The development and validation of an Army team resilience measure.

Given the demanding nature of its mission, the collective units of the Army, not just individual Soldiers, need to be able to withstand and adapt to a wide range of challenges. Therefore, it is important to be able to effectively assess resilience at the team-level and to understand the factors that can enable or diminish it. This article describes the development of a construct valid and psychometrically-sound measure of team resilience - the Team Resilience Scale (TRS). A theoretical framework of team resilience and related constructs is introduced. We then summarize the procedures for developing the TRS and related constructs, providing evidence of the content validity of the TRS. Finally, we assess the psychometric soundness and construct validity of the TRS in two Army field studies. Our analyses support the convergent validity of items and indicate that the measure can be used to examine three first-order dimensions of resilience (i.e., physical, affective, and cognitive) or as a single overall resilience composite. Results show the TRS was positively related to team performance in both samples and it co-varied with stressors and team actions. Practical recommendations for use of the measure and suggestions for future research are offered.

Holistic strategy for promoting effective handoffs.

BACKGROUND: Handoffs are ubiquitous in modern healthcare practice, and they can be a point of resilience and care continuity. However, they are prone to a variety of issues. Handoffs are linked to 80% of serious medical errors and are implicated in one of three malpractice suits. Furthermore, poorly performed handoffs can lead to information loss, duplication of efforts, diagnosis changes and increased mortality. METHODS: This article proposes a holistic approach for healthcare organisations to achieve effective handoffs within their units and departments. RESULTS: We examine the organisational considerations (ie, the facets controlled by higher-level leadership) and local drivers (ie, the aspects controlled by the individuals working in the units and providing patient care). CONCLUSION: We propose advice for leaders to best enact the processes and cultural change necessary to see positive outcomes associated with handoffs and care transitions within their units and hospitals.

Team FIRST framework: Identifying core teamwork competencies critical to interprofessional healthcare curricula.

Interprofessional healthcare team function is critical to the effective delivery of patient care. Team members must possess teamwork competencies, as team function impacts patient, staff, team, and healthcare organizational outcomes. There is evidence that team training is beneficial; however, consensus on the optimal training content, methods, and evaluation is lacking. This manuscript will focus on training content. Team science and training research indicates that an effective team training program must be founded upon teamwork competencies. The Team FIRST framework asserts there are 10 teamwork competencies essential for healthcare providers: recognizing criticality of teamwork, creating a psychologically safe environment, structured communication, closed-loop communication, asking clarifying questions, sharing unique information, optimizing team mental models, mutual trust, mutual performance monitoring, and reflection/debriefing. The Team FIRST framework was conceptualized to instill these evidence-based teamwork competencies in healthcare professionals to improve interprofessional collaboration. This framework is founded in validated team science research and serves future efforts to develop and pilot educational strategies that educate healthcare workers on these competencies.

Indexing dynamic collective constructs using computer-aided text analysis: Construct validity evidence and illustrations featuring team processes.

Organizational processes have been widely recognized as both multilevel and dynamic, yet traditional methods of measurements limit our ability to model and understand such phenomena. Featuring a popular model of team processes advanced by Marks et al. (2001), we illustrate a method to use individuals' communications as construct valid unobtrusive measures of collective constructs occurring over time. Thus, the purpose of this investigation is to develop computer-aided text analysis (CATA) techniques that can score members' communications into valid team process measures. We apply a deductive content validity-based method to construct CATA dictionaries for Marks et al.'s dimensions. We then demonstrate their convergent validity with subject matter experts' (SMEs) hand-coded team communications and different SMEs' behaviorally anchored rating scales based on video recordings of team interactions, using multitrait-multimethod analyses in two samples. Using a third sample of paramedics performing a high-fidelity mass casualty incident exercise, we further demonstrate the convergent validity of the CATA and SME scorings of communications. We then model the relationships among processes across episodes using all three samples. Next, we test criterion-related validity using a longitudinal dual-discontinuous change growth modeling design featuring the paramedic CATA-scored team processes as related to a dynamic performance criterion. Finally, we integrate behavioral data from wearable sensor badges to illustrate how CATA can be scored at the individual level and then leveraged to model dynamic networks of team interactions. Implications, limitations, directions for the future research, and guidelines for the application of these techniques to other collective constructs are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Helping healthcare teams save lives during COVID-19: Insights and countermeasures from team science.

As the COVID-19 pandemic has ravaged the United States, health care teams are on the frontlines of this global crisis, often navigating harrowing conditions at work, such as a lack of personal protective equipment and staffing shortages, and distractions at home, including worries about elderly relatives or making childcare arrangements. While the nature and severity of stressors impacting health care teams are in many ways unprecedented, decades of psychological research exploring teamwork in extreme contexts can provide insights to understand and improve outcomes for teams in a crisis. This review highlights the psychological principles that apply to teams in a crisis and illustrates how psychologists can use this knowledge to improve teamwork for medical teams in the midst of the COVID-19 pandemic., The review also provides a glimpse toward the future, noting both how psychologists can help health care teams recover and rebound, as well as how additional research can improve psychologists' understanding of teamwork in times of crisis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Informal field-based learning and work design.

U.S. organizations continue to invest most of their learning budgets in formal training and development programs despite estimates that the majority of learning in the workplace happens informally. In this study we focus on informal field-based learning (IFBL), which represents individuals engaging in self-directed, intentional, and field-based development of their knowledge and skills. We build on the informal learning literature to advance a cross-level model of individual and job-level characteristics as influences on IFBL and subsequent changes in job performance. We tested our model using a sample of 378 health care employees who occupied 47 different jobs. The results showed promotion-focused individuals more readily engaged in IFBL, as moderated by job time pressures. Moreover, engaging in IFBL behaviors positively related to performance improvements in jobs that require greater updating and use of relevant information, as well as in jobs with relatively low decision making and problem-solving requirements. Exploratory subdimensional analyses revealed some interesting countervailing relationships between the feedback-seeking and vicarious-learning elements of IFBL. Results are discussed in terms of contingency relationships associated with IFBL behaviors and different job types, as well as theoretical and practical implications. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Team development interventions: Evidence-based approaches for improving teamwork.

The rate of teamwork and collaboration within the workforce has burgeoned over the years, and the use of teams is projected to continue increasing. With the rise of teamwork comes the need for interventions designed to enhance teamwork effectiveness. Successful teams produce desired outcomes; however, it is critical that team members demonstrate effective processes to achieve these outcomes. Team development interventions (TDIs) increase effective team competencies and processes, thereby leading to improvements in proximal and distal outcomes. The effectiveness of TDIs is evident across domains (e.g., education, health care, military, aviation), and they are applicable in a wide range of settings. To stimulate the adoption and effective use of TDIs, the current article provides a review of four types of evidence-based TDIs including team training, leadership training, team building, and team debriefing. In doing so, we aim to provide psychologists with an understanding of the scientific principles underlying TDIs and their impact on team dynamics. Moreover, we provide evidence-based recommendations regarding how to increase the effectiveness of TDIs as well as a discussion on future research needed within this domain. (PsycINFO Database Record

A cross-level investigation of informal field-based learning and performance improvements.

Organizations often operate in complex and dynamic environments which place a premium on employees' ongoing learning and acquisition of new competencies. Additionally, the majority of learning in organizations does not take place in formal training settings, but we know relatively little about how informal field-based learning (IFBL) behaviors relate to changes in job performance. In this study, we first clarified the construct of IFBL as a subset of informal learning. Second, on the basis of this clarified construct definition, we developed a measure of IFBL behaviors and demonstrated its psychometric properties using (a) a sample of subject matter experts who made item content validity judgments and (b) both an Amazon Mechanical Turk sample (N = 400) and a sample of 1,707 healthcare employees. Third, we advanced a grounded theory of IFBL in healthcare, and related it to individuals' regulatory foci and contextual moderators of IFBL behaviors-job performance relationships using a cross-level design and lagged nonmethod bound measures. Specifically, using a sample of 407 healthcare workers from 49 hospital units, our results suggested that promotion-focused individuals, especially in well-staffed units, readily engage in IFBL behaviors. Additionally, we found that the IFBL-changes in job performance relationship was strengthened to the extent that individuals worked in units with relatively nonpunitive climates. Interestingly, staffing levels had a weakening moderating effect on the positive IFBL-performance improvements relationship. Detailed follow-up analyses revealed that the peculiar effect was attributable to differential relationships from IFBL subdimensions. Implications for future theory building, research, and practice are discussed. (PsycINFO Database Record

100 years of training and development research: What we know and where we should go.

Training and development research has a long tradition within applied psychology dating back to the early 1900s. Over the years, not only has interest in the topic grown but there have been dramatic changes in both the science and practice of training and development. In the current article, we examine the evolution of training and development research using articles published in the Journal of Applied Psychology (JAP) as a primary lens to analyze what we have learned and to identify where future research is needed. We begin by reviewing the timeline of training and development research in JAP from 1918 to the present in order to elucidate the critical trends and advances that define each decade. These trends include the emergence of more theory-driven training research, greater consideration of the role of the trainee and training context, examination of learning that occurs outside the classroom, and understanding training's impact across different levels of analysis. We then examine in greater detail the evolution of 4 key research themes: training criteria, trainee characteristics, training design and delivery, and the training context. In each area, we describe how the focus of research has shifted over time and highlight important developments. We conclude by offering several ideas for future training and development research. (PsycINFO Database Record

Do team and individual debriefs enhance performance? A meta-analysis.

OBJECTIVE: Debriefs (or "after-action reviews") are increasingly used in training and work environments as a means of learning from experience. We sought to unify a fragmented literature and assess the efficacy of debriefs with a quantitative review. BACKGROUND: Used by the U.S. Army to improve performance for decades, and increasingly in medical, aviation, and other communities, debriefs systematize reflection, discussion, and goal setting to promote experiential learning. Unfortunately, research and theory on debriefing has been spread across diverse disciplines, so it has been difficult to definitively ascertain debriefing effectiveness and how to enhance its effectiveness. METHOD: We conducted an extensive quantitative meta-analysis across a diverse body of published and unpublished research on team- and individual-level debriefs. RESULTS: Findings from 46 samples (N = 2,136) indicate that on average, debriefs improve effectiveness over a control group by approximately 25% (d = .67). Average effect sizes were similar for teams and individuals, across simulated and real settings, for within- or between-group control designs, and for medical and nonmedical samples. Meta-analytic methods revealed a bolstering effect of alignment and the potential impact of facilitation and structure. CONCLUSION: Organizations can improve individual and team performance by approximately 20% to 25% by using properly conducted debriefs. APPLICATION: Debriefs are a relatively inexpensive and quick intervention for enhancing performance. Our results lend support for continued and expanded use of debriefing in training and in situ. To gain maximum results, it is important to ensure alignment between participants, focus and intent, and level of measurement.

Thromboprophylaxis in medical and surgical patients undergoing physical medicine and rehabilitation: consensus recommendations.

Venous thromboembolism (deep venous thrombosis with or without its major complication, pulmonary embolism) commonly occurs in patients undergoing rehabilitative therapy for various surgical or traumatic conditions and in patients with incapacitating medical illnesses. Thromboprophylaxis utilizes medications that interfere with the coagulation process and mechanical measures such as graded elastic stockings and intermittent pneumatic compression. To obtain a range of expert opinion on the optimal use of the numerous antithrombotic modalities now available, a consortium comprising clinical directors at a number of rehabilitative centers in south Florida met to review the literature on thromboprophylaxis in rehabilitation patients and to discuss the strategies followed at their respective facilities. The consortium then assembled a set of recommendations based on available evidence-based literature and established consensus on acceptable forms of thromboprophylaxis in each clinical condition in rehabilitation associated with an increased risk of venous thromboembolism.