Introduction: Efforts to improve health care in the US are focusing on the Quadruple Aim which targets enhanced patient experiences, population health management, control of costs and improved provider satisfaction. Traditional academic centers have fallen behind in preparing pediatricians to practice in this new milieu; pediatric residents consistently report feeling least competent in systems-based practice. To better prepare residents to enter the work force, we introduced a team based care curriculum for pediatric residents in the 2016-2017 academic year. Methods: Participants in the new curriculum included all 21 residents in our academic based residency program. An inter-professional team developed a curriculum consisting of six core modules: team care, team communication, quality improvement, health care roles, champion teams and advanced communications. Prior to participation, residents completed a pre-test of knowledge and the validated Attitudes Toward Health Care Teams scale. The same instruments were administered after completion of the modules. Results: All 21 pediatric residents completed the pre and post-tests. Resident knowledge significantly improved from a pre-test score of 63% to a post test score of 70% (p< 0.05). The Quality Improvement and Team Roles subtests showed significant improvement (p<0.05). On the Attitudes Towards Health Care Teams scale, the residents had a favorable attitude toward team value and team efficiency; these did not significantly change from pre to post-test. Pediatric residents’ attitudes toward physicians shared role in the team improved significantly (p<0.01). They reported enhanced attitudes regarding two key constructs: 1) shared team leadership and responsibility and 2) limits on physician control of team function. Conclusions: While pediatric residents in general had a favorable view of team-based care, participation in a team-based care curriculum positively affected their views of the physician’s role on a team. Understanding shared labor within a team, may help residents to achieve the fourth Quadruple Aim of satisfaction in healthcare by all providers.

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To offer an insight into the themes which will be explored at the Masterclass, in this short video Dr. McKenzie Calhoun and colleagues at the ETSU Family Physicians in Kingsport, Tennessee discuss how a model of interprofessional collaboration is typically applied and put into practice in the care of patients at the center. They highlight the importance and value of a team-based approach in enhancing the provision of primary healthcare.

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Collaborative practice among interprofessional groups of health care providers is essential to the provision of safe and effective medical care. However, health professions training programs have not traditionally prepared students for interprofessional practice. One challenge in transforming health professions education programs has been a limited number of faculty prepared to teach students in an interprofessional learning environment. Thus, faculty development programs aimed at preparing faculty to provide interprofessional learning experiences across disciplines are increasingly important. Unfortunately, best practice in training faculty for interprofessional education programs is not well-defined. Interprofessional education faculty development programs should aim to train faculty to model and teach interprofessional education competencies, including collaboration; however, a faculty member’s culture orientation may impact their collaborative skills. Of the four subscales of the Individualism-Collectivism Scale, horizontal collectivism is the subscale most aligned with collaborative team-based competencies. Few, if any, studies have examined culture orientation in academic health science faculty. The current study explored culture orientation in academic health science faculty across five colleges at a southern university. Comparisons were made on each of the four Individualism-Collectivism subscales between academic health science faculty who had attended and had not attended an interprofessional education faculty development program. Also, comparisons were made by faculty members’ status as a first-generation student, type of courses taught, and gender. Correlations between scores on each subscale and years of teaching in higher education were also examined. Results indicated that the faculty members who had attended the interprofessional education faculty development program were significantly higher in horizontal collectivism than faculty who had not attended this program. Also, faculty who taught clinical courses were higher in vertical individualism than faculty who taught nonclinical courses. Implications for interprofessional practice, education, and faculty development are discussed, and recommendations for future research and practice are made.

yes / Introduction Combining Contents with Strategy: A Case for Team-Based Learning. The term "biosecurity‟ has been used in many different contexts for many different purposes. The present Handbook uses the concept of "biosecurity‟ (or biological security) to mean successful minimising of the risks that the biological sciences will be deliberately or accidentally misused in a way which causes harm for humans, animals, plants or the environment, including through awareness and understanding of the risks. Biosecurity thus involves a complex and rapidly evolving set of issues that concern a broad range of stakeholders: policy makers, legislators, industry, academia, the security community, science educators, life science students and practitioners, and the general public.1 Addressing those issues requires continuous cooperation among all concerned parties, that is, biosecurity awareness is a responsibility incumbent upon all. The need for fostering awareness of biological security among those engaged in the life sciences has been widely acknowledged in various fora and, as a result, over the past few years a number of important initiatives have been carried out, designed to further education about the broader social, ethical, security and legal implications of cutting-edge biotechnology.2 The chief objective of the present Handbook is to complement those efforts by combining teaching material in biological security with an active learning training approach – Team-Based Learning (TBL) – to empower educators, students and practitioners as they begin to engage with biological security. The Handbook seeks to supplement the Guide "Preventing Biological Threats: What You Can Do‟ by providing its users with tips and insights into how to implement its content in different educational settings. Part 5 of the Guide introduces the reader to the value of active learning in the context of biosecurity education and training. Chapter 20 in particular details the implementation of the TBL format at an interactive biosecurity seminar and the results achieved by the seminar participants. Consequently, the Handbook aims to: i. Highlight the strengths of the TBL format in teaching biological security. ii. Provide practical guidance on how to organise, run, and facilitate TBL biosecurity seminars. iii. Offer sample sets of exercises based on the individual chapters of the Guide. iv. Explain how each set of exercises can be used for achieving specific learning objectives. Each chapter of the Handbook introduces the reader to a key concept discussed in the respective chapter of the Guide and elaborates on the specific learning objectives, which the TBL exercises are aimed at. Each set comprises Individual and Team Readiness Assurance Test questions, and Application Exercises in the form of multiple-choice problem-solving tasks and practical scenarios (see below). A growing body of evidence suggests that the use of active learning approaches to teaching and training can significantly enhance the effectiveness of education programmes.3 Part of the reason behind this trend is the fact that active learning strategies aid the learner in „unlocking‟ their existing knowledge and linking new subject matter to their established conceptual framework.4 In other words, through case studies, scenarios, problem-solving games, role plays, and simulations – to name few examples of active learning methods – learners are prompted to think critically, reflect and develop understanding of unfamiliar concepts. Active learning approaches allow fostering a learner-centred environment where the learner rather than the instructor is at the centre of the activities taking place in the classroom.5 The Handbook focuses on a specific format of active learning instruction – Team Based Learning (TBL). This is a special form of collaborative learning which uses a specific sequence of individual work, group work, and immediate feedback to create a motivational framework, whereby the focus is shifted from conveying concepts by the instructor to the application of concepts by student teams.6 TBL is an easy-to-replicate, user-friendly approach, that can be applied in many different educational settings at various stages of instruction, and for different purposes. It enables the instructor to cover new material in a way that engages learners as active participants, allowing them to take ownership of their own learning, and develop reflection and self-evaluation skills.

Yes / The learning and teaching strategy for a pharmacy consultation skills module was changed to Team-Based Learning (TBL) with the aim of motivating students to engage with course material pre-class and take deeper approaches to learning during class. Results from administering a validated TBL instrument suggests that students are more accountable and are satisfied with and have preference for TBL over traditional methods. Exam results show a 13% improvement in mean end-of-year examinations compared with pre-TBL results. Thematic analysis of written comments on the module evaluation survey suggest that they enjoyed learning using TBL and found it more engaging, stimulating and more effective for their learning; however, it could be improved through better management of workshop timings and more effective facilitation of discussion. TBL appears to have potential as a pedagogic approach in pharmacy education.

O estudo da biologia animal, tendo como eixo integrador a evolução biológica, é uma forte recomendação no currículo nacional. A temática é bastante importante para a construção dos saberes científicos acerca da noção de diversidade, funcionamento dos ecossistemas e dos processos evolutivos, fisiológicos e morfológicos dos seres vivos. O foco no processo de ensino e de aprendizagem deve ser o desenvolvimento das capacidades de pesquisar e analisar informações, da capacidade de aprender e de adotar uma postura engajada em prol do meio ambiente. Dentro desse contexto o professor deve adotar estratégias metodologicamente ativas com valorização da contextualização, de atividades dinamizadas e colaborativas para contribuir para uma aprendizagem significativa. As atividades escolares devem ser pensadas sob a ótica da participação ativa do aluno, valorizando seus conhecimentos prévios para, desta forma, promover a aquisição do conhecimento e o desenvolvimento das habilidades e atitudes necessárias para o domínio das competências indicadas nos Parâmetros Curriculares Nacionais. A proposta para este trabalho envolveu a elaboração de uma sequência didática cuja fundamentação teórica foi pautada nos seguintes aspectos: a Aprendizagem Significativa de David Ausubel, a abordagem sociointeracionista de Vygostsky e a Metodologia Ativa da Aprendizagem Baseada em Equipes (ABE) proposta por Larry Michaelsen. A metodologia utilizada na pesquisa foi composta por diferentes estratégias sob uma abordagem quali e quantitativa de pesquisa-ação em duas turmas do segundo ano do Ensino Técnico Integrado ao Médio na disciplina de Biologia. Foram propostas atividades que, em sequência, possibilitaram o desenvolvimento de competências específicas da biologia e competências transversais: a aplicação adaptada da ABE e um projeto escolar de observação de aves. Ao mapear os resultados de todas as etapas, que incluiu análises de índices e formulários de opinião, o pesquisador pôde observar que atividades desencadeadas sob um viés construtivista contribuíram para o aproveitamento e satisfação escolar. / The study of animal biology, having as an integrating axis the biological evolution, is a strongly recommended topic in the national curriculum. The theme is very important for the construction of scientific knowledge about the notion of diversity, functioning of ecosystems and the evolutionary, physiological and morphological processes of living beings. The focus on the teaching and learning process should be the development of the research capacity and analytical skill, the ability to learn and to develop an awareness of the environmental issues. Within this context, the teacher must adopt methodologically active strategies with valuation of the contextualization, of dynamic and collaborative activities to contribute to a significant learning. School activities should be thought from the perspective of the active participation of the student, valuing their previous knowledge in order to promote the acquisition of knowledge and the development of the skills and attitudes necessary for the mastery of the competencies indicated in the National Curricular Parameters. The proposal for this work involved the elaboration of a didactic sequence whose theoretical foundation was based on the following aspects: Significant Learning of David Ausubel, the socio-interactionist approach of Vygostsky and the Active Methodology of the Team-Based Learning (TBL) proposed by Larry Michaelsen. The methodology used in this research was composed by different strategies under a qualitative and quantitative approaches of action- research in two classes of the second year of Integrated High School and Technical Education in the discipline of Biology. Activities were proposed that sequentially enabled the development of specific competences of biology and personal soft skills: the adapted application of the TBL methodology and the School Bird-watching Project. By mapping the results of all steps, which included numerical index analyzes and opinion forms, the researcher was able to observe that activities triggered under a constructivist bias contributed to academic achievement and satisfaction.

Made available in DSpace on 2016-04-27T13:10:26Z (GMT). No. of bitstreams: 1 Carlos Alberto de Oliveira.pdf: 2862192 bytes, checksum: f7f40d45250a304d594a733cc3b6a8e9 (MD5) Previous issue date: 2014-12-17 / The aim in proposing this intervention was to use and evaluate the use of TBL as a methodology of teaching and learning in a medical school. The hypothesis that it was possible to replace the lectures in our universities, for TBL sessions with teacher training and student participatory interest in compliance with the National Curriculum Guide was present. The importance of the work is grounded in the mandatory changes that must occur in medical education, due to these recently approved guidelines; in the valuation of medical professionals prepared to working in multidisciplinary teams, committed to ethical and humanitarian care and, finally, the challenge of teaching in large rooms, with huge amounts of students, heterogeneous and in need of individualized formative assessments. The session was held in TBL in the format proposed by the TBL Collaborative Group (USA), during the theoretical supports of the second year. Prior to the sessions was distributed articles with the content of the lesson, fully contemplating the module objectives. In summary, we highlight that the average individual score was much lower than the average score of the team, with 99.999% reliability. The best individual performance was worse than the performance of their own team. The students demonstrated in their responses to the questionnaire, acceptability to the method. Teachers approved the activities highlighting not being able to apply the TBL sessions. After the study, we believe that this active methodology will provide students with better knowledge building, provided they are responsible with their preparedness / O objetivo ao propor essa intervenção foi empregar e avaliar o uso do TBL como uma estratégia metodológica de ensino-aprendizagem em um curso de Medicina. A hipótese de que era possível substituir as aulas teóricas, em nossas universidades, por sessões em TBL, com a capacitação docente e o interesse participativo discente, em atendimento às Diretrizes Curriculares Nacionais esteve presente. A importância do trabalho se alicerça nas mudanças obrigatórias que devem ocorrer no ensino médico, em função destas diretrizes aprovadas recentemente; na valorização dos profissionais médicos, preparados para trabalharem em equipes multidisciplinares, comprometidos com a ética e cuidados humanitários e, por fim, no desafio de ensinar em salas grandes, com quantidades enormes de estudantes, heterogêneas e com necessidades de avaliações formativas individualizadas. A sessão em TBL foi realizada na formatação proposta pelo TBL Collaborative Group (EUA), durante a sustentação teórica do segundo ano. Previamente às sessões disponibilizamos artigos referentes ao conteúdo da aula, que atendesse plenamente aos objetivos propostos no módulo de Perturbações Hemodinâmicas. Como resumo dos achados, destacamos a diferença, com 99,999% de confiança, entre a média da pontuação individual quando comparada com a média da pontuação em equipe. O melhor desempenho individual foi pior do que o desempenho de sua equipe. Os discentes demonstraram, em suas respostas ao questionário, aceitabilidade ao método. Os docentes aprovaram as atividades destacando não estarem capacitados para realizar as sessões em TBL na sua plenitude. Após a realização do estudo, acreditamos que esta metodologia ativa propiciará aos estudantes uma melhor construção de conhecimentos, desde que sejam responsáveis com sua preparação prévia

This is an essay about health promotion and organisation development. The problem concerning all health issues that can be tied to work related illnesses has long been a problem in Sweden. For example did this problem alone cost the Swedish government 25 million crones a day between the years 2000-2001. This is a major issue and there is lots of money to save in this area. This is why we wanted to research how to promote health by changing the structure of the selected company. One model that has been given more approval is the flat team based organisations where the workers themselves get to take vital decisions concerning for example their own workstation and work hours. There are no bosses telling them what to do. The teams that the workers are placed in have all the control over their station and the thought is that the teams are going to work as a business in the company itself. With this in mind we would like to shed some light on which conditions team based organisations have for pursuing health-promoting work. This leads us directly in on our problem based questions at this matter. · How can a team-based organisation be described and understood from a healtpromoting perspective? · Which terms are important in a team-based organisation to develop a health promoting work climate? A part of the result of this study shows that to provide a good work climate in a team based organisation you have to have a leader that dare to let go a hand over the responsibility to his co-workers. His role has changed from a leading boss to a guide that works as a sounding board. Because of more people being involved in the whole process the communication is a vital part in making the new organisation work. As well as communication, learning new things is also a part in making the personnel more involved in the company. With knowing comes insight that brings a more meaningful feeling to the minds of the workers. So to make this short, learning, communication, understanding, a guiding leader and a sense of meaning is some of the most vital things to have in mind when creating a more inspiring environment for your co-workers. / Mellan år 2000 och 2001 hade staten sjukfrånvarorelaterade kostnader på cirka 25 miljoner kronor per dag (personlig kommunikation med forskaren Gunnar Aronsson från Arbetslivsinstitutet). Av detta kan det förstås att sjukfrånvaron är ett stort problem för såväl staten som företagen runt om i Sverige. Massor med pengar finns att spara, frågan är bara hur man ska gå tillväga. Ett sätt att få bukt med problemen har varit att företagen har börjat se över sina organisationsuppbyggnader och hur de kan utformas för att skapa friskare arbetsplatser. Bland annat har teambaserade organisationer blivit allt vanligare där integrering av medarbetarna i verksamheten är en central del. Tanken är att ta vara på medarbetarnas kunskaper och göra dem delaktiga och ansvarstagande. (Hanson, 2004, s. 25,229-230) Med bakgrund av detta är syftet med denna uppsats att utveckla kunskap om den teambaserade organisationens förutsättningar att bedriva ett hälsopromotivt arbete. Detta gör vi genom att studera ett företag som både har etablerat en teambaserad organisation och utvecklat ett hälsopromotivt arbetssätt. Vi har använt oss av en kvalitativ intervjustudie där sex av medarbetarna på företaget har intervjuats. Dock är syftet även att ta det hela ytterligare ett steg genom att inte endast se på saken utifrån det valda företagets perspektiv, utan även med hjälp av lämplig litteratur på området se mer generellt på vad en teambaserad organisation betyder för ett hälsopromotivt arbetsklimat. Därmed lyder våra frågeställningar som följer: § Hur kan en teambaserad organisation beskrivas och förstås utifrån ett hälsopromotivt perspektiv? § Vilka villkor är väsentliga inom en teambaserad organisation för att utveckla ett hälsopromotivt arbetsklimat? Resultatet av undersökningen visar att det är betydande för ett hälsopromotivt arbetsklimat i teamorganisationer att ha en ledare som vågar släppa ansvar och befogenheter till sina medarbetare och som mer fungerar som en stöttepelare och vägledare än en som talar om vad som ska göras. Vidare har kommunikation visat sig vara betydelsefullt för att medarbetarna i teamen ska förstå och lära känna varandra och kunna samarbeta på ett bra sätt, vilket gör att det blir roligare och lättare att gå till jobbet. Att satsa på kompetensutveckling är ett tredje villkor för att utveckla ett hälsopromotivt arbetsklimat. Att hela tiden lära sig nya saker stimulerar människan och skapar ett engagemang och en ökad förståelse för hur saker och ting hänger samman på arbetsplatsen. Har man denna förståelse blir det lättare att hantera situationer som uppstår, vilket i sin tur leder till att en meningsfullhet för den aktuella saken kan kännas. I arbetet har vi även lyft fram relationen mellan effektivitet och humanitet. Det är nämligen så att teambaserade organisationer inte endast har kommit till för att främja medarbetarnas hälsa. Det har även varit en metod för att öka effektiviteten på företagen. I och med att man tar vara på människans kunskaper och låter dem vara kreativa och ansvarstagande tror man att det är ett vinnande koncept både för medarbetarna själva och för företaget. Dock har det visat sig att det många gånger istället har lett till utbrändhet på grund av otydlighet och minskad fritid. (Hanson, 2004 s. 23-26) Men efter att ha genomfört denna studie där ett företag som har lyckats med sitt hälsopromotiva arbete har studerats har vi funnit att det viktigaste är att sätta människan i centrum. Hon måste komma före vinstintressen. Genom att se och prata med alla medarbetarna kan både ledaren och arbetskamrater upptäcka om något inte står rätt till med någon. Det är också viktigt att ledningen har en öppenhet mot sina anställda och informerar och kommunicerar ut hur företaget ligger till och så vidare. Det leder till en trygghet för de anställda.