The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork.

OBJECTIVE: This study empirically investigates the relationships between visibility attributes and both patients' and staff members' teamwork experiences. BACKGROUND: Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics. METHODS: This article measured teamwork perceptions of staff members and patients at four primary care clinics providing team-based care. Visual access to staff workstations from both staff and patient perspectives was analyzed using VisualPower tool(version 21). The relationships between teamwork perception and visibility attributes were analyzed for each entity: staff members and patients. RESULTS: The results showed that the visual relationships among staff members and those between staff members and patients have significant associations with overall perceptions of teamwork. While clinics providing more visual connections between staff workstations reported higher teamwork perception of staff members, patient perceptions of staff teamwork were inversely related to the number of visual connections between patients and staff workstations. CONCLUSIONS: The findings of the study provide implications for designing team-based primary care clinics to enhance the teamwork experience of both staff members and patients, which is also applicable to teamwork perceptions in other settings where both inhabitants and visitors are main user groups of the spaces. This study illustrates the representational function of space: Organizations can emphasize their values via layout design by regulating what they show to inhabitants or visitors.

Job search and employment success: A quantitative review and future research agenda.

Job search is an important activity that people engage in during various phases across the life span (e.g., school-to-work transition, job loss, job change, career transition). Based on our definition of job search as a goal-directed, motivational, and self-regulatory process, we present a framework to organize the multitude of variables examined in the literature on job seeking and employment success. We conducted a quantitative synthesis of the literature to test relationships between job-search self-regulation, job-search behavior, and employment success outcomes. We also quantitatively review key antecedents (i.e., personality, attitudinal factors, and contextual variables) of job-search self-regulation, job-search behavior, and employment success. We included studies that examined relationships with job-search or employment success variables among job seekers (e.g., new labor market entrants, unemployed individuals, employed individuals), resulting in 378 independent samples (N = 165,933). Most samples (74.3%, k = 281) came from articles published in 2001 or later. Findings from our meta-analyses support the role of job-search intensity in predicting quantitative employment success outcomes (i.e., rc = .23 for number of interviews, rc = .14 for number of job offers, and rc = .19 for employment status). Overall job-search intensity failed to predict employment quality. Our findings identify job-search self-regulation and job-search quality as promising constructs for future research, as these predicted both quantitative employment success outcomes and employment quality. Based on the results of the theoretical and quantitative synthesis, we map out an agenda for future research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Work in the 21st century: New directions for aging and adult development.

The changing nature of work is having a profound impact on the human experience, particularly among older workers. Two integrative theoretical and empirical frameworks of adult development over the past 3 decades provide new insights into aging and work in the 21st century. The first framework focuses on adult intellect and the second on work motivation. We provide a brief review of these frameworks, discuss the implications for reconsidering adult work lives in the context of interindividual differences, intraindividual change, and external forces, and argue for greater attention to individual differences in knowledge, skills, and motivation. Six broad themes, arising from the convergence of theory, research findings, and emerging patterns of work, are proposed as guides for forging new directions on the intellectual and motivational aspects of adult development in the world of 21st century work. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Backstage Staff Communication: The Effects of Different Levels of Visual Exposure to Patients.

OBJECTIVE: This article examines how visual exposure to patients predicts patient-related communication among staff members. BACKGROUND: Communication among healthcare professionals private from patients, or backstage communication, is critical for staff teamwork and patient care. While patients and visitors are a core group of users in healthcare settings, not much attention has been given to how patients' presence impacts staff communication. Furthermore, many healthcare facilities provide team spaces for improved staff teamwork, but the privacy levels of team areas significantly vary. METHOD: This article presents an empirical study of four team-based primary care clinics where staff communication and teamwork are important. Visual exposure levels of the clinics were analyzed, and their relationships to staff members' concerns for having backstage communication, including preferred and nonpreferred locations for backstage communication, were investigated. RESULTS: Staff members in clinics with less visual exposure to patients reported lower concerns about having backstage communication. Staff members preferred talking in team areas that were visually less exposed to patients in the clinic, but, within team areas, the level of visual exposure did not matter. On the other hand, staff members did not prefer talking in visually exposed areas such as corridors in the clinic and visually exposed areas within team spaces. CONCLUSIONS: Staff members preferred talking in team areas, and they did not prefer talking in visually exposed areas. These findings identified visually exposed team areas as a potentially uncomfortable environment, with a lack of agreement between staff members' preferences toward where they had patient-related communication.

For Whom the Pandemic Tolls: A Person-Centric Analysis of Older Workers.

We offer a worker-centric perspective on the impact of the COVID-19 pandemic for the aging workforce. We briefly describe 3 broad characteristics of pandemics-mortality salience, isolation from the workplace, and rising unemployment-in terms of their associated pathways of influence on older workers, and recommendations for future research.

Future time perspective: A systematic review and meta-analysis.

The ability to foresee, anticipate, and plan for future desired outcomes is crucial for well-being, motivation, and behavior. However, theories in organizational psychology do not incorporate time-related constructs such as Future Time Perspective (FTP), and research on FTP remains disjointed and scattered, with different domains focusing on different aspects of the construct, using different measures, and assessing different antecedents and consequences. In this review and meta-analysis, we aim to clarify the FTP construct, advance its theoretical development, and demonstrate its importance by (a) integrating theory and empirical findings across different domains of research to identify major outcomes and antecedents of FTP, and (b) empirically examining whether and how these variables are moderated by FTP measures and dimensions. Results of a meta-analysis of k = 212 studies reveal significant relationships between FTP and major classes of consequences (i.e., those related to achievement, well-being, health behavior, risk behavior, and retirement planning), and between antecedents and FTP, as well as moderating effects of different FTP measures and dimensions. Highlighting the importance of FTP for organizational psychology theories, our findings demonstrate that FTP predicts these outcomes over and above the big five personality traits and mediates the associations between these personality traits and outcomes. (PsycINFO Database Record

Motivation related to work: A century of progress.

Work motivation is a topic of crucial importance to the success of organizations and societies and the well-being of individuals. We organize the work motivation literature over the last century using a meta-framework that clusters theories, findings, and advances in the field according to their primary focus on (a) motives, traits, and motivation orientations (content); (b) features of the job, work role, and broader environment (context); or (c) the mechanisms and processes involved in choice and striving (process). Our integrative review reveals major achievements in the field, including more precise mapping of the psychological inputs and operations involved in motivation and broadened conceptions of the work environment. Cross-cutting trends over the last century include the primacy of goals, the importance of goal striving processes, and a more nuanced conceptualization of work motivation as a dynamic, goal-directed, resource allocation process that unfolds over the related variables of time, experience, and place. Across the field, advances in methodology and measurement have improved the match between theory and research. Ten promising directions for future research are described and field experiments are suggested as a useful means of bridging the research-practice gap. (PsycINFO Database Record

Age and reemployment success after job loss: An integrative model and meta-analysis.

Despite widespread popular concern about what it means to be over 40 and unemployed, little attention has been paid in the literature to clarifying the role of age within the job seeking experience. Extending theory, we propose mechanisms by which chronological age affects job search and reemployment outcomes after job loss. Through a meta-analysis and examination of 2 supplemental datasets, we examine 5 questions: (a) How strong is the relationship between age and reemployment speed? (b) Does age disadvantage individuals with respect to other reemployment outcomes? (c) Is the relationship between age and reemployment outcomes mediated by job search activities? (d) Are these relationships generalizable? and (e) Are these relationships linear or curvilinear? Our findings provide evidence for a negative relationship between age and reemployment status and speed across job search decade, world region, and unemployment rate, with the strength of the negative relationship becoming stronger over age 50. Job search self-efficacy and job search intensity partially mediate the relationship between age and both reemployment status and speed. (PsycINFO Database Record

Future time perspective and promotion focus as determinants of intraindividual change in work motivation.

In the near future, workforces will increasingly consist of older workers. At the same time, research has demonstrated that work-related growth motives decrease with age. Although this finding is consistent with life span theories, such as the selection optimization and compensation (SOC) model, we know relatively little about the process variables that bring about this change in work motivation. Therefore, we use a 4-wave study design to examine the mediating role of future time perspective and promotion focus in the negative association between age and work-related growth motives. Consistent with the SOC model, we found that future time perspective was negatively associated with age, which, in turn, was associated with lower promotion focus, lower work-related growth motive strength, and lower motivation to continue working. These findings have important theoretical implications for the literature on aging and work motivation, and practical implications for how to motivate older workers.

Use it or lose it? Wii brain exercise practice and reading for domain knowledge.

We investigated the training effects and transfer effects associated with 2 approaches to cognitive activities (so-called brain training) that might mitigate age-related cognitive decline. A sample of 78 adults between the ages of 50 and 71 completed 20 one-hr training sessions with the Nintendo Wii Big Brain Academy software over the course of 1 month and, in a second month, completed 20 one-hr reading sessions with articles on 4 different current topics (order of assignment was counterbalanced for the participants). An extensive battery of cognitive and perceptual speed ability measures was administered before and after each month of cognitive training activities, along with a battery of domain-knowledge tests. Results indicated substantial improvements on the Wii tasks, somewhat less improvement on the domain knowledge tests, and practice-related improvements on 6 of the 10 ability tests. However, there was no significant transfer of training from either the Wii practice or the reading tasks to measures of cognitive and perceptual speed abilities. Implications for these findings are discussed in terms of adult intellectual development and maintenance.

Test length and cognitive fatigue: an empirical examination of effects on performance and test-taker reactions.

Person and situational determinants of cognitive ability test performance and subjective reactions were examined in the context of tests with different time-on-task requirements. Two hundred thirty-nine first-year university students participated in a within-participant experiment, with completely counterbalanced treatment conditions and test forms. Participants completed three test sessions of different length: (a) a standard-length SAT test battery (total time 4(1/2) hr), (b) a shorter SAT test battery (total time 3(1/2) hr), and (c) a longer SAT test battery (total time 5(1/2) hr). Consistent with expectations, subjective fatigue increased with increasing time-on-task. However, mean performance increased in the longer test length conditions, compared with the shorter test length condition. Individual differences in personality/interest/motivation trait complexes were found to have greater power than the test-length situations for predicting subjective cognitive fatigue before, during, and at the end of each test session. The relative contributions of traits and time-on-task for cognitive fatigue are discussed, along with implications for research and practice. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Simulation-based crisis team training for multidisciplinary obstetric providers.

BACKGROUND: The use of team training programs is promising with regards to their ability to impact knowledge, attitudes, and behavior about team skills. The purpose of this study was to evaluate a simulation-based team training program called Obstetric Crisis Team Training Program (OBCTT) (based on the original training program of Crisis Team Training) framed within a multilevel team theoretical model. We hypothesized that participation in OBCTT would positively impact 10 variables: individual's knowledge (about team process and obstetric emergency care); confidence and competence in handling obstetric emergencies; and participant attitudes (toward the utility of a rapid response team, simulation technology as a teaching methodology, the utility of team skills in the workplace, comfort in assuming team roles; and individual and team performance). Improvement of objectively measured team performance in a simulated environment was also assessed. METHODS: Twenty-two perinatal health care professionals (attending physicians, nurses, resident, and nurse midwives) volunteered to participate in this pretest-posttest study design. All participants were given an online module to study before attending a 4-hour training session. Training consisted of participation in four standardized, simulated crisis scenarios with a female birthing simulator mannequin. Team simulations were video recorded. Debriefings were conducted after each simulation by having team members review the video and discuss team behaviors and member skills. Self-report measures of perinatal and team knowledge as well as several attitude surveys were given at the beginning and again at the end of the training session. A postsimulation attitude survey was administered immediately after the first and last simulation, and a course reaction survey was administered at the end of the training program. Objective task completion scores were computed after each simulation to assess performance. RESULTS: There were significant (P<0.004) improvements in three of the outcome variables, after controlling for type I error with Bonferroni's correction; attitudes toward competence in handling obstetric emergencies (t=1.6), as well as individual (t=4.2), and team performance (t=4.1). The remaining 6 variables, attitude toward simulation technology, attitude toward the rapid response team; confidence in handling obstetric emergencies; utility of team skills in the workplace; comfort in assuming various team roles; and knowledge, were not statistically significant. Overall task completion from the first to the last simulation (XF, df=3, n=3, 8.2, P=0.042) substantially improved (P<0.05). CONCLUSION: The crisis team training model is applicable to obstetric emergencies. Trainees exhibit a positive change in attitude; perception of individual and team performance, and overall team performance in a simulated environment. The ability of individuals to accurately assess their performance improved as a result of training.

Age and gender diversity as determinants of performance and health in a public organization: the role of task complexity and group size.

The influence of age and gender composition on group performance and self-reported health disorders was examined with data from 4,538 federal tax employees working in 222 natural work unit groups. As hypothesized, age diversity correlated positively with performance only in groups solving complex decision-making tasks, and this finding was replicated when analyzing performance data collected 1 year later. Age diversity was also positively correlated with health disorders--but only in groups working on routine decision-making tasks. Gender composition also had a significant effect on group performance, such that groups with a high proportion of female employees performed worse and reported more health disorders than did gender-diverse teams. As expected, effects of gender composition were most pronounced in large groups. Effects of age diversity were found when controlling for gender diversity and vice versa. Thus, age and gender diversity seem to play a unique role in performance and well-being. The moderating role of task complexity for both effects of age diversity and the moderating role of group size for both effects of gender diversity further suggest that the impact of these 2 variables depends on different group processes (e.g., knowledge exchange, variation in gender salience).

A multilevel study of leadership, empowerment, and performance in teams.

A multilevel model of leadership, empowerment, and performance was tested using a sample of 62 teams, 445 individual members, 62 team leaders, and 31 external managers from 31 stores of a Fortune 500 company. Leader-member exchange and leadership climate related differently to individual and team empowerment and interacted to influence individual empowerment. Also, several relationships were supported in more but not in less interdependent teams. Specifically, leader-member exchange related to individual performance partially through individual empowerment; leadership climate related to team performance partially through team empowerment; team empowerment moderated the relationship between individual empowerment and performance; and individual performance was positively related to team performance. Contributions to team leadership theory, research, and practices are discussed.

The predictive validity of self-efficacy in training performance: little more than past performance.

Past research on the influence of self-efficacy in training has provided mixed results. Key differences between studies pertain to whether past performance is operationalized as a residual variable or as an unadjusted variable and to the type of task used. In this study, the authors conducted and performed a reanalysis to examine the influence of self-efficacy using both operationalizations of past performance in 2 experimental tasks. Results indicate that, regardless of task version or type, self-efficacy predicted performance only when a residual measure of past performance was used, but not when past performance was unadjusted. However, when past performance was adjusted, the findings for self-efficacy were likely a statistical artifact. These results suggest that self-efficacy is a consequence rather than a cause of performance in training.

Determinants and consequences of health worker motivation in hospitals in Jordan and Georgia.

Health worker motivation reflects the interactions between workers and their work environment. Because of the interactive nature of motivation, local organizational and broader sector policies have the potential to affect motivation of health workers, either positively or negatively, and as such to influence health system performance. Yet little is known about the key determinants and outcomes of motivation in developing and transition countries. This exploratory research, unique in its broader study of a whole range of motivational determinants and outcomes, was conducted in two hospitals in Jordan and two in Georgia. Three complementary approaches to data collection were used: (1) a contextual analysis; (2) a qualitative 360-degree assessment; and (3) a quantitative in-depth analysis focused on the individual determinants and outcomes of the worker's motivational process. A wide range of psychometric scales was used to assess personality differences, perceived contextual factors and motivational outcomes (feelings, thoughts and behaviors) on close to 500 employees in each country. Although Jordan and Georgia have very different cultural and socio-economic environments, the results from these two countries exhibited many similarities among key determinants: self-efficacy, pride, management openness, job properties, and values had significant effects on motivational outcomes in both countries. Where results were divergent, differences between the two countries highlight the importance of local culture on motivational issues, and the need to tailor motivational interventions to the specific issues related to particular professional or other groupings in the workforce. While workers themselves state that financial reward is critical for their work satisfaction, the data suggest a number of non-financial interventions that may be more effective means to improve worker motivation. This research highlights the complexity of worker motivation, and the need for a more comprehensive approach to increasing motivation, satisfaction and performance, and for interventions at both organizational and policy levels.

Health sector reform and public sector health worker motivation: a conceptual framework.

Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms may have differential impacts on various cadres of health workers.