Building Better Bridges: Outcomes of a Community-Partnered New School Transition Intervention for Students on the Autism Spectrum.

New school transitions can be challenging for students on the autism spectrum. No published, evidence-based interventions exist to support families and teachers of students transitioning to elementary and secondary school during this critical period. Using Community Partnered Participatory Research, we developed Building Better Bridges (BBB), a caregiver coaching intervention that includes training on effective school communication, educational rights, advocacy, and child preparation strategies. We compared BBB (n = 83) to a module/resources-only comparison (n = 87) in a four-site randomized controlled trial in racially and ethnically diverse, under-resourced communities. In our intent-to-treat analysis, caregivers and teachers in BBB rated students' transitions to the new classroom as more positive, relative to the comparison group. Results suggest this low-cost intervention can improve the transition process for families and students at high risk of poor transitions.

Challenges With Robot-Assisted Surgery Setup for Complex Minimally Invasive Upper Gastrointestinal Surgery.

BACKGROUND: The utilization of robot-assisted approaches to surgery has increased significantly over the last two decades. This has introduced novel complexities into the operating room environment, requiring management of new challenges and workflow adaptation. This study aimed to analyze challenges in the surgical setup for complex upper gastrointestinal robot-assisted surgery (UGI-RAS) and identify opportunities for solutions. METHODS: Direct observations of surgical setup processes for UGI-RAS were performed by a trained Human Factors researcher at a non-profit academic medical center in Southern California. Setup tasks were subdivided into five phases: (1) before wheels-in; (2) patient transfer and anesthesia induction; (3) patient preparation; (4) surgery preparation; and (5) robot docking. Start/end times for each phase/task were documented along with workflow disruption (FD) narratives and timestamps. Setup tasks and FDs were analyzed using descriptive statistics. RESULTS: Twenty UGI-RAS setup procedures were observed between May-November 2023: sleeve gastrectomy +/- hiatal hernia repair (n = 9, 45.00%); para-esophageal hernia repair +/- fundoplication (n = 8, 40.00%); revision to Roux-en-Y gastric bypass (n = 2, 10.00%); and gastric band removal (n = 1, 5.00%). Frequent FDs included planning breakdowns (n = 20, 29.85%), equipment/supply management (n = 17, 25.37%), patient care coordination (n = 8, 11.94%), and equipment challenges (n = 8, 11.94%). Eleven of 20 observations were first-start cases, of which 10 experienced delayed starts. DISCUSSION: Interventions aimed at improving workflows during UGI-RAS setup include performing pre-operative team huddles and conducting trainings aimed at team coordination and equipment challenges. These solutions could result in improved teamwork, efficiency, and communication while reducing case start delays and turnover time.

An automated content-based measure of closed loop communication among critical care air transport teams.

Successful teamwork is essential to ensure critical care air transport (CCAT) patients receive effective care. Despite the importance of team performance, current training methods rely on subjective performance assessments and do not evaluate performance at the team level. Researchers have developed the Team Dynamics Measurement System (TDMS) to provide real-time, objective measures of team coordination to assist trainers in providing CCAT aircrew with feedback to improve performance. The first iteration of TDMS relied exclusively on communication flow patterns (i.e., who was speaking and when) to identify instances of various communication types such as closed loop communication (CLC). The research presented in this paper significantly advances the TDMS project by incorporating natural language processing (NLP) to identify CLC. The addition of NLP to the existing TDMS resulted in greater accuracy and fewer false alarms in identifying instances of CLC compared to the previous flow-based implementation. We discuss ways in which these improvements will facilitate instructor feedback and support further refinement of the TDMS.

Navigating the new normal: Examining coattendance in a hybrid work environment.

The recent rise of hybrid work poses novel challenges for synchronizing in-office work schedules. Using anonymized building access data, we quantified coattendance patterns among ~43k employees at a large global technology company. We used two-way fixed effects regression models to investigate the association between an employee's presence in the office and that of their manager and teammates. Our analysis shows that employee in-person attendance was 29% higher when their manager was present. Moreover, a 1-SD increase in the share of teammates who were present yielded a 16% increase in the individual employee's attendance. We also observed greater coattendance among employees who were recently hired, have a Corporate or Operations role, or work in shared office spaces. Thus, we find evidence of some voluntary alignment of work schedules. Companies could bolster such organic coordination by leveraging digital scheduling tools or providing guidance specifically aimed at increasing coattendance.

A Methodological Framework to Study Change in Team Cognition Under the Dynamical Hypothesis.

The dynamical hypothesis claims that cognitive systems, such as teams, are dynamical systems (i.e., an interdependent collection of individuals and their technology that change together over time). Following this hypothesis, team researchers have adopted dynamical approaches to better understand the team cognitive processes and states that form team cognition, as well as how they emerge over time. One approach focuses on team coordination dynamics, which examines the coupling of signals between interacting individuals in various modalities, and has been shown to reflect aspects of team functioning including team cognition. However, how changes in team coordination relate to high-level team cognitive processes and states, as well as important events, are not yet fully understood. To this end, we advance a methodological framework for researching team cognition under the dynamical hypothesis. Subsequently, we provided an empirical case-study application of this framework. Thereby, this work contributes methodologically and empirically to a deeper understanding of team cognition, the dynamical hypothesis, and the synergy between them.

The Next Giant Leap for Space Human Factors: The Opportunities.

OBJECTIVE: Propose areas of future space human factors research. BACKGROUND: Deep space, long-duration human spaceflight missions to the Moon and Mars still require advances in space human factors research. Key drivers relate to astronauts living and working in isolation, new novel technologies required to accomplish exploration missions, and the longer durations of these. RESULTS: Three areas of research are proposed for methods and techniques: (1) to enable more autonomous astronauts; (2) to monitor crew and improve ground team situation awareness; and (3) to detect and support changes in long-duration team coordination. CONCLUSIONS: Future human exploration missions will benefit from advances in space human factors research. APPLICATION: Human factors researchers can contribute to human spaceflight by prioritizing these research topics.

Dynamical biomarkers in teams and other multiagent systems.

Effective team behavior in high-performance environments such as in sport and the military requires individual team members to efficiently perceive the unfolding task events, predict the actions and action intents of the other team members, and plan and execute their own actions to simultaneously accomplish individual and collective goals. To enhance team performance through effective cooperation, it is crucial to measure the situation awareness and dynamics of each team member and how they collectively impact the team's functioning. Further, to be practically useful for real-life settings, such measures must be easily obtainable from existing sensors. This paper presents several methodologies that can be used on positional and movement acceleration data of team members to quantify and/or predict team performance, assess situation awareness, and to help identify task-relevant information to support individual decision-making. Given the limited reporting of these methods within military cohorts, these methodologies are described using examples from team sports and teams training in virtual environments, with discussion as to how they can be applied to real-world military teams.

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.

Conversation dynamics in a multiplayer video game with knowledge asymmetry.

Despite the challenges associated with virtually mediated communication, remote collaboration is a defining characteristic of online multiplayer gaming communities. Inspired by the teamwork exhibited by players in first-person shooter games, this study investigated the verbal and behavioral coordination of four-player teams playing a cooperative online video game. The game, Desert Herding, involved teams consisting of three ground players and one drone operator tasked to locate, corral, and contain evasive robot agents scattered across a large desert environment. Ground players could move throughout the environment, while the drone operator's role was akin to that of a "spectator" with a bird's-eye view, with access to veridical information of the locations of teammates and the to-be-corralled agents. Categorical recurrence quantification analysis (catRQA) was used to measure the communication dynamics of teams as they completed the task. Demands on coordination were manipulated by varying the ground players' ability to observe the environment with the use of game "fog." Results show that catRQA was sensitive to changes to task visibility, with reductions in task visibility reorganizing how participants conversed during the game to maintain team situation awareness. The results are discussed in the context of future work that can address how team coordination can be augmented with the inclusion of artificial agents, as synthetic teammates.

A Typology for the Application of Team Coordination Dynamics Across Increasing Levels of Dynamic Complexity.

OBJECTIVE: This review and synthesis examines approaches for measuring and assessing team coordination dynamics (TCD). The authors advance a system typology for classifying TCD approaches and their applications for increasing levels of dynamic complexity. BACKGROUND: There is an increasing focus on how teams adapt their coordination in response to changing and uncertain operational conditions. Understanding coordination is significant because poor coordination is associated with maladaptive responses, whereas adaptive coordination is associated with effective responses. This issue has been met with TCD approaches that handle increasing complexity in the types of TCD teams exhibit. METHOD: A three-level system typology of TCD approaches for increasing dynamic complexity is provided, with examples of research at each level. For System I TCD, team states converge toward a stable, fixed-point attractor. For System II TCD, team states are periodic, which can appear complex, yet are regular and relatively stable. In System III TCD, teams can exhibit periodic patterns, but those patterns change continuously to maintain effectiveness. RESULTS: System I and System II are applicable to TCD with known or discoverable behavioral attractors that are stationary across mid-to long-range timescales. System III TCD is the most generalizable to dynamic environments with high requirements for adaptive coordination across a range of timescales. CONCLUSION: We outline current challenges for TCD and next steps in this burgeoning field of research. APPLICATION: System III approaches are becoming widespread, as they are generalizable to time- and/or scale-varying TCD and multimodal analyses. Recommendations for deploying TCD in team settings are provided.

Insights From the Virtual Team Science: Rapid Deployment During COVID-19.

OBJECTIVE: To provide insights for organizations that must rapidly deploy teams to remote work. BACKGROUND: Modern situations, such as the COVID-19 pandemic, are rapidly accelerating the need for organizations to move employee teams to virtual environments, sometimes with little to no opportunities to prepare for the transition. It is likely that organizations will continually have to adapt to evolving conditions in the future. METHOD: This review synthesizes the literature from several sources on best practices, lessons learned, and strategies for virtual teams. Information from each article deemed relevant was then extracted and de-identified. Over 64 best practices were independently and blindly coded for relevancy for the swift deployment of virtual teams. RESULTS: As a result of this review, tips for virtual teams undergoing rapid transition to remote work were developed. These tips are organized at the organization, team, and individual levels. They are further categorized under six overarching themes: norm setting, performance monitoring, leadership, supportive mechanisms, communication, and flexibility. CONCLUSION: There is a significant deficit in the literature for best practices for virtual teams for the purposes of rapid deployment, leaving it to organizations to subjectively determine what advice to adhere to. This manuscript synthesizes relevant practices and provides insights into effective virtual team rapid deployment.

Cesarean Delivery in a Patient With Body Mass Index Over 100: Continuous Spinal Anesthesia in Two Consecutive Deliveries.

Anesthetic implications for morbidly obese parturients have been well described; however, the literature has not yet clarified whether there are additional or unique concerns if the body mass index (BMI) rises farther above the so-called super morbid obesity level: BMI >50 kg/m2. There have only been a few case reports focusing on patients with BMI close to or above 100. Parturients with BMI significantly greater than 50 are uncommon, but they represent an increasing proportion among the morbidly obese. In this report, we present the use of continuous spinal anesthesia in consecutive cesarean deliveries for a patient with a BMI of 102 at her first delivery and 116 at her second. For both deliveries, an intrathecal catheter dosing incrementally provided effective anesthesia with a cumulative dose of hyperbaric bupivacaine 12 mg, fentanyl 15 mcg, and morphine 100 mcg given in 0.25-ml increments over 12 minutes, with 0.25-ml sterile saline flushes between doses. While dosing the catheter, the patient was gradually lowered to a 30° semi-recumbent position for surgery. This strategy minimized the risk of high spinal block or respiratory distress. She did not develop any postdural puncture headache (PDPH). This case report offers an extreme example and provides estimates towards adjusting staffing, equipment, location, timing, positioning, anesthetic technique, and dosing for cesarean deliveries in patients with very high BMI levels.

Improving team coordination in primary-care settings via multifaceted team-based feedback: a non-randomised controlled trial study.

BACKGROUND: Coordination is critical to successful team-based health care. Most clinicians, however, are not trained in effective coordination or teamwork. Audit and feedback (A&F) could improve team coordination, if designed with teams in mind. AIM: The effectiveness of a multifaceted, A&F-plus-debrief intervention was tested to establish whether it improved coordination in primary care teams compared with controls. DESIGN & SETTING: Case-control trial within US Veterans Health Administration medical centres. METHOD: Thirty-four primary care teams selected from four geographically distinct hospitals were compared with 34 administratively matched control teams. Intervention-arm teams received monthly A&F reports about key coordination behaviours and structured debriefings over 7 months. Control teams were followed exclusively via their clinical records. Outcome measures included a coordination composite and its component indicators (appointments starting on time, timely recall scheduling, emergency department utilisation, and electronic patient portal enrolment). Predictors included intervention arm, extent of exposure to intervention, and degree of multiple team membership (MTM). RESULTS: Intervention teams did not significantly improve over control teams, even after adjusting for MTM. Follow-up analyses indicated cross-team variability in intervention fidelity; although all intervention teams received feedback reports, not all teams attended all debriefings. Compared with their respective baselines, teams with high debriefing exposure improved significantly. Teams with high debriefing exposure improved significantly more than teams with low exposure. Low exposure teams significantly increased patient portal enrolment. CONCLUSION: Team-based A&F, including adequate reflection time, can improve coordination; however, the effect is dose dependent. Consistency of debriefing appears more critical than proportion of team members attending a debriefing for ensuring implementation fidelity and effectiveness.

A Strategic Core Role Perspective on Team Coordination: Benefits of Centralized Leadership for Managing Task Complexity in the Operating Room.

OBJECTIVE: We examine whether surgical teams can handle changes in task requirements better when their formal leader and strategic core role holder-that is, the main surgeon-is central to team coordination. BACKGROUND: Evidence regarding the benefits of shared leadership for managing complex tasks is divided. We tested whether a strategic core role holder's centrality in team coordination helps teams to handle different types of task complexity. METHOD: We observed coordination as specific leadership behavior in 30 surgical teams during real-life operations. To assess the strategic core role holder's coordination centrality, we conducted social network analyses. Task complexity (i.e., surgical difficulty and unexpected events) and surgical goal attainment were rated in a questionnaire. RESULTS: In the critical operation phase, surgical difficulty impaired goal attainment when the strategic core role holder's coordination centrality was low, while this effect was nonsignificant when his/her coordination centrality was high. Unexpected events had a negative effect on surgical goal attainment. However, coordination centrality of the strategic core role holder could not help manage unexpected events. CONCLUSION: The results indicate that shared leadership is not beneficial when teams face surgical difficulty during the critical operation phase. In this situation, team coordination should rather be centralized around the strategic core role holder. Contrarily, when unexpected events occur, centralizing team coordination around a single leader does not seem to be beneficial for goal attainment. APPLICATION: Leaders and team members should be aware of the importance of distributing leadership differently when it comes to managing different types of task complexity.

Using Communication to Modulate Neural Synchronization in Teams.

Throughout training and team performance, teams may be assessed based on their communication patterns to identify which behaviors contributed to the team's performance; however, this process of establishing meaning in communication is burdensome and time consuming despite the low monetary cost. A current topic in team research is developing covert measures, which are easier to analyze in real-time, to identify team processes as they occur during team performance; however, little is known about how overt and covert measures of team process relate to one another. In this study, we investigated the relationship between overt (communication) and covert (neural) measures of team process by manipulating the interaction partner (participant or experimenter) team members worked with and the type of task (decision-making or action-based) teams performed to assess their effects on team neural synchronization (measured as neurodynamic entropy) and communication (measured as both flow and content). The results indicated that the type of task affected how the teams structured their communication but had unpredictable effects on the neural synchronization of the team when averaged across the task session. The interaction partner did not affect team neural synchronization when averaged. However, there were significant relationships when communication and neural processes were examined over time between the neurodynamic entropy and the communication flow time series due to both the type of task and the interaction partner. Specifically, significant relationships across time were observed when participants were interacting with the other participant, during the second task trial, and across different regions of the cortex depending on the type of task being performed. The findings from the time series analyses suggest that factors that are previously known to affect communication (interaction partner and task type) also structure the relationship between team communication and neural synchronization-cross-level effects-but only when examined across time. Future research should consider these factors when developing new conceptualizations of team process measurement for measuring team performance over time.

How Team Structure Can Enhance Performance: Team Longevity's Moderating Effect and Team Coordination's Mediating Effect.

Teams are more or less structured in function. Whether team structure is beneficial or harmful for the teams entail debates in current literature. Past studies mainly investigate the effects of team structure through learning or creativity. In this study, we tend to examine the effect of team structure on team performance through team coordination. We conducted two independent field studies with samples of 56 and 67 work teams to test our hypotheses. In both two substudies, we found team structure positively affect team performance by improving team coordination. Moreover, we found team longevity was able to moderate the relationship between team structure and team performance through team coordination, such that the positive relationship between team structure and team coordination were more significant when team longevity was high rather than low.

Coordination Cost and Super-Efficiency in Teamwork: The Role of Communication, Psychological States, Cardiovascular Responses, and Brain Rhythms.

To advance knowledge on the psychophysiological markers of "coordination cost" in team settings, we explored differences in meta-communication patterns (i.e., silence, speaking, listening, and overlap), perceived psychological states (i.e., core affect, attention, efficacy beliefs), heart rate variability (i.e., RMSSD), and brain rhythms (i.e., alpha, beta and theta absolute power) across three studies involving 48 male dyads (Mage = 21.30; SD = 2.03). Skilled participants cooperatively played three consecutive FIFA-17 (Xbox) games in a dyad against the computer, or competed against the computer in a solo condition and a dyad condition. We observed that playing in a team, in contrast to playing alone, was associated with higher alpha peak and global efficiency in the brain and, at the same time, led to an increase in focused attention as evidenced by participants' higher theta activity in the frontal lobe. Moreover, we observed that overtime participants' brain dynamics moved towards a state of "neural-efficiency", characterized by increased theta and beta activity in the frontal lobe, and high alpha activity across the whole brain. Our findings advance the literature by demonstrating that (1) the notion of coordination cost can be captured at the neural level in the initial stages of team development; (2) by decreasing the costs of switching between tasks, teamwork increases both individuals' attentional focus and global neural efficiency; and (3) communication dynamics become more proficient and individuals' brain patterns change towards neural efficiency over time, likely due to team learning and decreases in intra-team conflict.

Coordination breakdowns in nuclear power plant control rooms: cause identification and behaviour-sequence analysis.

This study aims to identify the causes of coordination breakdowns among control crews and to understand their coordination-behaviour patterns during emergencies in nuclear power plants (NPPs). On the basis of in-depth interviews with 18 control-crew operators, we identified 25 causes of coordination breakdown related to work processes, personnel, and situation and organisation. In addition, we observed 12 control-crew training sessions that dealt with emergencies and conducted lag-sequential analysis. The levels of coordination effectiveness were evaluated using the proportion of coordination breakdowns and the anticipation ratio. We found that higher-performing teams exhibited more non-random coordination behavioural patterns than did lower-performing teams. Coordination-behaviour patterns specific to the higher-performing teams included adaptive workload management (from senior operators) and proactive seeking performance monitoring (from junior operators). The findings of the study enrich our understanding of the critical factors and processes that influence coordination effectiveness of NPP control crews. Practitioner summary: Causes of coordination breakdowns among control crews of NPPs were identified based on in-depth interviews with control-crew operators, and behavioural-pattern analysis of control crews in 12 training sessions were analysed to reveal the patterns that differentiate higher- and lower-performing teams. The findings of the study enrich our understanding of the critical factors and processes that influence the coordination effectiveness of NPP control crews. Abbreviations: NPP: nuclear power plant; RO: reactor operator; TO: turbine operator; CO: coordinator; SRO: senior reactor operator.

Social ties influence teamwork when managing clinical emergencies.

BACKGROUND: Our current understanding of medical team competence is traditionally influenced by an individualistic perspective focusing on individual team members' knowledge, skills as well as on effective communication within the team. However, team dynamics may influence team performance more than previously anticipated. In particular, recent studies in other academic disciplines suggest that social ties between team members may impact team dynamics but this has not been explored for medical teams. We aimed to explore intensive care staff's perceptions about teamwork and performance in clinical emergencies focusing particularly on the teams' social ties. METHODS: Semi-structured interviews were conducted with a purposive sample of intensive care staff. We used a thematic analysis approach to data interpretation. RESULTS: Thematic saturation was achieved after three group interviews and eight individual interviews. Findings demonstrated that social ties influenced teamwork by affecting the teams' ability to co-construct knowledge, coordinate tasks, the need for hierarchy, the degree to which they relied on explicit or implicit communication, as well as their ability to promote adaptive behavior. CONCLUSIONS: Social ties may be an important factor to consider and acknowledge in the design of future team training, as well as for work planning and scheduling of team activities during clinical practice. More research is needed into the causal effect of social ties on team performance and outcome.

Beyond Dyadic Coordination: Multimodal Behavioral Irregularity in Triads Predicts Facets of Collaborative Problem Solving.

We hypothesize that effective collaboration is facilitated when individuals and environmental components form a synergy where they work together and regulate one another to produce stable patterns of behavior, or regularity, as well as adaptively reorganize to form new behaviors, or irregularity. We tested this hypothesis in a study with 32 triads who collaboratively solved a challenging visual computer programming task for 20 min following an introductory warm-up phase. Multidimensional recurrence quantification analysis was used to examine fine-grained (i.e., every 10 s) collective patterns of regularity across team members' speech rate, body movement, and team interaction with the shared user interface. We found that teams exhibited significant patterns of regularity as compared to shuffled baselines, but there were no systematic trends in regularity across time. We also found that periods of regularity were associated with a reduction in overall behavior. Notably, the production of irregular behavior predicted expert-coded metrics of collaborative activity, such as teams' ability to construct shared knowledge and effectively negotiate and coordinate execution of solutions, net of overall behavioral production and behavioral self-similarity. Our findings support the theory that groups can interact to form interpersonal synergies and indicate that information about system-level dynamics is a viable way to understand and predict effective collaborative processes.