Development of a Virtual Crew Resource Management Training Program to Improve Communication

Followership in interprofessional healthcare teams: a state-of-the-art narrative review

OBJECTIVE

A state-of-the-art (SotA) literature review-a type of narrative review- was conducted to answer: What historical developments led to current conceptualisations of followership in interprofessional healthcare teams (IHTs)?

DESIGN

Working from a constructivist orientation, SotA literature reviews generate a chronological overview of how knowledge evolved and presents this summary in three parts: (1) this is where we are now, (2) this is how we got here and (3) this is where we should go next. Using the SotA six-stage methodology, a total of 48 articles focused on followership in IHTs were used in this study.

RESULTS

Articles about followership within IHTs first appeared in 1993. Until 2011, followership was framed as leader-centric; leaders used their position to influence followers to uphold their dictums. This perspective was challenged when scholars outside of healthcare emphasised the importance of team members for achieving goals, rejecting a myopic focus on physicians as leaders. Today, followership is an important focus of IHT research but two contradictory views are present: (1) followers are described as active team members in IHTs where shared leadership models prevail and (2) conceptually and practically, old ways of thinking about followership (ie, followers are passive team members) still occur. This incongruity has generated a variable set of qualities associated with good followership.

CONCLUSIONS

Leadership and followership are closely linked concepts. For leaders and followers in today's IHTs to flourish, the focus must be on followers being active members of the team instead of passive members. Since theories are increasingly encouraging distributed leadership, shared leadership and/or situational leadership, then we must understand the followership work that all team members need to harness. We need to be cognizant of team dynamics that work within different contexts and use leadership and followership conceptualisations that are congruent with those contexts.

Dynamic system allocation and application of cloud computing virtual resources based on system architecture

Cloud computing is a system development method based on dynamic sharing, which allows a large number of systems to be combined to provide services. The purpose of this work is to study the design and implementation of a dynamic virtual resource allocation system in cloud computing, whose architecture allows load balancing between virtual resource pools and reduces resource wastage. Using the cluster network topology, the resource usage of the dynamic system cluster can be monitored in real time, and the total cluster load can be automatically determined based on the monitoring data. The experiment is divided into two parts. Performance testing and scenario testing. Performance tests examine execution time, processor, and memory performance. In the scenario test, JMeter is used to simulate the occurrence of a large number of concurrent application access requests, the loss rate, and processing time of these requests on the cloud platform, and load balancing tests are performed. The test results show that the system running time is about 22–27 ms, the CPU utilization is about 90–95%, and the RAM is about 3.5 ms. The results show that cloud technology can improve resource scheduling of large tasks and optimize resource load balance.

Improving knowledge and behavior of leadership and followership among the interprofessional team

OBJECTIVES

To examine virtual training on Crew Resource Management (CRM) principles of effective leadership and followership on participants' knowledge, applicability, and intended behaviors.

METHODS

Graduate students (n=41) from four health disciplines participated in the training, which included a self-learning module (e.g., didactic content and video vignettes) and an optional virtual simulation exercise. Knowledge was examined via a 10-item pre/post knowledge test. Applicability of the training and intended behaviors was measured post-training via an 11-item survey. T-test and Analysis of variance were applied to compare knowledge scores, as well as to determine variation in discipline responses.

RESULTS

Knowledge improved significantly post-training (t₍₄₀₎=10.47, p<0.001). Pharmacy students scored significantly lower on the post-knowledge test than medicine and nursing students [F_(2,36)=5.99, p=0.006]. On average, participants completing the module reported learning new skills and knowledge (M=4.17, SD=0.54) and intended to use skills/knowledge gained from the training in clinical practice (M=4.29, SD=0.56). No differences were noted among responses from the various disciplines. Those completing the simulation exercise (n=10) found value in the experience, again noting strong application to practice (M=4.9, SD=0.32) and intended use in practice (M=4.9, SD=0.32).

CONCLUSIONS

The CRM training was valuable and applicable to practice. Use of a virtual platform may provide an avenue for minimizing current barriers to successful interprofessional education by allowing participants to connect in various geographical locations. The module is ready for widespread use in health professional education.