Nickel-palladium bimetallic nanoparticles supported on multi-walled carbon nanotubes; versatile catalyst for Sonogashira cross-coupling reactions.

We have developed an efficient method to generate highly active nickel-palladium bimetallic nanoparticles supported on multi-walled carbon nanotubes (Ni-Pd/MWCNTs) by dry mixing of the nickel and palladium salts utilizing the mechanical energy of a ball-mill. These nanoparticles were successfully employed in Sonogashira cross-coupling reactions with a wide array of functionalized aryl halides and terminal alkynes under ligand and copper free conditions using a Monowave 50 heating reactor. Notably, the concentration of palladium can be lowered to a minimum amount of 0.81% and replaced by more abundant and less expensive nickel nanoparticles while effectively catalyzing the reaction. The remarkable reactivity of the Ni-Pd/MWCNTs catalyst toward Sonogashira cross-coupling reactions is attributed to the high degree of the dispersion of Ni-Pd nanoparticles with small particle size of 5-10 nm due to an efficient grinding method. The catalyst was easily removed from the reaction mixture by centrifugation and reused several times with minimal loss of catalytic activity. Furthermore, the concentration of catalyst in Sonogashira reactions can be reduced to a minimum amount of 0.01 mol% while still providing a high conversion of the Sonogashira product with a remarkable turnover number (TON) of 7200 and turnover frequency (TOF) of 21 600 h-1. The catalyst was fully characterized by a variety of spectroscopic techniques including X-ray diffraction (XRD), transmission electron microscopy (TEM) and X-ray photoelectron spectroscopy (XPS).

What are the critical success factors for team training in health care?

BACKGROUND: Ineffective communication among medical teams is a leading cause of preventable patient harm throughout the health care system. A growing body of literature indicates that medical teamwork improves the quality, safety, and cost-effectiveness of health care delivery, and expectations for teamwork in health care have increased. Yet few health care professions' curricula include teamwork training, and few medical practices integrate teamwork principles. Because of this knowledge gap, growing numbers of health care systems are requiring staff to participate in formal teamwork training programs. Seven evidence-based, practical, systematic success factors for preparing, implementing, and sustaining a team training and performance improvement initiative were identified. Each success factor is accompanied by tips for deployment and a real-world example of application. SUCCESS FACTORS: (1) Align team training objectives and safety aims with organizational goals, (2) provide organizational support for the team training initiative, (3) get frontline care leaders on board, (4) prepare the environment and trainees for team training, (5) determine required resources and time commitment and ensure their availability, (6) facilitate application of trained teamwork skills on the job; and (7) measure the effectiveness of the team training program. DISCUSSION: Although decades of research in other high-risk organizations have clearly demonstrated that properly designed team training programs can improve team performance, success is highly dependent on organizational factors such as leadership support, learning climate, and commitment to data-driven change. Before engaging in a teamwork training initiative, health care organizations should have a clear understanding of these factors and the strategies for their establishment.

Communicating, coordinating, and cooperating when lives depend on it: tips for teamwork.

BACKGROUND: In health care, others' lives depend on the team operating at a level beyond the sum of its individual parts. A framework (a heuristic) represents a three-pronged approach to teamwork in health care that entails communication, coordination, and cooperation. These fundamental requirements of teamwork represent the constant interaction that team members undertake to become an effective team. Guidelines, tips, and examples show how the framework can be applied to establishing and enabling teams to provide safe, reliable care. GUIDELINES: The guidelines are as follows: (1) Support precise and accurate communication through a closed-loop communication protocol; (2) diagnose communication errors as you would any illness--Examine the team and look for symptoms, then treat the symptoms through team learning and self-correction; (3) recognize functional expertise by identifying and publicizing topical experts to evenly distribute work load and increase accuracy; (4) institute frequent practice opportunities to keep team skills in good shape because poorly honed skills will limit performance; (5) refine the team's shared mental models (SMMs) by pre-planning to build its implicit coordination skills, adaptability, and flexibility; (6) shape adaptive expertise by fostering a deep understanding of the task to increase team effectiveness; (7) build team orientation by taking steps to increase trust and cohesion to lower stress levels and increase satisfaction, commitment, and collective efficacy; and (8) prepare the team by providing learning opportunities for new competencies that will expose members to feedback and increase the team's overall efficacy. CONCLUSION: Although not a comprehensive list, the guidelines and tips represent the most essential requirements for effective teamwork.

Using simulation-based training to improve patient safety: what does it take?

BACKGROUND: Through simulations health care workers can learn by practicing skills taught and experiencing mistakes before interacting with an actual patient. A number of areas within the health care industry are currently using simulation-based training to help individuals and teams improve patient safety. WHAT IS SIMULATION-BASED TRAINING? The key components of simulation-based training are as follows: performance history/skill inventory, tasks/competencies, training objectives, events/exercises, measures/metrics, performance diagnosis, and feedback and debrief. WHAT DOES IT TAKE FOR SIMULATION-BASED TRAINING TO BE EFFECTIVE? To be effective, simulation-based training must be implemented appropriately. The guidelines are as follows: understand the training needs and requirements; instructional features, such as performance measurement and feedback, must be embedded within the simulation; craft scenarios based on guidance from the learning outcomes; create opportunities for assessing and diagnosing individual and/or team performance within the simulation; guide the learning; focus on cognitive/psychological simulation fidelity; form a mutual partnership between subject matter experts and learning experts; and ensure that the training program worked. CONCLUSION: The health care community can gain significantly from using simulation-based training to reduce errors and improve patient safety when it is designed and delivered appropriately.

Measuring team performance in simulation-based training: adopting best practices for healthcare.

Team performance measurement is a critical and frequently overlooked component of an effective simulation-based training system designed to build teamwork competencies. Quality team performance measurement is essential for systematically diagnosing team performance and subsequently making decisions concerning feedback and remediation. However, the complexities of team performance pose a challenge to effectively measuring team performance. This article synthesizes the scientific literature on this topic and provides a set of best practices for designing and implementing team performance measurement systems in simulation-based training.

Errors in the heat of battle: taking a closer look at shared cognition breakdowns through teamwork.

OBJECTIVE: We developed a theoretically based taxonomy for classifying shared cognition breakdowns related to teamwork which contribute to fratricide incidents. BACKGROUND: Fratricide on the battlefield is an inescapable cost of war. A number of technological advancements have been made in terms of combat identification systems to reduce the risk of these incidents. However, fratricide continues to occur at alarming rates. METHOD: We take a human-centered approach to understanding errors leading to fratricide incidents by focusing on shared cognition. We turn to the literature and provide the theoretical foundations for an error classification taxonomy to improve understanding of why fratricide incidents occur. RESULTS: Based on our review of the literature, we identified a number of problem areas leading to fratricide incidents. However, many of the cited contributing factors were broad terms (e.g., poor coordination) and did little to tell us why the breakdown occurred and where improvements are needed. Therefore, we chose to focus on one specific area--teamwork breakdowns--and discuss in depth how these breakdowns contribute to fratricide. CONCLUSION: In this paper, we take a first step toward proposing a taxonomy that allows for the diagnostic assessment of what causes teamwork breakdowns in fratricide. We understand that a taxonomy is only as good as the data available and encourage richer case studies from which to learn. APPLICATION: To apply this taxonomy in an operational setting, we provide a set of behavioral markers that can be used to identify teamwork breakdowns on the battlefield.

Does crew resource management training work? An update, an extension, and some critical needs.

OBJECTIVE: This review provides the state of crew resource management (CRM) training evaluations since the E. Salas, C. S. Burke, C. A. Bowers, and K. A. Wilson (2001) review and extends it to areas beyond aviation cockpits. Some critical evaluation needs in CRM training are also covered. BACKGROUND: Because of the purported success of CRM training in aviation, other high-consequence domains have begun to implement CRM training for their workforces. However, the true impact of CRM training in aviation and these other domains has yet to be determined. METHOD: Using D. L. Kirkpatrick's (1976) framework for evaluating training (i.e., reactions, learning, behavior, and organizational impact), we reviewed 28 published accounts of CRM training to determine its effectiveness within aviation, medicine, offshore oil production and maintenance, shipping/maritime, and nuclear power domains. RESULTS: Findings indicate that CRM training generally produced positive reactions from trainees; however, the impact of training on learning and behavioral changes suggest mixed results across and within domains. Furthermore, and as was found by Salas, Burke, et al. in 2001, we cannot ascertain whether CRM has had an impact on the organization's bottom line (i.e., safety). CONCLUSION: Based on the results, there are several critical needs that the CRM training community must address before CRM training can have the desired impact on safety: a mandate, access to data, and resources. APPLICATION: As CRM training expands to organizations beyond aviation, it is critical that its impact be understood such that it can be improved and achieve the intended results.