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1.
J Appl Psychol ; 109(6): 871-896, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38270988

ABSTRACT

Recognizing the challenges that conflict poses, organizational researchers have invested considerable energy toward investigating the processes by which conflict occurs and spreads within a team. However, current theoretical frameworks of conflict contagion posit a static growth trajectory in which members become engaged in conflict and stay in conflict. While this trajectory is certainly possible, the broader conflict literature outside of the organizational sciences has shown evidence for a more varied set of potential trajectories of conflict contagion. To advance theory on team conflict, we integrate conflict research from micro-level (interpersonal) to macro-level (interstate) perspectives into a formal theory of intrateam conflict contagion. Drawing from conflict stage and social contagion theory, we theorize that team members move through three stages of conflict (disengaged, at-risk, engaged) at rates determined by four process mechanisms (faultlines, forgiveness, frustration, integration) such that disengaged individuals become at-risk of engaging in conflict, engage in conflict, then disengage, only to potentially become at risk of reengaging at a later point in time. Using computational modeling, we demonstrate the generative sufficiency of our theory to account for conflict trajectories observed in the broader conflict literature. To facilitate the interpretation of such trajectories, we present a typology of contagion trajectories, discuss the dynamic properties of these trajectories (e.g., stability, bifurcations), and provide implications for future theory building and practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Conflict, Psychological , Group Processes , Humans , Systems Theory , Employment/psychology , Adult
2.
J Occup Health Psychol ; 27(1): 53-73, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34351190

ABSTRACT

Humanity will mount interplanetary exploration missions within the next two decades, supported by a growing workforce operating in isolated, confined, and extreme (ICE) conditions of space. How will future space workers fare in a closed social world while subjected to persistent stressors? Using a sample of 32 participants operating in ICE conditions over the course of 30-45 days, we developed and tested a dynamic model of conflict and strain. Drawing on conservation of resources (COR) theory, we investigated reciprocal relationships between different forms (i.e., task and relationship) of conflict, and between conflict and strain. Results demonstrated evidence for a resource threat feedback loop as current-day task conflict predicted next-day relationship conflict and current-day relationship conflict predicted next-day task conflict. Additionally, results indicated support for a resource loss feedback loop as current-day relationship conflict predicted next-day strain, and current-day strain predicted next-day relationship conflict. Moreover, we found that job conditions affected these associations as current-day relationship conflict was more associated with next-day task conflict when next-day workload was high, but not when next-day workload was low. Similarly, current-day relationship conflict was more associated with next-day strain when next-day workload was high; however, this association decreased when next-day workload was low. Therefore, the results suggest that workload plays a critical role in weakening the effect of these spirals over time, and suggests that targeted interventions (e.g., recovery days) can help buffer against the negative impact of relationship conflict on strain and decrease the extent that relationship conflict spills over into task disputes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Conflict, Psychological , Interpersonal Relations , Humans , Workload , Workplace
3.
J Am Coll Emerg Physicians Open ; 2(1): e12348, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33532754

ABSTRACT

OBJECTIVE: Team leadership facilitates teamwork and is important to patient care. It is unknown whether physician gender-based differences in team leadership exist. The objective of this study was to assess and compare team leadership and patient care in trauma resuscitations led by male and female physicians. METHODS: We performed a secondary analysis of data from a larger randomized controlled trial using video recordings of emergency department trauma resuscitations at a Level 1 trauma center from April 2016 to December 2017. Subjects included emergency medicine and surgery residents functioning as trauma team leaders. Eligible resuscitations included adult patients meeting institutional trauma activation criteria. Two video-recorded observations for each participant were coded for team leadership quality and patient care by 2 sets of raters. Raters were balanced with regard to gender and were blinded to study hypotheses. We used Bayesian regression to determine whether our data supported gender-based advantages in team leadership. RESULTS: A total of 60 participants and 120 video recorded observations were included. The modal relationship between gender and team leadership (ß = 0.94, 95% highest density interval [HDI], -.68 to 2.52) and gender and patient care (ß = 2.42, 95% HDI, -2.03 to 6.78) revealed a weak positive effect for female leaders on both outcomes. Gender-based advantages to team leadership and clinical care were not conclusively supported or refuted, with the exception of rejecting a strong male advantage to team leadership. CONCLUSIONS: We prospectively measured team leadership and clinical care during patient care. Our findings do not support differences in trauma resuscitation team leadership or clinical care based on the gender of the team leader.

4.
Crit Care Med ; 48(1): 73-82, 2020 01.
Article in English | MEDLINE | ID: mdl-31725441

ABSTRACT

OBJECTIVES: Trauma resuscitations are complex critical care events that present patient safety-related risk. Simulation-based leadership training is thought to improve trauma care; however, there is no robust evidence supporting the impact of leadership training on clinical performance. The objective of this study was to assess the clinical impact of simulation-based leadership training on team leadership and patient care during actual trauma resuscitations. DESIGN: Randomized controlled trial. SETTING: Harborview Medical Center (level 1 trauma center). SUBJECTS: Seventy-nine second- and third-year residents were randomized and 360 resuscitations were analyzed. INTERVENTIONS: Subjects were randomized to a 4-hour simulation-based leadership training (intervention) or standard orientation (control) condition. MEASUREMENTS AND MAIN RESULTS: Participant-led actual trauma resuscitations were video recorded and coded for leadership behaviors and patient care. We used random coefficient modeling to account for the nesting effect of multiple observations within residents and to test for post-training group differences in leadership behaviors while controlling for pre-training behaviors, Injury Severity Score, postgraduate training year, and days since training occurred. Sixty participants completed the study. There was a significant difference in post-training leadership behaviors between the intervention and control conditions (b1 = 4.06, t (55) = 6.11, p < 0.001; intervention M = 11.29, SE = 0.66, 95% CI, 9.99-12.59 vs control M = 7.23, SE = 0.46, 95% CI, 6.33-8.13, d = 0.92). Although patient care was similar between conditions (b = 2.00, t (55) = 0.99, p = 0.325; predicted means intervention M = 62.38, SE = 2.01, 95% CI, 58.43-66.33 vs control M = 60.38, SE = 1.37, 95% CI, 57.69-63.07, d = 0.15), a test of the mediation effect between training and patient care suggests leadership behaviors mediate an effect of training on patient care with a significant indirect effect (b = 3.44, 95% CI, 1.43-5.80). Across all trauma resuscitations leadership was significantly related to patient care (b1 = 0.61, SE = 0.15, t (273) = 3.64, p < 0.001). CONCLUSIONS: Leadership training resulted in the transfer of complex skills to the clinical environment and may have an indirect effect on patient care through better team leadership.


Subject(s)
Leadership , Patient Care Team , Resuscitation/education , Simulation Training , Wounds and Injuries/therapy , Adult , Female , Humans , Male , Middle Aged
5.
Am Psychol ; 73(4): 576-592, 2018.
Article in English | MEDLINE | ID: mdl-29792469

ABSTRACT

Psychologists have studied small-group and team effectiveness for decades, and although there has been considerable progress, there remain significant challenges. Meta-analyses and systematic research have provided solid evidence for core team cognitive, motivational, affective, and behavioral processes that contribute to team effectiveness and empirical support for interventions that enhance team processes (e.g., team design, composition, training, and leadership); there has been substantial evidence for a science of team effectiveness. Nonetheless, there have also been concerns that team processes, which are inherently dynamic, have primarily been assessed as static constructs. Team-level processes and outcomes are multilevel phenomena that emerge, bottom-up from the interactions among team members over time, under the shifting demands of a work context. Thus, theoretical development that appropriately conceptualizes the multiple levels, process dynamics, and emergence of team phenomena over time are essential to advance understanding. Moreover, these conceptual advances necessitate innovative research methodologies to better capture team process dynamics. We explicate this foundation and then describe 2 promising streams of scientific inquiry-team interaction sensors and computational modeling-that are advancing new, unobtrusive measurement techniques and process-oriented research methods focused on understanding the dynamics of cohesion and cognition in teamwork. These are distinct lines of research, each endeavoring to advance the science, but doing so through the development of very different methodologies. We close by discussing the near-term research challenges and the potential long-term evolution of these innovative methods, with an eye toward the future for process-oriented theory and research on team effectiveness. (PsycINFO Database Record


Subject(s)
Cooperative Behavior , Group Processes , Psychology, Industrial/methods , Psychology, Social/methods , Research , Humans
6.
Perspect Psychol Sci ; 13(2): 205-212, 2018 03.
Article in English | MEDLINE | ID: mdl-29232536

ABSTRACT

Teamwork has been at the core of human accomplishment across the millennia, and it was a focus of social psychological inquiry on small group behavior for nearly half a century. However, as organizations world-wide reorganized work around teams over the past two decades, the nature of teamwork and factors influencing it became a central focus of research in organizational psychology and management. In this article, I reflect on the impetus, strategy, key features, and scientific contribution of "Enhancing the Effectiveness of Work Groups and Teams," by Kozlowski and Ilgen, a review monograph published in Psychological Science in the Public Interest in 2006.

7.
Acad Emerg Med ; 25(2): 196-204, 2018 02.
Article in English | MEDLINE | ID: mdl-28715105

ABSTRACT

OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine (EM) teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement. Interprofessional emergency medical teams, consisting of EM resident physicians, nurses, and medical students, were recruited from the University of Washington (Seattle, WA) and Wayne State University (Detroit, MI). Each team completed a simulated emergency resuscitation scenario. Immediately following the simulation, team members completed a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. Subject matter expert reviews and pilot testing of the TSA measure provided evidence of content and response process validity. Simulations were recorded and independently coded for team performance using a previously validated measure. The relationships between the TSA measure and other variables (team clinical performance, team perception of shared understanding, team leader effectiveness, and team experience) were explored. The TSA agreement metric was indexed by averaging the pairwise agreement for each dyad on a team and then averaging across dyads to yield agreement at the team level. For the team perception of shared understanding and team leadership effectiveness measures, individual team member scores were aggregated within a team to create a single team score. We computed descriptive statistics for all outcomes. We calculated Pearson's product-moment correlations to determine bivariate correlations between outcome variables with two-tailed significance testing (p < 0.05). RESULTS: A total of 123 participants were recruited and formed three-person teams (n = 41 teams). All teams completed the assessment scenario and postsimulation measures. TSA agreement ranged from 0.19 to 0.9 and had a mean (±SD) of 0.61 (±0.17). TSA correlated with team clinical performance (p < 0.05) but did not correlate with team perception of shared understanding, team leader effectiveness, or team experience. CONCLUSIONS: Team situational awareness supports adaptive teams and is critical for high reliability organizations such as healthcare systems. Simulation can provide a platform for research aimed at understanding and measuring TSA. This study provides a feasible method for simulation-based assessment of TSA in interdisciplinary teams that addresses prior measure limitations and is appropriate for use in highly dynamic, uncertain situations commonly encountered in emergency department systems. Future research is needed to understand the development of and interactions between individual-, team-, and system (distributed)-level cognitive processes.


Subject(s)
Awareness , Clinical Decision-Making , Emergency Medicine/education , Hospital Rapid Response Team/organization & administration , Simulation Training/methods , Emergency Medicine/standards , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/standards , Female , Health Services Research/methods , Humans , Prospective Studies , Resuscitation/education
8.
Simul Healthc ; 12(2): 96-103, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28704287

ABSTRACT

STATEMENT: Simulation has had a major impact in the advancement of healthcare team training and assessment. To date, most simulation-based training and assessments focus on the teamwork behaviors that impact team performance, often ignoring critical cognitive, motivational, and affective team processes. Evidence from team science research demonstrates a strong relationship between team cognition and team performance and suggests a role for simulation in the development of this team-level construct. In this article, we synthesize research from the broader team science literature to provide foundational knowledge regarding team cognition and highlight best practices for using simulation to target team cognition.


Subject(s)
Clinical Competence , Cognition , Group Processes , Patient Care Team/organization & administration , Simulation Training/organization & administration , Attitude of Health Personnel , Communication , Health Knowledge, Attitudes, Practice , Humans , Leadership , Patient Care Team/standards
9.
J Appl Psychol ; 102(3): 589-598, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28206773

ABSTRACT

In a century of research published in the Journal of Applied Psychology, we have seen significant advances in our science. The results of this science have broad applications to the workplace and implications for improving organizational effectiveness through a variety of avenues. Research has focused on understanding constructs, relationships, and processes at multiple levels, including individual, team, and organizational. A plethora of research methods and questions have driven this work, resulting in a nuanced understanding of what matters in the workplace. In this paper, we synthesize the most salient discoveries, findings, and/or conclusions in 19 domains. We seek to summarize the progress that has been made and highlight the most salient directions for future work such that the next century of research in industrial and organizational psychological science can be as impactful as the first century has been. (PsycINFO Database Record


Subject(s)
Organization and Administration , Psychology, Industrial/trends , History, 20th Century , History, 21st Century , Humans , Psychology, Industrial/history
10.
J Appl Psychol ; 102(3): 237-253, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28206775

ABSTRACT

To launch this Special Issue of the Journal of Applied Psychology celebrating the 1st century of the journal we conducted a review encompassing the background of the founding of the journal; a quantitative assessment of its evolution across the century; and an examination of trends examining article type, article length, authorship patterns, supplemental materials, and research support. The journal was founded in March of 1917 with hopeful optimism about the potential of psychology being applied to practical problems could enhance human happiness, well-being, and effectiveness. Our quantitative content assessment using both keyword frequencies and latent semantic analyses of raw content, in both bottom-up (corpus driven) and top-down modes (analyst driven), converged to document an evolution ranging from a broad and exploratory applied psychology to a more focused industrial psychology to an industrial and organizational psychology to an organizational psychology. With respect to other trends, during the first 4 decades 20 to 30% of journal items were book reviews, which then abruptly ceased in the mid-1950s. Articles have grown increasingly longer over time. Author teams are increasingly larger, and sole authored articles are vanishingly small in frequency. The use of supplemental materials and articles reporting research support have surged dramatically in the most recent period. Across the various foci we examined, our review portrays the evolution of the journal as reflecting the development of a mature, focused, and cumulative scientific discipline addressing psychological science applied to work and organizations. (PsycINFO Database Record


Subject(s)
Periodicals as Topic/history , Psychology, Applied/history , History, 20th Century , History, 21st Century , Humans
11.
J Appl Psychol ; 102(3): 580-588, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28182463

ABSTRACT

In this reflection on my experiences as editor of the Journal of Applied Psychology, I consider 6 foci including (a) information on the background, infrastructure, and mechanics of running this top-tier journal; (b) statistics on journal operations across the 7 years of editorial activity (i.e., incoming plus 6 years on the masthead); (c) innovations that my senior editorial team introduced (i.e., transparency via supplemental materials, revival of monographs, initiation of integrative conceptual reviews); (d) impact and influence with respect to articles, authors, and institutions; (e) latent sematic analysis findings to illustrate the evolution and change of journal content over a 33-year comparison period (i.e., it has evolved substantially); and desirable directions for future evolution of the journal (i.e., strengthen our scientific foundation, increase multidisciplinary linkages, focus on multilevel system dynamics as core capabilities, and improve the translation of industrial and organizational science to evidence-based practice and vice versa). (PsycINFO Database Record


Subject(s)
Periodicals as Topic , Psychology, Applied , History, 21st Century , Humans , Periodicals as Topic/history , Periodicals as Topic/statistics & numerical data , Periodicals as Topic/trends , Psychology, Applied/history , Psychology, Applied/statistics & numerical data , Psychology, Applied/trends
12.
J Appl Psychol ; 101(10): 1353-1385, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27504660

ABSTRACT

Team cognition has been identified as a critical component of team performance and decision-making. However, theory and research in this domain continues to remain largely static; articulation and examination of the dynamic processes through which collectively held knowledge emerges from the individual- to the team-level is lacking. To address this gap, we advance and systematically evaluate a process-oriented theory of team knowledge emergence. First, we summarize the core concepts and dynamic mechanisms that underlie team knowledge-building and represent our theory of team knowledge emergence (Step 1). We then translate this narrative theory into a formal computational model that provides an explicit specification of how these core concepts and mechanisms interact to produce emergent team knowledge (Step 2). The computational model is next instantiated into an agent-based simulation to explore how the key generative process mechanisms described in our theory contribute to improved knowledge emergence in teams (Step 3). Results from the simulations demonstrate that agent teams generate collectively shared knowledge more effectively when members are capable of processing information more efficiently and when teams follow communication strategies that promote equal rates of information sharing across members. Lastly, we conduct an empirical experiment with real teams participating in a collective knowledge-building task to verify that promoting these processes in human teams also leads to improved team knowledge emergence (Step 4). Discussion focuses on implications of the theory for examining team cognition processes and dynamics as well as directions for future research. (PsycINFO Database Record


Subject(s)
Cognition , Group Processes , Humans , Knowledge , Models, Psychological , Psychological Theory
13.
J Appl Psychol ; 99(3): 390-403, 2014 May.
Article in English | MEDLINE | ID: mdl-23205494

ABSTRACT

Using a field sample of 101 virtual teams, this research empirically evaluates the impact of traditional hierarchical leadership, structural supports, and shared team leadership on team performance. Building on Bell and Kozlowski's (2002) work, we expected structural supports and shared team leadership to be more, and hierarchical leadership to be less, strongly related to team performance when teams were more virtual in nature. As predicted, results from moderation analyses indicated that the extent to which teams were more virtual attenuated relations between hierarchical leadership and team performance but strengthened relations for structural supports and team performance. However, shared team leadership was significantly related to team performance regardless of the degree of virtuality. Results are discussed in terms of needed research extensions for understanding leadership processes in virtual teams and practical implications for leading virtual teams.


Subject(s)
Group Processes , Interpersonal Relations , Leadership , Personnel Management/methods , Telecommunications , Adult , Female , Humans , Male , Middle Aged , Young Adult
14.
Crit Care Med ; 41(11): 2551-62, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23949473

ABSTRACT

OBJECTIVES: To determine the impact of a low-resource-demand, easily disseminated computer-based teamwork process training intervention on teamwork behaviors and patient care performance in code teams. DESIGN: A randomized comparison trial of computer-based teamwork training versus placebo training was conducted from August 2010 through March 2011. SETTING: This study was conducted at the simulation suite within the Kado Family Clinical Skills Center, Wayne State University School of Medicine. PARTICIPANTS: Participants (n = 231) were fourth-year medical students and first-, second-, and third-year emergency medicine residents at Wayne State University. Each participant was assigned to a team of four to six members (nteams = 45). INTERVENTIONS: Teams were randomly assigned to receive either a 25-minute computer-based training module targeting appropriate resuscitation teamwork behaviors or a placebo training module. MEASUREMENTS: Teamwork behaviors and patient care behaviors were video recorded during high-fidelity simulated patient resuscitations and coded by trained raters blinded to condition assignment and study hypotheses. Teamwork behavior items (e.g., "chest radiograph findings communicated to team" and "team member assists with intubation preparation") were standardized before combining to create overall teamwork scores. Similarly, patient care items ("chest radiograph correctly interpreted"; "time to start of compressions") were standardized before combining to create overall patient care scores. Subject matter expert reviews and pilot testing of scenario content, teamwork items, and patient care items provided evidence of content validity. MAIN RESULTS: When controlling for team members' medically relevant experience, teams in the training condition demonstrated better teamwork (F [1, 42] = 4.81, p < 0.05; ηp = 10%) and patient care (F [1, 42] = 4.66, p < 0.05; ηp = 10%) than did teams in the placebo condition. CONCLUSIONS: Computer-based team training positively impacts teamwork and patient care during simulated patient resuscitations. This low-resource team training intervention may help to address the dissemination and sustainability issues associated with larger, more costly team training programs.


Subject(s)
Cardiopulmonary Resuscitation/education , Computer Simulation , Education, Medical, Undergraduate/methods , Patient Care Team , Clinical Competence , Communication , Group Processes , Humans , Leadership
15.
J Appl Psychol ; 98(4): 579-92, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23647209

ABSTRACT

We develop and test a model based on social cognitive theory (Bandura, 1991) that links abusive supervision to followers' ethical intentions and behaviors. Results from a sample of 2,572 military members show that abusive supervision was negatively related to followers' moral courage and their identification with the organization's core values. In addition, work unit contexts with varying degrees of abusive supervision, reflected by the average level of abusive supervision reported by unit members, moderated relationships between the level of abusive supervision personally experienced by individuals and both their moral courage and their identification with organizational values. Moral courage and identification with organizational values accounted for the relationship between abusive supervision and followers' ethical intentions and unethical behaviors. These findings suggest that abusive supervision may undermine moral agency and that being personally abused is not required for abusive supervision to negatively influence ethical outcomes.


Subject(s)
Leadership , Military Personnel/psychology , Morals , Personnel Loyalty , Adult , Humans , Male , Models, Psychological , Organizational Culture , United States
16.
BMJ Qual Saf ; 22(5): 436-48, 2013 May.
Article in English | MEDLINE | ID: mdl-23355693

ABSTRACT

BACKGROUND: Whether for team training, research or evaluation, making effective use of simulation-based technologies requires robust, reliable and accurate assessment tools. Extant literature on simulation-based assessment practices has primarily focused on scenario and instructional design; however, relatively little direct guidance has been provided regarding the challenging decisions and fundamental principles related to assessment development and implementation. OBJECTIVE: The objective of this manuscript is to introduce a generalisable assessment framework supplemented by specific guidance on how to construct and ensure valid and reliable simulation-based team assessment tools. The recommendations reflect best practices in assessment and are designed to empower healthcare educators, professionals and researchers with the knowledge to design and employ valid and reliable simulation-based team assessments. OVERVIEW: Information and actionable recommendations associated with creating assessments of team processes (non-technical 'teamwork' activities) and performance (demonstration of technical proficiency) are presented which provide direct guidance on how to Distinguish the underlying competencies one aims to assess, Elaborate the measures used to capture team member behaviours during simulation activities, Establish the content validity of these measures and Proceduralise the measurement tools in a way that is systematically aligned with the goals of the simulation activity while maintaining methodological rigour (DEEP). SUMMARY: The DEEP framework targets fundamental principles and critical activities that are important for effective assessment, and should benefit healthcare educators, professionals and researchers seeking to design or enhance any simulation-based assessment effort.


Subject(s)
Guidelines as Topic , Health Personnel/education , Inservice Training/standards , Patient Care Team/standards , Patient Safety , Patient Simulation , Benchmarking , Clinical Competence , Employee Performance Appraisal , Health Knowledge, Attitudes, Practice , Humans , Interprofessional Relations , Reproducibility of Results
17.
J Appl Psychol ; 94(1): 1-4, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19186891

ABSTRACT

The Journal of Applied Psychology is the oldest and largest top-tier journal publishing theory and research relevant to industrial and organizational psychology, organizational behavior, and human resources management. The primary emphasis of this journal is the publication of original investigations that advance theoretical understanding and create new knowledge for applied psychology within the broad scope of the organizational sciences. We are primarily interested in publishing empirical research and conceptual articles that enhance understanding of psychological phenomena in human and organizational systems. This editorial also covers the expectations and review process that the Journal of Applied Psychology has for manuscripts submitted to the journal. (PsycINFO Database Record (c) 2009 APA, all rights reserved).


Subject(s)
Editorial Policies , Periodicals as Topic , Psychology, Applied , Humans , Peer Review, Research , United States
18.
Acad Emerg Med ; 15(11): 1104-12, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18828831

ABSTRACT

The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.


Subject(s)
Emergency Medicine/organization & administration , Patient Care Team/organization & administration , Clinical Competence , Communication , Emergency Medical Services/organization & administration , Emergency Service, Hospital/organization & administration , Humans , Leadership , Models, Organizational , Patient Care Team/standards , Task Performance and Analysis , Triage
19.
Acad Emerg Med ; 15(11): 1025-36, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18785937

ABSTRACT

Current health care literature cites communication breakdown and teamwork failures as primary threats to patient safety. The unique, dynamic environment of the emergency department (ED) and the complexity of patient care necessitate the development of strong interdisciplinary team skills among emergency personnel. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," our workshop group identified key theory and evidence-based recommendations for the design and implementation of team training programs. The authors then conducted an extensive review of the team training literature within the domains of organizational psychology, aviation, military, management, and health care. This review, in combination with the workshop session, formed the basis for recommendations and need for further research in six key areas: 1) developing and refining core competencies for emergency medicine (EM) teams; 2) leadership training for emergency physicians (EPs); 3) conducting comprehensive needs analyses at the organizational, personnel, and task levels; 4) development of training platforms to maximize knowledge transfer; 5) debriefing and provision of feedback; and 6) proper implementation of simulation technology. The authors believe that these six areas should form an EM team training research platform to advance the EM literature, while leveraging the unique team structures present in EM to expand team training theory and research.


Subject(s)
Emergency Medicine/standards , Patient Care Team/organization & administration , Clinical Competence , Emergency Medicine/organization & administration , Evidence-Based Medicine , Feedback , Humans , Leadership , Medical Errors/prevention & control , Patient Care Team/standards , Patient Simulation , Transfer, Psychology
20.
J Appl Psychol ; 93(2): 296-316, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18361633

ABSTRACT

This article describes a comprehensive examination of the cognitive, motivational, and emotional processes underlying active learning approaches; their effects on learning and transfer; and the core training design elements (exploration, training frame, emotion control) and individual differences (cognitive ability, trait goal orientation, trait anxiety) that shape these processes. Participants (N = 350) were trained to operate a complex, computer-based simulation. Exploratory learning and error-encouragement framing had a positive effect on adaptive transfer performance and interacted with cognitive ability and dispositional goal orientation to influence trainees' metacognition and state goal orientation. Trainees who received the emotion-control strategy had lower levels of state anxiety. Implications for development of an integrated theory of active learning, learner-centered design, and research extensions are discussed.


Subject(s)
Adaptation, Psychological , Learning , Self Efficacy , Social Control, Informal , Teaching , Adolescent , Adult , Affect , Cognition , Female , Humans , Male
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