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In recent years, the concept of One Health (OH) has arisen as an approach that helps to catalyze the creation of transdisciplinary teams needed for surveillance and investigation of emerging disease dynamics. Besides a wealth of descriptions of what the OH approach encompasses, a dearth of information is available regarding the training of individuals in OH competencies. In 2019, the Nigerian Center for Disease Control developed an OH strategic plan to meet the country's human, animal, and environmental health challenges. In response to the demand for clinicians, scientists, climatologists, conservationists, and environmentalists, who have expertise in environment, human, plant, and animal health to work collaboratively in addressing OH challenges in Nigeria. An interprofessional group of faculty from the University of Texas Medical Branch, the University of Jos, and the National Veterinary Research Institute convened to develop a novel OH course 'entitled 'One Health for Translational Team Science. The objective of the course was to explore the evolution of an emerging epidemic, capitalizing on various learning environments, including animal, environmental, human, and public health perspectives. The 6-week course comprised of three parts: 2-weeks virtual part of case-based group discussions focusing on animal and environmental aspects, 2 weeks of individual field experiences, and a final virtual part focusing on human health. Pedagogical tools used were: case-based group discussions, breakout group presentations, role-play activities, field project write-up, peer evaluation, group writing assignments, and weekly reflections with the goal of working in teams to develop and practice the fundamental leadership and management skills in addressing emerging public health challenges. Post-course evaluations showed that all participants felt more confident identifying and practicing the necessary attitudes and skills to participate effectively in the evaluation of an outbreak. Furthermore, the roles, responsibilities, and "One Health ways of thinking" for the various disciplines and professions involved in improving global health were articulated and identified.
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One Health , Nigeria , Humans , Curriculum , Interprofessional Relations , Health Policy , Cooperative BehaviorABSTRACT
While considerable attention has been devoted to positive leadership patterns in the realm of project management, the dark side of leadership has rarely been studied within project teams. To address this gap, we focus on abusive supervision in project teams and develop a team-level moderated mediation model to examine whether, how, and when abusive supervision influences project outcomes by drawing from the Proactive Motivation Theory. Survey data were collected from 132 project teams containing 132 project managers and 392 project members using a multi-source time-lagged survey design. Our findings reveal significant negative relationships between abusive supervision and both project performance and project team creativity. Furthermore, we found that a team's proactive behavior plays a mediating role in these relationships. More importantly, our study identifies that team building mitigates the direct negative impact of abusive supervision on proactive behavior and the indirect effects of abusive supervision on project performance and project team creativity. These findings provide valuable theoretical and managerial implications for abusive supervision and project management scholars and practitioners.
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BACKGROUND: Rescue operations are in Norway defined as situations where patients are difficult to access or that more resources are needed than the health services alone possess and can put in operation (Bull A, Redningshåndboken er endelig her! [Internet]. Hovedredningssentralen. 2018 [cited 2023 May 15]. Available from: https://www.hovedredningssentralen.no/redningshandboken-er-endelig-her/ ). Rescue operations after large incidents may include civil protection, military forces, non-governmental organizations and other resources, but the initial rescue effort must be performed by the emergency services as time often is of essence. The central area of an accident where special training and personal protection equipment is necessary or mandatory is called the Hot Zone. This study examines Urban Search And Rescue (USAR) firefighters and police officers reported experiences from ambulance personnel's contribution in the Hot Zone. METHODS: We conducted five focus group interviews with USAR-trained firefighters and police officers. The interviewees were those on duty on the agreed dates. The interviews were taped, transcribed, and analysed using thematic analysis as described by Braun & Clarke. RESULTS: Three themes were identified; Feeling safe during missions, Building USAR capacity, and Trust-building within USAR-teams. The firefighters and police officers reported their and the patients' safety are best managed by EMS-personnel, whose presence strongly contributes to their own feeling of safety in a dangerous area. When EMS handles victims and injured emergency workers, firefighters and police officers can focus on their own primary tasks. Indeed, interviewees reported that building a USAR capacity depends on having USAR-trained EMS-personnel in the Hot Zone. The interviewees have clear and consistent opinions on how to establish an interagency USAR capacity effectively. Trust is paramount to the interviewees, and they express a high degree of trust within USAR Oslo. CONCLUSIONS: Firefighters and police officers regard USAR-trained EMS-personnel as a natural and integrated part in urban search and rescue teams. EMS-personnel in the dangerous area deliver safety and medical professional assistance to both rescue workers and patients. Informants in this study had clear opinions on how to establish and maintain such a service.
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Firefighters , Police , Humans , Female , Male , Animals , Cattle , Dogs , Police/education , Firefighters/education , Paramedics , Focus Groups , Rescue WorkABSTRACT
Objective: In this paper, we present a comprehensive overview of our experience in establishing and leading distinct extracorporeal cardiopulmonary resuscitation (ECPR)-related teams to independently handle ECPR in the early stages in the emergency department. Methods: A retrospective analysis was conducted on the clinical data of 29 patients who underwent ECPR treatment in the emergency room between May 2018 and April 2022. A control group, consisting of 10 patients treated between May 2018 and September 2019 was managed using a standard rescue coordination mode. The 19 patients who received ECPR between October 2019 and April 2022 were treated by members of the department's 24-h extracorporeal life support team. We compared the implementation and operational challenges faced by the two groups, including item preparation, circuit setup, and ECPR initiation times, among other factors. Results: Gender, age, cardiac arrest risk factors, and other baseline data did not significantly differ between the two groups. Extracorporeal membrane oxygenation (ECMO) pipeline prefilling time (from 35.27±10.34 to 13.46±5.32), ECPR establishment time (from 62.35±29.61 to 30.98±13.41), and item preparation time (from 16.42±9.78 to 3.19±1.49) all considerably decreased when compared to the control group. The rate of return of spontaneous circulation recovery rose from 37.50 % to 77.78 % (P < 0.05). The consequences of gastrointestinal and pulmonary bleeding were greatly reduced while ECPR was being used, and the difference was statistically significant (P < 0.05). Significant improvements were made in the ECPR weaning rate (from 25.00 % to 38.89 %) and survival rate (from 20.0 % to 36.8 %). Conclusion: The establishment of a 24-h extracorporeal life support team significantly reduced the time needed for rescue during the early stage of independent setup of ECPR in the emergency department and serves as a guide for effective care of critically ill patients.
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In April 2023, the first American Roentgen Ray Society (ARRS) Wellness Summit was held in Honolulu, Hawaii. The Summit was a communal call to action bringing together professionals from the field of radiology to critically review our current state of wellness and reimagine the role of radiology and radiologists to further wellbeing. The in-person and virtual Summit was available free-of-cost to all meeting registrants and included 12 sessions with 44 invited moderators and panelists. The Summit aimed to move beyond simply rehashing the repeated issues and offering theoretical solutions, and instead focus on intentional practice evolution, identifying implementable strategies so that we as a field can start to walk our wellness talk. Here, we first summarize the thematic discussions from the 2023 ARRS Wellness Summit, and second, share several strategic action items that emerged.
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Burnout, Professional , Radiology , United States , Humans , X-Rays , RadiologistsABSTRACT
Although all committee work can be fraught with difficulty and laborious time commitments, committees designed to disrupt the cycle of inequity and bias are particularly fraught with social and emotional land mines that come as baggage to years of unaddressed inequity. As such, leaders must take special care and attend to the complex psychology that underpins the difficult discussions that must be had by these committees as they begin to address topics of inequity within professional medical institutions. The authors describe, in an accessible summary format, how to lay the foundations for a smooth transition into the work of a diversity, equity, and inclusion committee, the best steps to build a team, and the core concepts that should underpin all diversity, equity, and inclusion work, starting from the intrapersonal level and moving toward the organizational level. This is done with the help of available scientific data where they are available, including literature on teamwork, health equity, and psychological safety, among other topics.
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Diversity, Equity, Inclusion , Health Equity , Humans , Emotions , Psychological SafetyABSTRACT
A positive culture is important to team retention and a successful business. Building a culture is not a fast process, but it is worth the hard work and time. Building up and supporting leaders is necessary to building a good team and a great culture. Team leadership must be courageous and open to communication as it is key to a successful and positive culture. The practice must be a psychologically safe workplace that encourages the team to learn from mistakes and take risks. The team needs to be involved in building and maintaining a great culture.
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Communication , Leadership , Animals , Patient Care TeamABSTRACT
Talents are the core driving force to promote the high-quality development of public hospitals,and the talent team building is an important factor for hospitals to get sustainable development and improve comprehensive competitiveness.In view of the shortage of high-level talents,the imperfect talent reserve system,and the lagging personnel management mechanism of public hospitals and the resulting unreasonable talent team structure and talent gap,public hospitals should take talent team building as the starting point,pay equal attention to the introduction and training of talents,interact with discipline construction and talent construction,vigorously promote the construction of personnel management system and mechanism innovation,form a standardized,scientific,refined and efficient modern hospital management system,so that the effectiveness of talents can be max-imized,and provide intellectual support for the high-quality development of public hospitals.
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Biomedical graduate students receive intensive training in their scientific area of interest yet need additional skills for successful scientific careers. Our aim was to promote team building, improve collaborations and enhance communication skills. An off-site yearly retreat was organized for the graduate students in our NIH-funded Research Initiative for Scientific Enhancement (RISE) graduate training program. Retreat themes were addressed through short presentations, case studies, live podcasts, webinars, focus groups, role-play, and breakout sessions with various team building exercises to practice communication skills and identify abilities, knowledge, values, and behaviors. Trainees gave short presentations and served as discussion leaders on topics related to the central theme. Expert guest speakers participated in discussion sessions with the trainees. Trainees evaluated the retreats at the end. A total of 48 trainees, 12 RISE Program faculty and staff, and 26 external speakers from industry, academia, media/journalism, the arts, psychology, and holistic medical fields participated over 9 years. The overall average benefit of the in-person retreats was rated 4.80 on a Likert scale of 1-5 by trainees. Trainees particularly enjoyed the informal interactions with program faculty, staff, and fellow trainees. They appreciated the opportunity to learn soft skills, such as interpersonal communication, conflict resolution, and leadership. Two additional retreats conducted virtually because of the COVID-19 pandemic were perceived as less beneficial. We conclude that off-site interactive retreats are a valuable tool for enhancing soft skills and a sense of team identity in a biomedical sciences graduate program, while covering important issues related to scientific careers.NEW & NOTEWORTHY Off-site interactive science-related retreats are a valuable tool for enhancing soft skills and sense of team identity in a biomedical sciences graduate program, while covering important issues related to pursuing a career in science. There are many perceived benefits, so we encourage other training programs to include a similar type of regular activity in students' training with the goal of improving trainee well-being and supporting their academic and research productivity.
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Faculty , Pandemics , Humans , Education, Medical, Graduate , Students , CommunicationABSTRACT
BACKGROUND: The conflict between Russia and Ukraine has strained the health systems of countries that welcome war refugees on all levels, from national to local. Despite the Public Health guidelines regarding assistance being published on the topic, the scientific literature currently lacks evidence on the experience of applying theory in practice. This study aims to describe evidence-based practices that were implemented and to provide a detailed description of emerging problems and solutions pertaining Ukrainian refugee assistance in the context of one of the biggest Local Health Authorities in Italy (LHA Roma 1). METHODS: LHA Roma 1 developed a strategic plan based on local expertise, national and international guidelines to ensure infectious disease prevention and control, as well as continuity of care for non-communicable diseases and mental health. RESULTS: The insertion of Ukrainian refugees in the National Health System through an identification code assignment and other services such as COVID-19 swab and vaccination were provided either in one of the three major assistance hubs or in local district level ambulatories spread throughout the LHA. Many challenges were faced during the implementation phase of the outlined practice guidelines, which required sensible and timely solutions. These challenges include the necessity of rapid resource provision, overcoming linguistic and cultural barriers, guaranteeing a standard of care across multiple sites and coordination of interventions. Public Private Partnerships, the creation of a centralized multicultural and multidisciplinary team and the mutually beneficial collaboration with the local Ukrainian community were essential to guarantee the success of all operations. CONCLUSIONS: The experience of LHA Roma 1 helps shed light on the importance of leadership in emergency settings and how a dynamic relationship between policy and practice would allow each intervention to be modulated according to the local environment, to better realize the potential of local realities to provide appropriate health interventions to all those in need.
Subject(s)
COVID-19 , Refugees , Roma , Humans , Public Policy , Health PolicyABSTRACT
BACKGROUND: Palliative care teams work under challenging conditions in a sensitive setting with difficult tasks. The multi-professional team can play an important role. Mindfulness and compassion-based practices are used to build resilience. Our aim was to examine (1) feasibility and acceptability, (2) satisfaction and impact, and (3) opportunities and limitations of a mindfulness course. METHODS: An eight-week mindfulness and compassion course was delivered in a university-based specialized palliative care unit. A meditation teacher provided preparatory evening sessions and meditation exercises that could be integrated into daily activities. The scientific analysis of the course was based on a questionnaire developed for quality assessmentThe first two parts consisted of demographic, Likert-type, and free-text items. Part 3 consisted of learning objectives that were self-assessed after finishing the course (post-then). In the analysis, we used descriptive statistics, qualitative content analysis, and comparative self-assessment. RESULTS: Twenty four employees participated. 58% of participants attended 4 or more of the 7 voluntary mindfulness days. 91% expressed moderate to high satisfaction and would recommend the palliative care program to others. Three main categories emerged in the qualitative content analysis: providing feedback on the course, personal impact, and impact on professional life. The opportunity for self-care in a professional context was highlighted. Learning gains (CSA Gain) were high (38.5-49.4%) in terms of knowledge and techniques, moderate (26.2-34.5%) in terms of implementation of learned skills, and rather low (12.7-24.6%) in terms of changes to attitude. CONCLUSION: Our evaluation shows that the participants of a mindfulness and compassion course considered it as a feasible and welcome tool to familiarize a multi-professional palliative care team with self-care techniques. TRIAL REGISTRATION: Internal Clinical Trial Register of the Medical Faculty, Heinrich Heine University Düsseldorf, No. 2018074763 (registered retrospectively on 30th July 2018).
Subject(s)
Empathy , Mindfulness , Palliative Care , Self Care , Humans , Mindfulness/methods , Palliative Care/psychology , Retrospective Studies , Self-Assessment , Self Care/methods , Self Care/psychologyABSTRACT
Despite the importance of teamwork in the operating room (OR), teamwork can often be conflated with teamwork components (e.g., communication, cooperation). We reviewed the existing literature pertaining to OR teamwork to understand which teamwork components have been assessed. Following PRISMA guidelines for scoping reviews, 4,233 peer-reviewed studies were identified using MEDLINE and Embase. Eighty-seven studies were included for synthesis and analysis. Using the episodic model of teamwork as an organizing framework, studies were grouped into the following teamwork categories: (a) transition processes (e.g., goal specification), (b) action processes (e.g., coordination), (c) interpersonal processes (e.g., conflict management), (d) emergent states (e.g., psychological safety), or (e) omnibus topics (a combination of higher-order teamwork processes). Results demonstrated that action processes were most frequently explored, followed by transition processes, omnibus topics, emergent states, and interpersonal processes. Although all studies were framed as investigations of teamwork, it is important to highlight that most explored only one or a few constructs under the overarching umbrella of teamwork. We advocate for enhanced specificity with descriptions of OR teamwork, reporting practices pertaining to interprofessional demographics and outcomes, and increased diversity in study design and surgery type to advance understanding of teamwork and its implications.
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Interprofessional Relations , Operating Rooms , Humans , Communication , Cooperative Behavior , Patient Care TeamABSTRACT
Interdisciplinary research teams can be extremely beneficial when addressing difficult clinical problems. The incorporation of conceptual and methodological strategies from a variety of research disciplines and health professions yields transformative results. In this setting, the long-term goal of team science is to improve patient care, with emphasis on population health outcomes. However, team principles necessary for effective research teams are rarely taught in health professional schools. To form successful interdisciplinary research teams in cardio-oncology and beyond, guiding principles and organizational recommendations are necessary. Cardiovascular disease results in annual direct costs of $220 billion (about $680 per person in the US) and is the leading cause of death for cancer survivors, including adult survivors of childhood cancers. Optimizing cardio-oncology research in interdisciplinary research teams has the potential to aid in the investigation of strategies for saving hundreds of thousands of lives each year in the United States and mitigating the annual cost of cardiovascular disease. Despite published reports on experiences developing research teams across organizations, specialties and settings, there is no single journal article that compiles principles for cardiology or cardio-oncology research teams. In this review, recurring threads linked to working as a team, as well as optimal methods, advantages, and problems that arise when managing teams are described in the context of career development and research. The worth and hurdles of a team approach, based on practical lessons learned from establishing our multidisciplinary research team and information gleaned from relevant specialties in the development of a successful team are presented.
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Emergency first responders (EFRs) such as police officers, firefighters, paramedics and logistics personnel often suffer high turnover due to work-related stress, high workloads, fatigue, and declining professional wellbeing. As attempts to counter this through resilience programmes tend to have limited success, there is a need for further research into how organisational policies could change to improve EFRs' professional wellbeing. AIM: To identify the factors that may contribute to or affect EFRs' professional wellbeing. METHODS: A systematic literature review has been carried out. Three databases (Science Direct, ProQuest, and PubMed) were searched using keywords developed based on the PICo (population, interest, and context) framework. A total of 984 articles were extracted. These were then critically appraised for the quality of the evidence presented, leading to a total of five being ultimately included for review. RESULTS: Thematic analysis revealed that although EFRs may be exposed daily to traumatic events, factors that contribute to a decline in professional wellbeing emerge from within the organisational environment, rather than from the event itself. CONCLUSION: The study concludes that organisational and team relations factors significantly impact EFRs ability to cope with stress. As such, organisational policy should evolve to emphasise team relations over resilience programmes.
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Emergency Responders , Occupational Stress , Humans , Occupations , Police , Occupational Stress/epidemiology , Adaptation, PsychologicalABSTRACT
This study aimed to evaluate a newly developed gamification-based intervention of serious play training (SPT). A randomized controlled trial was conducted to assess the efficacy of the new intervention program in comparison with a widely adopted cognitive-behavioral training (CBT) program. Real-life work teams were recruited to enhance the ecological validity of outcome evaluation. The participants comprised 250 Chinese working adults (68% men; median age = 25 years, range: 18-40) who took part voluntarily. They were randomly assigned to the SPT, CBT, and waitlist conditions. For outcome evaluation, team effectiveness was the primary outcome, whereas coping flexibility was the secondary outcome. For explanation of outcome changes, group cohesion and discriminative thinking were tested as the hypothesized learning mechanisms. The results revealed that the SPT group alone reported greater team effectiveness over time, with an increase in group cohesion found to explain the improvement. Both the SPT and CBT groups reported greater coping flexibility over time, with discriminative thinking found to account for the beneficial changes. These findings provide initial evidence indicating the efficacy of utilizing the gamification approach in corporate training for team-building and personal coping.
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Purpose: To study the effect of a communication tool entitled: "I START-END" (I-Identify; S-Story; T-Task; A-Accomplish/Adjust; R-Resources; T-Timely Updates; E-Exit; N-Next; D-Document and Debrief) in simulated urgent scenarios in non-operating room settings (referred to as "Ad Hoc") with anesthesia residents. The "I START-END" tool was created by incorporating Crisis Resource Management (CRM) principles into a practical and user-friendly format. Methods: This was a mixed methods pre/post observational study with 47 anesthesia resident volunteers participating from July 2014 to June 2016. Each resident served as their own control, and participated in three simulated Ad Hoc scenarios. The first simulation served as a baseline. The second simulation occurred 1-2 weeks after I START-END training. The third simulation occurred 3-6 months later. Simulation performance was videotaped and reviewed by trained experts using technical skill checklists and Anesthesia Non-Technical Skills (ANTS) score. Residents filled out questionnaires, pre-simulation, 1-2 weeks after I START-END training and 3-6 months later. Concurrently, resident performance at actual Code Blue events was scored by trained observers using the Mayo High Performance Teamwork Scale. Results: 80-90% of residents stated the tool provided an organized approach to Ad Hoc scenarios - specifically, information helpful to care of the patient was obtained more readily and better resource planning occurred as communication with the team improved. Residents stated they would continue to use the tool and apply it to other clinical settings. Resident video performance scores of technical skills showed significant improvement at the "late" session (3-6 months post exposure to the I START-END). ANTS scores were satisfactory and remained unchanged throughout. There was no difference between residents with and without I START-END training as measured by the Mayo High Performance Teamwork Scale, however, debriefing at Code Blues occurred twice as often when residents had I START-END training. Conclusion: Non-operating room settings are fraught with unfamiliarity that create many challenges. The I START-END tool operationalizes key CRM elements. The tool was well received by residents; it enabled them to speak up more readily, obtain vital information and continually update each other by anticipating, planning, and debriefing in an organized and collaborative way.
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In ball games, individuals collaborate to enhance their team's performance by sharing images and ideas that have not been verbalized. One of a coach's roles is to ascertain whether players share a common understanding of their team's images so as to devise tactics. Accordingly, this study aimed to verify the hypothesis that sharing images such as tacit knowledge that has not been verbalized occurs in collective interaction when utterances increase substantially during problem-solving. The participants were 13 male university handball players whose teams were championship contenders in Japan. A mixed methods research design was employed. Scenes in which two groups engaged in problem-solving were recorded and data of each participant's utterances were obtained. The utterances were analyzed quantitatively by employing Smirnoff-Grubbs and the time periods including those with a substantial number of utterances were identified. What happened during the identified time periods verified as outliers including the high frequency utterances were analyzed qualitatively by employing consensual qualitative analysis. Finally, the results of the consensual qualitative analysis were used to examine statistically to determine whether specific events occurred during times of extreme high frequency utterances. The exact binomial test was used to determine the 95% confidence interval of the population ratio and the effect size (g) of the mother ratio (0.05) to determine whether non-verbalized images such as tacit knowledge were being shared among members. Of the 26 time periods, 22 were supported the hypothesis. Of the time periods with extremely high utterances, the population ratio of the time periods supporting the hypothesis was 0.846 (CI = 0.681-1.00, g = 0.80). The results revealed that tacit image sharing occurred when there were a substantial number of utterances. This study demonstrated the possibility that sharing images that have not been verbalized occurs in collective interaction when there is a hotspot of utterances.
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Due to its great creative potential for innovation and scientific discovery, inter- and multidisciplinary collaboration is being increasingly encouraged by institutions and funding agencies. The increased opportunities in the multidisciplinary arena also come with significant challenges like the added experimental, analytical and logistical complexity, blended with a high likelihood of miscommunications. When is multidisciplinarity worth the effort, and how can we be better collaborators? With a focus on cross-disciplinary collaborative work to answer burning questions in biology and biomedicine, this paper discusses both large challenges and opportunities with multidisciplinary biophotonics, how we can better navigate the arena of big data and artificial intelligence combined with open, reproducible science and biological discoveries.
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Artificial Intelligence , Deep LearningABSTRACT
As collaborative work in medical education has increasingly moved online, team mentors have had to adapt their practices into the virtual environment. Fostering connection, communication and productivity on virtual teams requires specific skills and deliberate practice that differ from in-person teamwork. Drawing from best practices in business, education and medicine and also from our own experience as a virtual team, we present a guide for mentors to create and sustain successful virtual teams. Grounded in Tuckman's Five Stage Model of Team Development, we offer specific strategies for virtual team mentors to promote team cohesion, mitigate conflict, maintain productivity and leverage the benefits of the virtual environment.
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Education, Medical , Mentors , Communication , HumansABSTRACT
BACKGROUND: With the growing number of older and old patients as well as patients affected by multimorbidity, cognitive impairments and frailty in hospital and expansion of long-term care, the challenges in the various geriatric and gerontological care settings are also increasing. Social networks and resources become fragile due to the changing family structures. A strong interprofessional team building and networking of the main actors in the nursing and healthcare systems become necessary. OBJECTIVE: A qualification program for students of medicine, social work and relevant study courses for nursing was established. In this program participants should collectively learn to deal with the concerns and needs of geriatric patients in a case-related manner and to develop suitable plans for treatment and interventions. METHOD: The qualification program for interprofessional team building was evaluated during the development phase as a pilot project and scientifically evaluated (nâ¯= 78) using the Freiburg questionnaire on interprofessional learning evaluation (FILE). RESULTS: The program experienced a high level of approval by approximately 98% of the participants. The measurement of change showed an improvement in team skills and ability to work in a team. CONCLUSION: Opening up a learning field for interprofessional learning and working to students of different disciplines and professions during their studies creates a good basis for successful interprofessional team building in the subsequent professional practice. The interuniversity and interprofessional teaching project presented is now firmly anchored in the curriculum at the participating universities with the teaching module "The geriatric patient". It is therefore a possible model for similar projects.