Adverse events and medical errors plague the healthcare system. Hospital acquired infections and teamwork are some of the biggest contributor to these adverse outcomes. In an effort to mitigate these problems, administrators and clinicians alike have developed mechanisms, such as telemedicine. However, little research has been conducted investigating the role of telemedicine on teamwork -- a fundamental component of quality patient care. The purpose of this study is to gain a better understanding of the impact of telemedicine on teamwork behaviors and subsequent teamwork attitudes and cognitions during a common medical task, rounds within the Trauma-Intensive Care Unit. To this end, rounds were conducted with and without telemedicine. During this 60 day period, 16 clinicians completed three surveys and 34 rounds were video recorded. The results of this study suggest that the relationships between teamwork attitudes, behaviors, cognitions, and outcomes are differential impacted under conditions with and without telemedicine. More specifically, telemedicine is associated with an increase in attendance and communication density. Meanwhile, it does not significantly impact teamwork attitudes or cognitions. The primary implications of these findings indicate that telemedicine is not the solution for improving all teamwork elements but yet it is not a complete detriment either

This thesis presents contributions to the theory and practice of team activity recognition. A particular focus of our work was to improve our ability to collect and label representative samples, thus making the team activity recognition more efficient. A second focus of our work is improving the robustness of the recognition process in the presence of noisy and distorted data. The main contributions of this thesis are as follows: We developed a software tool, the Teamwork Scenario Editor (TSE), for the acquisition, segmentation and labeling of teamwork data. Using the TSE we acquired a corpus of labeled team actions both from synthetic and real world sources. We developed an approach through which representations of idealized team actions can be acquired in form of Hidden Markov Models which are trained using a small set of representative examples segmented and labeled with the TSE. We developed set of team-oriented feature functions, which extract discrete features from the high-dimensional continuous data. The features were chosen such that they mimic the features used by humans when recognizing teamwork actions. We developed a technique to recognize the likely roles played by agents in teams even before the team action was recognized. Through experimental studies we show that the feature functions and role recognition module significantly increase the recognition accuracy, while allowing arbitrary shuffled inputs and noisy data.

<P> With the rise of globalization, international assignments and multicultural teams, managing cultural diversity has become essential to organizations. As managing cultural diversity in team work has historically been a challenge (Earley & Gibson , 2002), academics and practitioners have directed resources toward enhancing understanding of how best to manage team diversity and improve effectiveness of international assignments (Tsui et al, 2007). Cultural Intelligence (CQ) is the abi lity to behave effectively in culturally diverse situations (Earley & Ang, 2003). Theory and research suggest that cultural diversity within teams often relate negatively to team member experiences of team processes, thereby negatively impacting team outcomes. The current study relies on similarity/attraction theory (Byrne, 1971 ), social identification theory (Turner, 1982) and self-categorization theory (Turner. 1982) to evaluate the relationship between cultural diversity and team processes (cohesion , participation, relationship and task conflict) and team outcomes (performance and satisfaction). The moderating effect of Cultural Intelligence on the relationship between cultural diversity and team processes was also explored. Data were collected from fourth year business school students working in teams of four to six to manage a virtual company competing with other teams in a stimulated market. A significant negative relationship was found between cultural diversity and team cohesion and participation; and a significant positive relationship was noted between cultural diversity and both team relationship conflict and task conflict. Furthermore, team satisfaction correlated positively with team cohesion and negatively with both types of team conflict while team performance was unrelated to team cultural diversity and perceptions of team processes. Finally, team members' CQ positively moderated the relationship between team cultural diversity and team processes (cohesion, participation and relationship conflict), where the team was comprised of two different cultures only. Where teams were comprised of members from more than two cultural groups, the moderation was negative. </p> / Thesis / Doctor of Philosophy (PhD)

This study compared the accuracy of criminal profiles produced by individuals versus profiles produced by teams of two. Participants were 239 college students who were randomly assigned to work alone or in a team. Participants were asked to read a double sexual homicide case, profile the offender, and answer the Profiling Offender Characteristics Questionnaire. The results indicate that although novice profiler teams only slightly outperformed individuals on overall profile accuracy, teamwork significantly improved profiling accuracy for the cognitive characteristics of the offender. In contrast, teams and individuals showed similar profile accuracy for all other facets of the offender. These results may reflect the type of reasoning used by teams and individuals to profile different offender characteristics.

Interpersonal conflict in organizations plays an important role in performance, but the exact nature of that role remains unclear. Among conflict researchers a shift has occurred from believing that all conflict is debilitating for organizational performance to the realization that there are both positive and negative aspects of conflict. Contemporary research adopts a distinction between task conflict and relationship conflict. Conceptually, a positive relationship has been proposed between task conflict and performance, while a negative relationship has been proposed between relationship conflict and performance. Empirically, however, there has been wide variation in the findings linking either type of conflict with performance. A recent meta-analysis by De Wit and Greer (2008) found that across studies linking task conflict and performance, findings reflected positive, negative and no relationships. Similarly, for relationship conflict, though a predominantly negative relationship was found across studies, there was wide variation in relationship magnitudes across studies. These meta-analytic results show that the effects sizes across both types of conflict studies are mainly negative. However, given the large standard deviation estimates in both cases, there were also positive effect sizes in some of the studies. The wide variation across studies leads to the conclusion that in most studies conflict is detrimental, but in some it truly can be useful. Also, it suggests that the relationship between both task and relationship conflict and performance needs to be clarified. Consequently, this research aims to examine the source of the inconsistencies within the conflict literature by introducing a behavioral taxonomy to help explain the relationship between performance and the two types of conflict. Using a quasi-experimental design to study conflict, I will be able to induce conflict and observe the team behavioral dynamics as they unfold. Revised file, GMc 5/28/2014 per Dean DePauw / Ph. D.

The purpose of this study was to determine the distribution of interdisciplinary team organization in Virginia high schools, to identify common elements of implementation, to assess the importance of those elements as perceived by team members, and to assess the relationship of these factors to school demographics. In this study, an interdisciplinary team was two or more teachers of different disciplines (one of which is a core subject), who share the same students and have a common planning period. A stratified sampling was used to select 123 Virginia high schools of which 67 consented to participate in the study. All core subject teachers in each school were surveyed. The survey used Erb and Doda's (1989) model of four hierarchical developmental areas of interdisciplinary team organization as the research base. / Ed. D.

No / Purpose – The purpose of this paper is to understand the need and resources firefighters have to deal with death and dying (D&D) that they encounter whilst on duty and to present a curriculum to support D&D issues for firefighters. Design/methodology/approach – A qualitative methodology involving focus groups was conducted in two fire stations in Spain. The sample was 38 male participants with a mean age of 46 y/o (range: 30-59 years) and an average tenure of employment of 18 years (range: 6-35 years). Data were subjected to a thematic analysis. Dual coding of the transcripts in addition to member checking enhanced analysis. Findings – Nine themes emerged: witnessing D&D during rescue operations;memories about D&D and trauma; impact on firefighter’s families; decision-making process under stress; teamwork: protective and self-support; inadequate D&D preparation and training; adequate technical and physical training preparation; relationship between equipment, legal-moral obligation, and victims’ outcomes; communication issues: toward the victim and/or their relatives. These themes were subsequently framed into three basic domains: personal impact of D&D, team impact of D&D, and victim impact. Each domain, in its turn, is covered by three curriculum topics. The curriculum’s pedagogy is primarily based on experimental-reflective activities during 16 study-hours. Research limitations/implications – The absence of female participants. All fire stations were in cities with no more than 150,000 inhabitants. Practical implications – Individuals who take this curriculum will: increase their ability for self-care and resilience; improve teamwork, leadership skills, and to decrease burnout; provide more effective care for victims; provide skills to cope with compassion fatigue; reduced the levels of post-traumatic stress disorders. Originality/value – Understanding firefighters’ needs with relation to D&D, and assessing the resources available to mitigate these issues will provide a comprehensive approach to their education and promote health both personally and professionally. A comparable curriculum or proposal has not been previously identified.

Yes / This article reviews studies conducted “in the wild” that explore the “ironies of automation” in Robotic Assisted Surgery (RAS). Workload may be reduced for the surgeon, but increased for other team members, with postural stress relocated rather than reduced, and the introduction of a range of new challenges, for example, in the need to control multiple arms, with multiple instruments; and the increased demands of being physically separated from the team. Workflow disruptions were not compared with other surgeries; however, the prevalence of equipment and training disruptions differs from other types of surgeries. A consistent observation is that communication and coordination problems are relatively frequent, suggesting that the surgical team may need to be trained to use specific verbal and non-verbal cues during surgery. RAS also changes the necessary size of the operating room instrument cleaning processes. These studies demonstrate the value of clinically-based human factors engineers working alongside surgical teams to improve the delivery of RAS. / National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) Programme (project number 12/5005/04). We acknowledge the support of the NIHR Clinical Research Network. The research by Hallbeck and colleagues made possible in part by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The research of Weigl and colleagues was supported by the Munich Centre for Health Sciences (MC-Health). The research by Bisantz and colleagues was supported by the University at Buffalo, the ATLAS lab, and the Roswell Park Alliance Foundation. The research by Anger and Catchpole was funded by National Institute of Biomedical Imaging & Biomedical Engineering Award R03EB017447 (Catchpole/Anger) and the UCLA Medical Student Training in Aging Research Program-the National Institute on Aging (T35AG026736), the John A. Hartford Foundation, and the Lillian R. Gleitsman Foundation.

Yes / This article recounts our experience of eliciting, cataloguing and prioritizing conjectured Context-Mechanism-Outcome configurations at the outset of a realist evaluation, to provide new insight into how Context-Mechanism-Outcome configurations can be generated and theorized. Our construction of Context-Mechanism-Outcome configurations centred on how, why and in what circumstances teamwork was impacted by robotic surgery, rather than how and why this technology improved surgical outcomes as intended. We found that, as well as offering resources, robotic surgery took away resources from the theatre team, by physically reconfiguring the operating theatre and redistributing the surgical task load, essentially changing the context in which teamwork was performed. We constructed Context-Mechanism-Outcome configurations that explain how teamwork mechanisms were both constrained by the contextual changes, and triggered in the new context through the use of informal strategies. We conclude by reflecting on our application of realist evaluation to understand the potential impacts of robotic surgery on teamwork.

Bakgrund: En betydande orsak till många skador och anmälningar som görs inom vården är när muntlig eller skriftlig kommunikation saknar struktur och effektivitet. Detta kan i sin tur leda till att patientsäkerheten blir lidande. SBAR är en kommunikationsmodell som används inom hälso- och sjukvården för att strukturera upp information och presentera viktig fakta på ett snabbt och effektivt sätt, vilket leder till en förbättrad patientsäkerhet. Syfte: Syftet med studien var att undersöka vad sjuksköterskestuderande hade för kunskap och kännedom om kommunikationsmodellen SBAR. Metod: Studien var en kvantitativ deskriptiv studie, där data har samlats in via en enkät som bestod av elva frågor där sju av dem besvarades med svarsalternativ, tre med öppna svarsalternativ och en med skattningsbart svar. Resultat: Resultatet av studien visade på en begränsad kunskap om SBAR modellen, endast tre deltagare kände till den av 25. De ansåg att modellen var lätt att använda, lättförståelig, effektiv och att den ökade patientsäkerheten. Slutsats: Inom sjukvården är det väldigt viktigt att kommunikationen fungerar för att undvika misstag som i sin tur kan äventyra patientsäkerheten. Därför är det angeläget att det finns en kommunikationsmodell som underlättar och strukturerar upp kommunikationen, en sådan modell är SBAR modellen. Studien indikerar på en begränsad kunskap om SBAR modellen hos de sjuksköterskestudenter som deltog i studien. / Background: A significant reason to many damages and announcements that is done within the healthcare is when verbal or written communication lacks on structure and effectiveness. This can also affect on the patient safety. SBAR is a communication model that is used in healthcare to structure information and present important facts on a fast and effective way, this will also improve on patient safety. Aim: The aim with the study was to examine what nurse students had for knowledge and understanding about the communication model SBAR. Method: The study was a quantitative descriptive study, where data have been collected through a questionnaire that consisted of eleven questions, seven of them were multiple choice, three open alternatives and one were the students had to estimate their answers. Results: The result of the study revealed a limited knowledge and understanding about the SBAR model, only three participants had knowledge and understanding of the model on a total of 25 participants. They considered that the model where easy to use, easy understandable, effective and that the model increased patient safety. Conclusion: In the health care sector, it is extremely important that there is a communication model that facilitates and organizes up communication, such a model is SBAR. The study indicates that the nurse students that participated in the study had a meager knowledge of the SBAR model.