence in attitude towards interprofessional cooperation within a professional group. Conclusions: In the institution examined, the prerequisites for successful interprofessional cooperation exist. In general, it should be further examined which factors influence the divergence in attitude per occupational group and whether these divergences in attitude are also associated with the quality of the actual cooperation.