Presence and Power: Teams with Hierarchical Representation of Underrepresented Minorities are More Attractive

Across four studies (N = 1,555) we find that individuals perceive teams with hierarchical representation (i.e., minority employees represented throughout their hierarchy) as more attractive than equally diverse teams that lack hierarchical representation. Teams with hierarchical representation are perceived as more diverse and as having superior team functioning (Study 1). Furthermore, the effect of hierarchical representation on team attractiveness did not differ between racial minority and majority participants (Studies 2-3), suggesting that attitudes about race among racial majority members might have evolved since a previous study found only racial minorities to be concerned with hierarchical representation. Additionally, diverse teams without hierarchical representation are perceived as no more attractive than hierarchical teams with objectively lower diversity (Study 3) and non-hierarchical teams without diversity (Study 4). These studies highlight the importance of minority representation across every echelon of a hierarchy rather than only at lower levels.

Seeing Through the FOG: A Classroom Exercise Illustrating the Challenges of Sharing Information as Facts, Opinions, and Guesses in Teams

Information sharing is a critical aspect of effective team functioning. However, it can be challenging to discern whether the information communicated is fact, opinion, or someone’s best guess (FOG) due to the varied understandings, assumptions, and interests team members bring to any collaboration. In this article, we introduce a role-play exercise that helps participants better understand the complexities associated with information sharing in teams and how to sort through the FOG associated with information exchanges. Drawing upon research on motivated information processing, this exercise simulates the challenges of information sharing and assists teachers in demonstrating strategies to overcome them.

Intraoperative Simulation: Team Training for Resuscitation While Using Intraoperative Computed Tomography: 2-Dimensional Operative Video

Spine surgeons increasingly use intraoperative computed tomography (iCT) to facilitate surgery. iCT has several advantages, including the ability to decrease radiation exposure, improve surgical accuracy, and decrease operative time.1-3 However, the large footprint of the equipment can impede fast patient access in the event of an emergency resuscitation. This challenge is compounded when the patient is prone with rigid head fixation. To achieve fast, high-quality resuscitation, a large team must overcome numerous challenges. Cohesive team functioning under these circumstances requires planning, practice, and refinement.4 As a result of our simulation sessions, we have made several changes to the setup of our iCT cases. The following equipment is now routinely used: extralong tubing between the anesthesia circuit and patient, portable vital monitor, additional intravenous access is obtained, and extension tubing is used with all lines. We have created educational diagrams to streamline 2 challenging processes: optimal bed placement (for supination) and removal of equipment from the operating room (OR) to accommodate an influx of emergency personnel and equipment. Since the implementation of this protocol, 1 prone posterior cervical patient had intraoperative cardiac arrest. The protocol was followed. Return of spontaneous circulation was achieved within 5 min. The patient was discharged from the hospital with no neurological sequelae. During debriefing, stakeholders uniformly credited the simulated practice with this positive outcome. Emergency planning is a multifaceted process that continually evolves. With a steady flux of personnel and equipment, ongoing practice is essential to ensure readiness. Here, we share the key elements of our twice-yearly simulation. This simulation was performed on a training mannequin. This study did not involve human subjects. Any depictions of care rendered to nonidentifiable patients were standard (nonexperimental).

Interdisciplinary Health Care Evaluation Instruments: A Review of Psychometric Evidence

Teamwork among health care professionals has been found to improve patient outcomes and reduce burnout. Surveys from individual team members are often used to measure the effectiveness of teamwork performance, as they provide an efficient way to capture various constructs of teamwork. This allows evaluators to better understand team functioning, areas of strength, and to identify potential areas for improvement. However, the majority of published surveys are yet to be validated. We conducted a review of psychometric evidence to identify instruments frequently used in practice and identified in the literature. The databases searched included MEDLINE, EMBASE, CINAHL, and PsycINFO. After excluding duplicates and irrelevant articles, 15 articles met the inclusion criteria for full assessment. Seven surveys were validated and most frequently identified in the literature. This review aims to facilitate the selection of instruments that are most appropriate for research and clinical practice. More research is required to develop surveys that better reflect the current reality of teamwork in our evolving health system, including a greater consideration for patient as team members. Additionally, more research is needed to encompass an increasing development of team assessment tools.

Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

Medical Students’ Insights Towards Patient Safety

Objectives: This study aimed to explore Saudi Arabian medical students’ perceptions of patient safety. Methods: A cross-sectional descriptive study was conducted in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, in September 2019. The Attitudes to Patient Safety Questionnaire (APSQ III) was used to explore undergraduate medical students’ attitudes towards and knowledge of PS. The main outcomes measured were the APSQ III’s nine domains. Data were analysed using Statistical Package for the Social Sciences and students’ attitudes were communicated as mean scores ± standard deviations. Results: A total of 301 participants were included in this study (response rate: 85.75%). Six domains reflected a positive attitude while three domains showed a neutral attitude. The domain of ‘team functioning’ had the highest mean score (5.8) followed by ‘working hours as a cause of error’ (5.6) and ‘error inevitability’ (5.4). There was a significant difference between gender in the domain ‘patient involvement in reducing error’ (P = 0.012) and ‘importance of patient safety (PS) in the curriculum’ (P = 0.001). In addition, the ‘importance of PS in the curriculum’ domain was significantly different across different age groups (P = 0.039). Conclusion: Medical students were highly interested in PS and recommended implementing a comprehensive undergraduate PS programme to fulfil their educational needs. Keywords: Undergraduate Medical Education; Patient Safety; Medical Errors; Attitude; Medical Students; Medical Ethics; Patient Care; Saudi Arabia.

448 The Impact of Noise in the Operating Theatre: A Review of the Evidence

Background Noise has been recognised to have a negative impact on performance and wellbeing in many settings. Average noise levels have been found to range between 51-79 dB in operating theatres. Despite this, there is little research investigating the effect of noise on surgical team functioning. Method A literature review to look at the impact of noise in the operating theatre was performed on MEDLINE which included the search terms ‘noise’ OR ‘distraction’ AND ‘technical skill’ OR ‘Surgical skill’ OR ‘Operating Room’. 10 of 307 articles identified were deemed relevant. Results 8 of 10 studies found noise to be detrimental to communication and surgical performance, particularly regarding total errors and time to task completion. No studies found noise to be beneficial. Two studies found case irrelevant verbal communication to be a frequent form of noise pollution in operating theatres; this is both perceived by surgeons to be distracting and delays patient care. Noise was most harmful to trainees. Conclusions Noise and irrelevant verbal communications were both found to be harmful to surgical performance, surgeon experience and team functioning. The worsened effect on the trainee exposes an urgent need to address noise pollution in the training environment.