A concurrent mixed-method study exploring the experiences of interprofessional collaboration among Canadian midwives and obstetricians.

AIM: This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. DESIGN: A concurrent mixed-methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. METHOD: Eighteen RMs across Canada completed a demographic survey and the Midwifery-Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery-Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi-structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. RESULTS: The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife-physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician-midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter-Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. CONCLUSION: This study provides support for the Midwifery-Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. IMPLICATIONS: The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. REPORTING METHOD: The authors adhered to Consolidated criteria for reporting qualitative research (COREQ).

IQ After Pediatric Concussion.

OBJECTIVES: This study investigated IQ scores in pediatric concussion (ie, mild traumatic brain injury) versus orthopedic injury. METHODS: Children (N = 866; aged 8-16.99 years) were recruited for 2 prospective cohort studies from emergency departments at children's hospitals (2 sites in the United States and 5 in Canada) ≤48 hours after sustaining a concussion or orthopedic injury. They completed IQ and performance validity testing postacutely (3-18 days postinjury; United States) or 3 months postinjury (Canada). Group differences in IQ scores were examined using 3 complementary statistical approaches (linear modeling, Bayesian, and multigroup factor analysis) in children performing above cutoffs on validity testing. RESULTS: Linear models showed small group differences in full-scale IQ (d [95% confidence interval] = 0.13 [0.00-0.26]) and matrix reasoning (0.16 [0.03-0.30]), but not in vocabulary scores. IQ scores were not related to previous concussion, acute clinical features, injury mechanism, a validated clinical risk score, pre- or postinjury symptom ratings, litigation, or symptomatic status at 1 month postinjury. Bayesian models provided moderate to very strong evidence against group differences in IQ scores (Bayes factor 0.02-0.23). Multigroup factor analysis further demonstrated strict measurement invariance, indicating group equivalence in factor structure of the IQ test and latent variable means. CONCLUSIONS: Across multisite, prospective study cohorts, 3 complementary statistical models provided no evidence of clinically meaningful differences in IQ scores after pediatric concussion. Instead, overall results provided strong evidence against reduced intelligence in the first few weeks to months after pediatric concussion.

A measure of parent engagement: plan appropriateness, partnering, and positive outcome expectancy in pediatric rehabilitation sessions.

PURPOSE: To examine the psychometric properties of a parent-report measure of engagement in pediatric rehabilitation. METHOD: 113 parents (of children 4 months to 18 years, varying in diagnoses) were recruited from standard outpatient/inpatient, early intervention, and life skills programs, sampled from different sites in Canada, the US, and Australia. Parents completed the Pediatric Rehabilitation Intervention Measure of Engagement-Parent version (PRIME-P) twice, after two therapy sessions approximately two weeks apart. Analyses examined factor structure, internal consistency, and test-retest reliability, and assessed construct validity hypotheses concerning participant characteristics and contextual factors. RESULTS: The resulting 11-item PRIME-P has three factors capturing engagement in terms of Plan Appropriateness, Partnering, and Positive Outcome Expectancy. The factors displayed strong internal consistency and test-retest reliability (Partnering demonstrated slightly weaker test-retest reliability). Construct validity was shown by significant associations between the PRIME-P scales and parents' presence versus absence during the sessions, as well as service providers' years of experience. CONCLUSIONS: The PRIME-P captures parent engagement as a multifaceted construct involving appropriateness of the therapy plan, a sense of active partnership in the intervention process, and an expectation for a positive outcome. The PRIME-P has promise for research, clinical practice, and educational purposes.IMPLICATIONS FOR REHABILITATIONThe PRIME-P is a psychometrically sound tool that fills a gap in how researchers and practitioners can measure the engagement of parents in the therapy process.To enhance parent engagement, service providers can encourage collaboration in planning, foster a sense of working in partnership, and convey a sense of hope.The findings point to the need to pay attention to parents' beliefs about the therapy plan and outcomes, in addition to their behavioral involvement.The PRIME-P is a promising tool for pediatric rehabilitation that can be used to investigate the role of a crucial, yet poorly understood variable in the therapy process.

Psychometric Testing of a Theory-Based Measure to Evaluate Clinical Performance of Nursing Students.

AIM: The aim of this study was to psychometrically test a clinical evaluation tool that measures instructors' gut feelings for placing students on a learning contract. BACKGROUND: Evaluators feel unprepared or hesitant to fail students who do not meet professional and clinical expectations. METHOD: A multiphase process was used to determine the reliability and validity of the Gut Feelings Scale. The first phase focused on item generation, the second phase focused on content validity and feedback from expert raters, and the third phase focused on psychometric evaluation to streamline the item pool and explore validity. RESULTS: Correlations and descriptive statistics for each subscale were calculated. Reliability analyses revealed relatively strong estimates of internal consistency; specifically, the reliability estimates surpassed our criteria of >.70. CONCLUSION: This pilot study established the validity and reliability of the scale and found it to be a reliable tool to guide instructors' evaluative decision-making.

A latent profile analysis of adverse childhood experiences and adult health in a community sample.

BACKGROUND: Childhood adversity is generally associated with adult mental health problems, but most studies have an insufficient sample size to examine relationships among various aspects of childhood adversity and adult mental health outcomes. Further, past research has predominantly been restricted to a single or limited types of adverse events, which ignores the inherent interdependence among childhood adversity indicators. OBJECTIVE: The current study explored various configurations of adverse childhood experiences (ACEs) and then examined the relationships among these configurations and various mental health constructs with a person-centered analytic framework. PARTICIPANTS AND SETTING: A sample of 3, 932 adult outpatients was recruited in primary care settings, during regular physician visits. METHODS: Participants provided informed consent, demographic information, and then completed validated measure of ACEs (emotional abuse, physical abuse, sexual abuse, physical neglect, emotional neglect, family dysfunction), and a series of validated mental health measures. RESULTS: Latent profile analyses revealed four configurations (or profiles) of ACEs, which were analysed for their relationships with mental health outcomes. The profile with a dominance of physical neglect was associated with the highest levels of anxiety and depression. The profiles with high levels of sexual abuse, either alone or combined with general adversity, had more emotional problems than the profile with low levels of adversity. The profiles characterizing mistreatment did not consistently differ from each other on the mental health outcomes. CONCLUSIONS: It is critical to consider ACEs in their complex relationship with each other. Different patterns of ACEs are associated with differential health outcomes in adults.

The complexities and synergies of engagement: an ethnographic study of engagement in outpatient pediatric rehabilitation sessions.

PURPOSE: To investigate client (youth/caregiver) and service provider engagement in outpatient pediatric rehabilitation therapy sessions. METHODS: In an ethnographic study, five research assistants attended 28 outpatient sessions, mostly delivered by occupational, physical, and speech-language therapists, and rated signs of client, provider, and relational engagement using the Pediatric Rehabilitation Intervention Measure of Engagement - Observation version. Post-session interviews were conducted individually with 13 youth, 15 caregivers, and 26 providers. RESULTS: Overall, there was a moderate to great extent of engagement. Provider engagement was rated as higher than client engagement, particularly in sessions with activities focusing on body structure/function. The interviews indicated associations among engagement-related constructs: (a) expectations influenced engagement/disengagement and therapy progress, (b) engagement was associated with positive affect and relationships, and (c) engagement was strongly associated with relationships and collaboration. CONCLUSIONS: Engagement is a central process within a complex system of psychosocial constructs operating in therapy. Engagement is emergent, synergistic, and change-inducing - it emanates from, involves, and influences multiple aspects of therapy. Notably, engagement ties two pivotal elements - positive expectations and positive affect - to positive relationships, collaboration, and therapy progress. Implications for practice include an understanding of how providers manage the therapeutic context and work to foster engagement.Implications for rehabilitationEngagement, and its various elements, plays a central role in shaping how clients, parents, and clinicians value therapeutic encounters.Optimal therapy is often thought to include engagement, relationships, and collaboration; the importance of therapy expectations, positive affect, and perceptions of progress are frequently overlooked.Engagement and motivation may be maximized when youth and caregivers are asked explicitly about how they view their engagement in therapy.In addition to clarifying and aligning expectations with youth and caregivers, service providers can enhance engagement and motivation by intentionally creating enjoyable and meaningful interactions, developing relationships, negotiating consensus on goals and plans, and demonstrating therapy progress.Service providers can harness engagement and the system of related constructs by listening and communicating effectively, by entering the world of the client and family, and by being aware of, anticipating, and responding to engagement and disengagement.

Resiliency to adversity in military personnel: The role of self-regulation.

Military service can include numerous adverse events. As such, resiliency has been considered as a means of potentially helping active-duty personnel face adversity and be better prepared for the demands of military service. However, research in military contexts has been hindered by use of disparate conceptualizations, definitions, and measures of resiliency. To provide some resolution to these inconsistencies, we use a comprehensive, theoretically based model of resiliency to explore how self-regulation processes contributed to Soldiers' negative affect and self-perceived effectiveness. We hypothesized that self-regulation (comprising distinct affective, behavioral, and cognitive processes) increments prediction of Soldiers' outcomes over and above trait-based resiliency protective factors. Using a sample of active-duty military personnel, cognitive self-regulation and affective self-regulation incremented the prediction of negative affect and self-perceived Soldier effectiveness, respectively, over and above trait-based protective factors. These results support the use of a comprehensive model and measure of resiliency, which may enable greater consistency across future research endeavors. As these results validated the links between self-regulation and post-adversity outcomes, this study provides a basis for developing new resiliency training programs. Additional implications for theory and continued research on resiliency in military contexts are discussed.

Challenging the "static" quo: Trajectories of engagement in team processes toward a deadline.

Although team effectiveness research has advanced our understanding of team processes, much of this research has been based on static methodologies, despite the recognition that team processes change over time. Thus, the purpose of this article is to advance the team dynamics literature by developing and testing a theoretical account of team engagement in processes toward a deadline. We theorize about team process trajectories, which we suggest is the form of process change over time (i.e., pattern of increase/decrease). Further, we identify a key driver of process trajectories and consider the implications of trajectories for team performance. Results from a series of linear multilevel latent growth models suggested that teams' engagement in strategy and planning, monitoring goal progress, and cooperative conflict management (cf. Marks, Mathieu, & Zaccaro, 2001) increased over time toward a deadline, and that steeper increases tended to be positively related to team performance. Finally, achievement-striving was found to be an important within-team factor driving team-specific process trajectories and was indirectly related to performance. This study provides new theoretical insights with respect to how teams engage in processes toward a deadline, along with team achievement-striving as a compositional input, and the performance implications of team process trajectories. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Emergence of Group Potency and Its Implications for Team Effectiveness.

Much of the previous research on the emergence of team-level constructs has overlooked their inherently dynamic nature by relying on static, cross-sectional approaches. Although theoretical arguments regarding emergent states have underscored the importance of considering time, minimal work has examined the dynamics of emergent states. In the present research, we address this limitation by investigating the dynamic nature of group potency, a crucial emergent state, over time. Theory around the "better-than-average" effect (i.e., an individual's tendency to think he/she is better than the average person) suggests that individuals may have elevated expectations of their group's early potency, but may decrease over time as team members interact gain a more realistic perspective of their group's potential. In addition, as members gain experience with each other, they will develop a shared understanding of their team's attributes. The current study used latent growth and consensus emergence modeling to examine how potency changes over time, and its relation with team effectiveness. Further, in accordance with the input-process-output framework, we investigated how group potency mediated the relations between team-level compositions of conscientiousness and extraversion and team effectiveness. We collected data at three time points throughout an engineering design course from 337 first-year engineering students that comprised 77 project teams. Results indicated that group potency decreased over time in a linear trend, and that group consensus increased over time. We also found that teams' initial potency was a significant predictor of team effectiveness, but that change in potency was not related to team effectiveness. Finally, we found that the indirect effect linking conscientiousness to effectiveness, through initial potency, was supported. Overall, the current study offers a unique understanding of the emergence of group potency, and facilitate a number theoretical and practical implications, which are discussed.

Development of an observational measure of therapy engagement for pediatric rehabilitation.

PURPOSE: The Pediatric Rehabilitation Intervention Measure of Engagement-Observation (PRIME-O) version was designed to capture signs of affective, cognitive and behavioral involvement for clients and service providers and in the client-provider interaction. METHODS: Phase 1 examined interrater consensus and construct validity of a pilot version, using observer ratings of engagement indicators made while viewing videos of therapy sessions differing in high and low engagement (Sample 1). Phase 2 examined these properties in a 10-item version (Samples 2 and 3). Phase 3 examined the content validity of the 10-item version, using observed signs of child, youth and parent engagement, as reported in an interview study involving 10 service providers. RESULTS: There was excellent interrater consensus for both versions and ratings significantly discriminated between videos differing in high and low engagement, providing evidence for construct validity. Content validity was demonstrated by service provider reports of engagement signs. More behavioral signs were reported for children and more cognitive signs were reported for youth and parents, providing evidence for the developmental appropriateness of the PRIME-O. CONCLUSIONS: The PRIME-O provides a multifaceted view of affective, cognitive and behavioral components of engagement in pediatric rehabilitation. The PRIME-O has potential utility for research, clinical practice and continuing education. Implications for Rehabilitation Measures of engagement in therapy are needed to identify factors associated with successful therapy sessions and positive client outcomes. The PRIME-O is an observational measure that captures indicators of affective, cognitive and behavioral components of engagement for both clients and service providers. The PRIME-O may further help in understanding of the strategies service providers can use to facilitate an optimal state of engagement within a therapy session. Clinical practice may be enhanced by attending to the client's signals of engagement in therapy. The PRIME-O can help service providers to more accurately identify signs of engagement and disengagement, monitor their own success in creating an engaging intervention atmosphere, and instigate strategies to optimize engagement.

To Be or Not to Be: Exploring the Nature of Positively and Negatively Keyed Personality Items in High-Stakes Testing.

Including equal numbers of positively and negatively keyed items is common in Five-Factor Model (FFM) personality measures. Much literature has demonstrated the presence of positive and negative keying factors in low-stakes testing situations, but there is a dearth of research investigating these factors in high-stakes testing. To address this gap, we investigated whether an FFM measure used in high-stakes testing was influenced by positive and negative keying factors. We also examined the overlap of the positive and negative keying factors with social desirability, rule-consciousness, acquiescence, and cognitive ability. Confirmatory factor analysis supported the inclusion of distinct factors associated with positively and negatively keyed items and suggested that the keying factors accounted for a substantial portion of variation in responses to FFM items. Social desirability and rule-consciousness were found to have significant relations with both keying factors, whereas acquiescence was only related to the negative keying factor. Implications for the construct validity of FFM measures used in high-stakes testing and directions for future research are discussed.

Current misuses of multiple regression for investigating bivariate hypotheses: an example from the organizational domain.

By definition, multiple regression (MR) considers more than one predictor variable, and each variable's beta will depend on both its correlation with the criterion and its correlation with the other predictor(s). Despite ad nauseam coverage of this characteristic in organizational psychology and statistical texts, researchers' applications of MR in bivariate hypothesis testing has been the subject of recent and renewed interest. Accordingly, we conducted a targeted survey of the literature by coding articles, covering a five-year span from two top-tier organizational journals, that employed MR for testing bivariate relations. The results suggest that MR coefficients, rather than correlation coefficients, were most common for testing hypotheses of bivariate relations, yet supporting theoretical rationales were rarely offered. Regarding the potential impact on scientific advancement, in almost half of the articles reviewed (44 %), at least one conclusion of each study (i.e., that the hypothesis was or was not supported) would have been different, depending on the author's use of correlation or beta to test the bivariate hypothesis. It follows that inappropriate decisions to interpret the correlation versus the beta will affect the accumulation of consistent and replicable scientific evidence. We conclude with recommendations for improving bivariate hypothesis testing.