The effect of using desktop VR to practice preoperative handovers with the ISBAR approach: a randomized controlled trial

AIM

The aim was to investigate whether second-year undergraduate nursing students practicing the Identification-Situation-Background-Assessment-Recommendation (ISBAR) communication approach in a desktop virtual reality (VR) application had a non-inferior learning outcome compared with the traditional paper-based method when sorting patient information correctly based on the ISBAR structure.

METHODS

A non-inferior parallel group assessor blinded randomized controlled trial, conducted in simulation sessions as part of preparation for clinical placements in March and April 2022. After a 20-minute introductory session, the participants were randomized to self-practice the ISBAR approach for 45 minutes in groups of three in either an interactive desktop VR application (intervention) or traditional paper-based (TP) simulation. The primary outcome concerned the proportion of nursing students who sorted all 11 statements of patient information in the correct ISBAR order within a time limit of 5 min. The predefined, one-sided, non-inferiority limit was 13 percentage points in favor of traditional paper-based simulation.

RESULTS

Of 210 eligible students, 175 (83%) participated and were allocated randomly to the VR (N = 87) or TP (N = 88) group. Practicing in the desktop VR application (36% of everything correct) was non-inferior to the traditional paper-based method (22% everything correct), with a difference of 14.2 percentage points (95% CI 0.7 to 27.1) in favor of VR. The VR group repeated the simulation 0.6 times more (95% CI 0.5 to 0.7). Twenty percent more (95% CI 6.9 to 31.6) of the students in the VR group reported liked how they practiced. All the other outcomes including the System Usability Scale indicated non-inferiority or were in favor of VR.

CONCLUSIONS

Self-practicing with the ISBAR approach in desktop VR was non-inferior to the traditional paper-based method and gave a superior learning outcome.

TRIAL REGISTRATION NUMBER

ISRCTN62680352 registered 30/05/2023.

Identity leadership and cohesion in elite sport: The mediating role of intra-team communication

One perspective on leadership that has recently gained increased attention in sport is identity leadership; however, research on elite sport teams is still in its infancy. Thus, the main purpose of this research is to investigate identity leadership in elite team sports in relation to task cohesion, and subsequently to explore the mediating role of the intra-team communication dimensions of acceptance and distinctiveness. A cross-sectional design was employed and 441 elite athletes from division 1 and division 2 in handball and ice hockey participated in the present study. Structural equation modeling was used to assess relationships between identity leadership and task cohesion, and the mediating role of acceptance and distinctiveness. Results revealed that identity leadership positively predicted task cohesion, and that this relationship was mediated by intra-team communication acceptance. In conclusion, findings in the present study expand our understanding of performance-related benefits of identity leadership in elite sport.

Usability Evaluation of the Preoperative ISBAR (Identification, Situation, Background, Assessment, and Recommendation) Desktop Virtual Reality Application: Qualitative Observational Study

BACKGROUND

Systematic communication, such as the ISBAR (identification, situation, background, assessment, recommendation) approach, comprises a generic, transferable nontechnical skill. It can be used during the handover of patients set to undergo surgery and can be practiced in various ways, including virtual reality (VR). VR increasingly has been implemented and valued in nursing education as a positive contribution to teach students about pre- and postoperative nursing. A new nonimmersive 3D learning activity called the Preoperative ISBAR Desktop VR Application has been developed for undergraduate nursing students to learn preoperative handover using the ISBAR approach. However, the usability of this learning activity has not been studied.

OBJECTIVE

This study aimed to investigate how second-year undergraduate nursing students evaluated the usability of the Preoperative ISBAR Desktop VR Application.

METHODS

This was a qualitative study with observation and interviews. The inclusion criteria were undergraduate second-year nursing students of varying ages, gender, and anticipated technological competence. The System Usability Scale (SUS) questionnaire was used to get a score on overall usability.

RESULTS

A total of 9 second-year nursing students aged 22-29 years participated in the study. The average score on the SUS was 83 (range 0-100), which equals a "B" on the graded scale and is excellent for an adjective-grade rating. The students expressed increased motivation to learn while working in self-instructed desktop VR. Still, a few technical difficulties occurred, and some students reported that they experienced some problems comprehending the instructions provided in the application. Long written instructions and a lack of self-pacing built into the application were considered limitations.

CONCLUSIONS

The nursing students found the application to be usable overall, giving it an excellent usability score and noting that the application provided opportunities for active participation, which was motivational and facilitated their perceived learning outcomes. The next version of the application, to be used in a randomized controlled trial, will be upgraded to address technological and comprehension issues.

A Qualitative Exploration of Collective Collapse in a Norwegian Qualifying Premier League Soccer Match-The Successful Team's Perspective

The current case study focused on a crucial match in the qualification for the Norwegian Premier League (Eliteserien). In the match, the participants of the study experienced a radical change in performance toward the end of the second half, from being behind by several goals to scoring 3 goals in 6 min and winning the qualifying game. The purpose of this study was therefore to examine the perceptions and reflections of players and coaches (sporting director) on what occurred within their own team and within the opposing team. The momentum shift in the opposition team can be described as a collective collapse. In the study, the theoretical collective collapse process model was used as a guide for the design of the interview questions where five semi-structured interviews were conducted with participants involved in the match (players, coach, and sporting director). The participants watched excerpt clips from the match to recall the main events, which they subsequently reflected on. The results highlighted the importance of the "before-game" aspects (i.e., pressure, first game result), the "during-the-game" behavior (i.e., goals scored, playing with a low degree of risk) and the cognitive (i.e., feelings of pressure, despair) and emotional reactions (i.e., frustration, joy) to the match unfolding. In addition, social contagion processes were evident in both teams relating to emotion and behavior. Overall, the data from this study investigated the general structure of the process model of collective sport team collapse and found support for the notion of a temporal cascade of causes for a team collapse. Future research is encouraged to examine this model, to provide guidance to teams, coaches, and sport psychologists in order to make recommendations for dealing with collective collapse in sport teams.

Development and Initial Validation of the Humor Climate in Sport Scale

In sport teams, humor is an essential element that influences communication processes, and plays an important role in group dynamics. Despite this, no current instrument is presented in the literature to measure humor climate in sport teams. Therefore, the current study presents the development and initial validation of the Humor Climate in Sport Scale (HCSS). The aim was to assess content, structural and concurrent validity of the developed instrument, and to examine differential item functioning (DIF) as a function of sex. Three different phases were completed in this study. The first phase involved focus groups (n = 5) that explored humor as communication in a team sport context. In phase 2, information from the focus groups was used to create a pool of potential items for the questionnaire. Two discussion groups with sport science students contributed to the development of 80 potential items, that two different expert groups then assessed for item quality. The final version of the instrument after this phase contained 14 items, representing three different humor dimensions. In phase 3, two independent samples with a total number of 776 participants were recruited for the psychometric evaluation of the instrument. EFA, ICM-CFA, and ESEM analysis were performed, supporting a three-factor structure with positive humor, negative humor in-group, and negative humor out-group. In addition, partial DIF as a function of sex on the negative humor dimensions was found, indicating differences in how male and female interpret the negative humor items. The findings in the current study expand our understanding of humor in sport teams and may be a starting point for further research on humor climate in sport teams and its role in group function.

An Examination of the Relationship Between Coaches' Transformational Leadership and Athletes' Personal and Group Characteristics in Elite Youth Soccer

There is a growing body of the literature highlighting the positive impact of transformational leadership behaviours across contexts, including sport. However, there is a lack of knowledge of this relationship within elite sport settings. Thus, the purpose of the present study was to examine the relationship between elite youth athletes' perceptions of coaches' transformational coaching-behaviours and variables that have been linked to transformational leadership in other settings (i.e., group cohesion, motivational climate, self-regulation of learning and athlete satisfaction). Norwegian elite youth soccer players (n = 753) selected into the national talent development program completed questionnaires to measure the variables of interest. Using structural equation modelling, results revealed a positive path from transformational leadership to both task and social cohesion, task-oriented motivational climates, self-regulation of learning and athlete satisfaction. Finally, a negative path from transformational leadership to ego-oriented climates was identified. The findings are in line with previous research in associating transformational leadership behaviours with adaptive outcomes, and further indicating that such relationships may also be valid in elite sport contexts.

Talent Development Environments in Football: Comparing the Top-Five and Bottom-Five-Ranked Football Academies in Norway

Background: The aim of this study was to examine junior-elite football players’ perception of their talent development environment by comparing clubs ranked as the top-five and bottom-five in the 2017 Norwegian academy classification. Methods: In total, 92 male junior-elite football players recruited from under-19 teams from five professional football club academies took part in the study. The Talent Development Environment Questionnaire (TDEQ-5; Martindale et al. 2010) was used to measure the players’ perceptions of their team environment. Results: The subscale long-term development focus and support network had the highest score and indicated that they perceived that the environment was high quality with respect to those factors. Players from the top-five-ranked clubs perceived their development environments to be significantly more positive with respect to holistic quality preparation, alignment of expectations, communication and, compared to players from the bottom-five-ranked clubs. Conclusions: The players’ perceptions of the talent development environment seem to be in alignment of the academy classification undertaken by the Norwegian top football association.

Sykepleiestudentenes kliniske praksis – om klinisk læringsmiljø og studenttilfredshet

Nurse practice – clinical learning environment and student satisfaction The purpose of this study was to investigate nursing students’ satisfaction with the clinical learning environment during clinical practice. A questionnaire was distributed to nursing students at a university (N=250) in Norway. Student satisfaction, task orientation, pedagogical atmosphere, supervisory relationship, and the premises of nursing on the ward were measured. Of the 250 students invited, 163 (66 %) completed the survey. Nursing students were largely satisfied with their clinical placement experiences, but they were more satisfied with hospital placements than home care placements. Supervision more than once a week and having one supervisor was important for student satisfaction. Students’ relationship with their supervisors was strongest associated with satisfaction with their clinical placements. Supervisors play an important role in nursing students’ satisfaction with their clinical practice, with results indicating that this should be emphasized in the development of nursing education. The results indicate that nursing guidance skills should be strengthened to ensure the quality of clinical placements in nursing education.

Childhood football play and practice in relation to self-regulation and national team selection; a study of Norwegian elite youth players

Childhood sport participation is argued to be important to understand differences in self-regulation and performance level in adolescence. This study sought to investigate if football-specific activities in childhood (6-12 years of age) is related to self-regulatory skills and national under 14- and 15-team selection in Norwegian elite youth football. Data of practice histories and self-regulatory skills of 515 youth football players selected at Norwegian regional level were collected and further analysed using multilevel analyses. The results revealed that high self-regulated players were more likely to be selected for national initiatives, and increased their involvement in peer-led football practice and adult-led football practice during childhood, compared to players with lower levels of self-regulation. While national level players reported higher levels of peer-led football play in childhood, the interaction effect suggest that the regional level players increased their involvement in peer-led play during childhood compared to national level players. In conclusion, the findings indicate that childhood sport participation may contribute to later differences in self-regulation, and highlights the importance of childhood engagement in football-specific play and practice in the development of Norwegian youth football players.

Mental Toughness Moderates Social Loafing in Cycle Time-Trial Performance

PURPOSE

The purpose of this study was to determine if mental toughness moderated the occurrence of social loafing in cycle time-trial performance.

METHOD

Twenty-seven men (Mage = 17.7 years, SD = 0.6) completed the Sport Mental Toughness Questionnaire prior to completing a 1-min cycling trial under 2 conditions: once with individual performance identified, and once in a group with individual performance not identified. Using a median split of the mental toughness index, participants were divided into high and low mental toughness groups. Cycling distance was compared using a 2 (trial) × 2 (high-low mental toughness) analysis of variance. We hypothesized that mentally tough participants would perform equally well under both conditions (i.e., no indication of social loafing) compared with low mentally tough participants, who would perform less well when their individual performance was not identifiable (i.e., demonstrating the anticipated social loafing effect).

RESULTS

The high mental toughness group demonstrated consistent performance across both conditions, while the low mental toughness group reduced their effort in the non-individually identifiable team condition.

CONCLUSIONS

The results confirm that (a) clearly identifying individual effort/performance is an important situational variable that may impact team performance and (b) higher perceived mental toughness has the ability to negate the tendency to loaf.

Perceived Social Loafing and Anticipated Effort Reduction among Young Football (Soccer) Players: An Achievement Goal Perspective

This study investigated the relationship between motivational climates, personal achievement goals, and three different aspects of social loafing in football (soccer). 170 male competitive football players completed questionnaires assessing perceived motivational climate, achievement goal, and measures of perceived social loafing (anticipation of lower effort amongst their teammates and themselves). The results indicated a marginal but significant positive relationship between an ego-oriented achievement goal and perceived social loafing. In addition, a mastery climate was negatively associated with perceived social loafing and anticipation of lower effort of team members, particularly for athletes who also strongly endorsed a task-oriented achievement goal. A performance climate, in contrast, related positively with these two aspects of social loafing. A mastery climate also related negatively to the third aspect of social loafing, i.e., players' readiness to reduce their own effort in response to their perception of social loafing among their teammates.

The Relationship Between Group Cohesion, Group Norms, and Perceived Social Loafing in Soccer Teams

The purpose of this study was to examine the relationship between group cohesion, group norms, and perceived social loafing among 118 soccer players playing junior league in Norway. Each player completed a questionnaire assessing group cohesion (task cohesion and social cohesion), team norms (productive norms, role involvement, and social support norms), and perceived social loafing. As predicted, all cohesion- and team-norm subscales were negatively correlated with perceived social loafing. Furthermore, the results showed that the players’ attraction to their team’s task as well as their perception of the productive- and social-support norm predicted perceptions of social loafing. A significant three-way interaction between task cohesion, social cohesion, and performance norm emerged. The analysis showed that the combination of high social cohesion, low task cohesion, and low team norms seems to underlie perceptions of social loafing.

A team fares well with a fair coach: Predictors of social loafing in interactive female sport teams

The present research aimed to develop and test a theoretical model that links players' perceived justice of the coach to a more optimal motivational climate, which in turn increases players' team identification and cohesion, and results in lower levels of social loafing in female sport teams. Belgian elite female basketball, volleyball, and football players (study 1; N = 259; M(age)  = 22.6) and Norwegian world-class female handball players (study 2; N = 110; M(age)  = 22.8) completed questionnaires assessing players' perceived justice (distributive and procedural), motivational climate, team identification, team cohesion (task and social), and social loafing (perceived and self-reported). In both studies, confirmatory and exploratory path analyses indicated that perceived justice was positively related to a mastery climate (P < 0.05) and negatively to a performance climate (P < 0.05). In turn, a mastery climate was linked to increased levels of team identification (P < 0.05) and task cohesion (P < 0.05). Consequently, players' perceived and self-reported social loafing decreased (P < 0.05). The findings of both independent studies demonstrated the impact of coaches' fairness, and consequently, the motivational climate created by the coach on the optimal functioning of female sport teams.

Academic self-efficacy mediates the effects of school psychological climate on academic achievement

This study investigated the effects of proximal and distal constructs on adolescent's academic achievement through self-efficacy. Participants included 482 ninth- and tenth- grade Norwegian students who completed a questionnaire designed to assess school-goal orientations, organizational citizenship behavior, academic self-efficacy, and academic achievement. The results of a bootstrapping technique used to analyze relationships between the constructs indicated that school-goal orientations and organizational citizenship predicted academic self-efficacy. Furthermore, school-goal orientation, organizational citizenship, and academic self-efficacy explained 46% of the variance in academic achievement. Mediation analyses revealed that academic self-efficacy mediated the effects of perceived task goal structure, perceived ability structure, civic virtue, and sportsmanship on adolescents' academic achievements. The results are discussed in reference to current scholarship, including theories underlying our hypothesis. Practical implications and directions for future research are suggested.

Return to work after vocational rehabilitation: does mindfulness matter?

Purpose

Mindfulness has become an important construct in return-to-work (RTW) rehabilitation. The aim of this study was to investigate whether mindfulness is a predictor for RTW, and to examine the indirect effect of mindfulness on RTW and work ability through quality of life (QOL).

Methods

A retrospective study was conducted among 80 former participants (71 females and seven males) from age 24 to 66, in a multidisciplinary vocational rehabilitation program (MVRP). Self-report questionnaires were used to measure work status, work ability, QOL, and mindfulness. Demographic data were also collected.

Results

In the current sample, 47% of participants reported having returned to ordinary work. The majority of the non-working sub-sample reported being in work-related activity or education. A bias-corrected bootstrapping technique was used to examine indirect effects. Results revealed that mindfulness was indirectly related to both RTW and work ability through QOL. There was no significant total effect of mindfulness on work ability or RTW. Logistic regression analysis was performed to assess the impact of mindfulness on the likelihood that respondents returned to work. None of the independent mindfulness variables (observe, describe, act aware, non-judge, non-react) made a unique statistically significant contribution to the model. The covariates work ability and education level significantly predicted RTW. However, when the data were analyzed after stratification by education level, the “observation” facet of mindfulness made a significant contribution to the model (odds ratio =1.28, confidence interval =1.03–1.59) for “high educated” participants.

Conclusion

These data suggest that mindfulness may enhance RTW and work ability through QOL. Furthermore, for “high educated” participants the observation facet of mindfulness significantly predicted RTW.

Normative data of BMI and physical fitness in a Norwegian sample of early adolescents

Aim: The purpose of the present study was to 1) provide normative data quantifying the physical fitness level and body mass index of 13–15-year-old Norwegian adolescents using a multi-component fitness assessment, and 2) compare the physical fitness of Norwegian teenagers with available European and International fitness data. Methods: 1059 adolescents (529 males, 530 females) from 12 public schools in Kristiansand were invited to testing at age 13, 14, and 15 years (Grades 8–10). Test participation was 75%–80%. The participants performed objectively anthropometrical measures (height and weight) and six field-based physical fitness tests. Results and Conclusions: As expected, sex differences in physical fitness expanded from age 13 to 15. Strength and power increased more in males than females. Aerobic capacity increased slightly in males while remaining stable or tending to decline in females. Balance and gross motor coordination improved identically in males and females from age 13 to 15. Compared to European and International reference data, the sample performed superior in endurance and balance, slightly above median in lower-body strength, but inferior in flexibility.

Self-reported learning difficulties and dietary intake in Norwegian adolescents

Aim: The academic performance of children impacts future educational attainment which may increase socioeconomic status which again influences their health. One of several factors that might affect academic performance is the diet. The aim of this study was to investigate the cross sectional relation between diet and self-reported reading-, writing-, and mathematical difficulties in Norwegian adolescents. Methods: In total, 475 ninth- and tenth-grade students out of 625 eligible ones from four different secondary schools in three different municipalities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy and unhealthy food items, questions of meal frequency and different learning difficulties. Results: Regular breakfast was significantly associated with decreased odds of both writing and reading difficulties (OR: 0.44 (0.2–0.8), p = 0.01) and mathematical difficulties (OR: 0.33 (0.2–0.6), p ≤ 0.001). In addition, having lunch, dinner and supper regularly were associated with decreased odds of mathematical difficulties. Further, a high intake of foods representing a poor diet (sugar-sweetened soft drinks, sweets, chocolate, savory snacks, pizza and hot dogs) was significantly associated with increased odds of mathematical difficulties. Conclusions: Having a less-frequent intake of unhealthy foods and not skipping meals are associated with decreased odds of self-reported learning difficulties in Norwegian adolescents in this study. The results of this study support the need for a larger study with a more representative sample.

Diet and behavioral problems at school in Norwegian adolescents

BACKGROUND

Discussion about dietary factors in relation to behavioral problems in children and adolescents has been going on for a long time.

OBJECTIVE

The aim of this study was to investigate the cross-sectional relation between diet and self-reported behavioral problems at school in adolescents in the southern part of Norway.

DESIGN

In total, 475 ninth- and tenth-grade students (236 boys and 239 girls) out of 625 eligible students from four different secondary schools in three different communities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy (e.g. fruits, vegetables, and fish) and unhealthy (e.g. sweets, sugar-sweetened beverages, and crisps) food items, questions of meal frequency, and four questions regarding behavioral problems at school.

RESULTS

HAVING BREAKFAST REGULARLY WAS SIGNIFICANTLY ASSOCIATED WITH DECREASED ODDS OF BEHAVIORAL PROBLEMS (OR: 0.29 (0.15 - 0.55), p≤0.001). A high intake of unhealthy foods, such as sugar-sweetened soft drinks (OR: 2.8 (1.06 - 7.42), p=0.03) and sweets (OR: 2.63 (1.39 - 4.98), p=0.003), was significantly associated with increased odds of behavioral problems. At the same time, a high intake of fruits was associated with decreased odds of behavioral problems in Norwegian adolescents (OR: 0.30 (0.10 - 0.87), p=0.03). All ORs are adjusted for sex and BMI.

CONCLUSIONS

This study shows that having an optimal diet and not skipping meals are associated with decreased odds of behavioral problems at school in Norwegian adolescents. Hence, it is important to improve the dietary intake and meal pattern of Norwegian adolescents. The cross-sectional design of this study limits any causal interpretations of the results of the study.