Measured Wound Outcome Feedback Improves Surgical Site Infection Rates

Feedback supports learning. No matter how effective medical professionals think they are, evidence of measured patient wound outcomes helps inform their wound care practice, empowering them to improve patient outcomes. Prospective randomized clinical trials (RCTs) proved this principle in relation to healing chronic wounds. Measuring wound healing outcomes and providing caregivers with feedback about the 4-week healing progress increased the percentage of diabetic foot ulcers healed within 20 weeks and venous leg ulcers healed within 24 weeks. Longitudinal research2 suggests this principle holds true in preventing surgical site infections (SSIs). When individual orthopedic surgeons were provided written feedback about their hand hygiene practices and corresponding SSI rates, surgeon hand hygiene improved and SSI rates in their patients were reduced. This Evidence Corner describes systematic review evidence indicating that feedback given to responsible wound care professionals reduced SSI incidence for patients undergoing orthopedic or trauma surgery3 and abdominal surgery.

How do outcome-based competitive relationships shape future risky cooperation?

There is growing evidence that cooperative behavior between individuals is regulated by their experience of previous interactions with others. However, it is unclear how a relationship that stems from the evaluation of outcomes from competitive interactions can affect subsequent cooperation between these individuals. To address this issue, we examined how participants cooperated with a partner having just competed with them. While competing, participants (N = 164) were randomly assigned to receive one of four types of outcome feedback regarding their performance (win vs. loss vs. uncertain vs. control). We found that both the experience of loss and of uncertainty as competitive outcomes exerted a negative impact on the extent to which participants then engaged in mutually cooperative behavior toward their opponents. Moreover, these effects operated in a context-dependent manner: they were only found when we manipulated the relational context to imply a high potential for incurring personal costs rather than imply no risk for incurring personal costs and mutual gains. Finally, our mediation analysis further revealed that the effect of the loss outcome was mediated by the intention of participants to cooperate and their level of interpersonal trust, while the effect of uncertain competitive outcome was mediated only by the extent to which participants intended to cooperate. This suggests the presence of distinct psychological processes underlying the effects of these two types of competitive outcome. Taken together, these finding offer novel insight into how risky cooperation may cascade from previous exposure to competitive settings.

Implementing evidence-based assessment and selection in organizations: A review and an agenda for future research

In personnel- and educational selection, a substantial gap exists between research and practice, since evidence-based assessment instruments and decision-making procedures are underutilized. We provide an overview of studies that investigated interventions to encourage the use of evidence-based assessment methods, or factors related to their use. The most promising studies were grounded in self-determination theory. Training and autonomy in the design of evidence-based assessment methods were positively related to their use, while negative stakeholder perceptions decreased practitioners’ intentions to use evidence-based assessment methods. Use of evidence-based decision-making procedures was positively related to access to such procedures, information to use it, and autonomy over the procedure, but negatively related to receiving outcome feedback. A review of the professional selection literature showed that the implementation of evidence-based assessment was hardly discussed. We conclude with an agenda for future research on encouraging evidence-based assessment practice.

Task satisfaction: the effect of relative performance information versus outcome feedback

PurposeIn this empirical study, the primary aim is to examine whether the type of feedback provided, relative performance information (RPI) vs outcome, affects individual's task satisfaction in a context without financial incentives. A secondary objective is to explore whether differences in individuals' task satisfaction were associated with their performance level.Design/methodology/approachParticipants completed a mundane, effort-based task in a 1 × 2 between-subjects experimental design where the type of feedback was manipulated at two levels (RPI vs outcome).FindingsThe results revealed a positive link between providing RPI feedback to individuals and their self-reported task satisfaction compared to individuals provided with outcome feedback. We find that individuals' task satisfaction is not associated with their task performance, supporting our prediction that the level of knowledge of results affects individuals' task satisfaction.Research limitations/implicationsThe experimental task used in this study was mundane and effort intensive. Consequently, future research may be needed to examine whether the results generalize to more creative, less effort-intensive tasks. This study also utilized student participants as a proxy for employees, which is appropriate for the task, but may not generalize to organizational settings requiring specialized knowledge or task experience.Practical implicationsThe findings suggest that organizations may find providing employees with RPI to be a relatively low-cost, non-financial incentive for improving employee task satisfaction, a construct documented to reduce employee turnover and absenteeism.Originality/valueWhile prior research focuses on the effects of providing RPI on individuals' performance and effort, this study extends prior research to individuals' task satisfaction, an affective construct, illustrating that RPI is multi-dimensional. Our results also have implications for theory. We extend the feedback proposition of the widely applied Job Characteristics Model (JCM) by illustrating the type of feedback provided to individuals has task satisfaction effects beyond those associated with the mere presence of feedback.

Choices in a key press decision-making task are more optimal after gaining both aiming and reward experience

When presented with two different target–penalty configurations of similar maximum expected gain (MEG), participants prefer aiming to configurations with more advantageous spatial, rather than more advantageous gain parameters—perhaps due to the motor system’s inherent prioritisation of spatial information during movements with high accuracy demands such as aiming. To test this hypothesis, participants in the present studies chose between target–penalty configurations via key presses to reduce the importance of spatial parameters of the response and performance-related feedback. Configurations varied in spatial (target–penalty region overlap) and gain parameters (negative penalty values) and could have similar or different MEG. Choices were made without prior aiming experience (Experiment 1), after aiming experience provided information of movement variability (Experiment 2), or after aiming experience provided information of movement variability and outcome feedback (Experiment 3). Overall, configurations with advantageous spatial or gain parameters were chosen equally (Both-Similar condition) in all experiments. However, average behaviour at the group level was not reflective of the behaviour of most individual participants with three subgroups emerging: those with a value preference, distance preference, or no preference. In Experiments 1 and 2, these individual differences cannot be explained by MEG differences between configurations or participants’ movement variability, but these variables predicted choice behaviour in Experiment 3. Further in the Both-Different condition, participants only selected the larger MEG configuration at a level above chance when both variability and outcome information were given prior to the key press task (Experiment 3). In sum, the data indicate that prioritisation of spatial information did not emerge at the group level when performing key presses and more optimal behaviour emerged when information regarding movement variability and outcome feedback were given.

Tonically active neurons in the monkey dorsal striatum signal outcome feedback during trial-and-error search behavior

An animal’s choice behavior is shaped by the outcome feedback from selected actions in a trial-and-error approach. Tonically active neurons (TANs), presumed cholinergic interneurons in the striatum, are thought to be involved in the learning and performance of reward-directed behaviors, but it remains unclear how TANs are involved in shaping reward-directed choice behaviors based on the outcome feedback. To this end, we recorded activity of TANs from the dorsal striatum of two macaque monkeys (Macaca fuscata; 1 male, 1 female) while they performed a multi-step choice task to obtain multiple rewards. In this task, the monkeys first searched for a rewarding target from among three alternatives in a trial-and-error manner and then earned additional rewards by repeatedly choosing the rewarded target. We found that a considerable proportion of TANs selectively responded to either the reward or the no-reward outcome feedback during the trial-and-error search, but these feedback responses were not observed during repeat trials. Moreover, the feedback responses of TANs were similarly observed in any search trials, without distinctions regarding the predicted probability of rewards and the location of chosen targets. Unambiguously, TANs detected reward and no-reward feedback specifically when the monkeys performed trial-and-error searches, in which the monkeys were learning the value of the targets and adjusting their subsequent choice behavior based on the reward and no-reward feedback. These results suggest that striatal cholinergic interneurons signal outcome feedback specifically during search behavior, in circumstances where the choice outcomes cannot be predicted with certainty by the animals.HighlightsTANs signal reward and no-reward outcome feedback when monkeys made search behaviorsTANs respond regardless of predicted reward probability or chosen target locationTANs may signal feedback outcomes when rewards cannot be predicted with certainty