Background: The number of people with multiple chronic conditions increases as a result of ageing. To deal with the complex health-care needs of these patients, it is important that health-care professionals collaborate in interprofessional teams. To deliver patient-centred care, it is often recommended to include the patient as a member of the team. Objective: To gain more insight into how health-care professionals and patients, who are used to participate in interprofessional team meetings, experience and organize patient participation in the team meetings. Methods: A qualitative study including observations of meetings (n=8), followed by semi-structured interviews with participating health-care professionals (n=8), patients and/or relatives (n=11). Professionals and patients were asked about their experiences of patient participation immediately after the team meetings. Results from both observations and interviews were analysed using content analysis. Results: The findings show a variety of influencing factors related to patient participation that can be divided into five categories: (i) structure and task distribution, (ii) group composition, (iii) relationship between professionals and patients or relatives, (iv) patients’ characteristics and (v) the purpose of the meeting. Conclusion: Patient participation during team meetings was appreciated by professionals and patients. A tailored approach to patient involvement during team meetings is preferable. When considering the presence of patients in team meetings, it is recommended to pay attention to patients’ willingness and ability to participate, and the necessary information shared before the meeting. Participating patients seem to appreciate support and preparation for the meeting.
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Background: The number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients’ perspective. Objective: The aim was to explore the patients’ perspectives regarding IPT meetings in primary care. Methods: A qualitative study with a focus group design was conducted in the Netherlands. Two focus group meetings took place, for which the same patients were invited. The participants, chronically ill patients with experience on interprofessional collaboration, were recruited through the regional patient association. Participants discussed viewpoints, expectations, and concerns regarding IPT meetings in two rounds, using a focus group protocol and selected video-taped vignettes of team meetings. The first meeting focused on conceptualization and identification of themes related to IPT meetings that are important to patients. The second meeting aimed to gain more in-depth knowledge and understanding of the priorities. Discussions were audio-taped and transcribed verbatim, and analyzed by means of content analysis. Results: The focus group meetings included seven patients. Findings were divided into six key categories, capturing the factors that patients found important regarding IPT meetings: (1) putting the patient at the center, (2) opportunities for patients to participate, (3) appropriate team composition, (4) structured approach, (5) respectful communication, and (6) informing the patient about meeting outcomes. Conclusions: Patients identified different elements regarding IPT meetings that are important from their perspective. They emphasized the right of patients or their representatives to take part in IPT meetings. Results of this study can be used to develop tools and programs to improve interprofessional collaboration.
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Background: The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. Objectives: This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Methods. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Results: Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. Conclusion: IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members’ awareness of aspects that could be improved before training them in dealing with specific challenges.
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Learning teams in higher education executing a collaborative assignment are not always effective. To remedy this, there is a need to determine and understand the variables that influence team effectiveness. This study aimed at developing a conceptual framework, based on research in various contexts on team effectiveness and specifically team and task awareness. Core aspects of the framework were tested to establish its value for future experiments on influencing team effectiveness. Results confirmed the importance of shared mental models, and to some extent mutual performance monitoring for learning teams to become effective, but also of interpersonal trust as being conditional for building adequate shared mental models. Apart from the importance of team and task awareness for team effectiveness it showed that learning teams in higher education tend to be pragmatic by focusing primarily on task aspects of performance and not team aspects. Further steps have to be taken to validate this conceptual framework on team effectiveness.
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Walking meetings are a promising way to reduce unhealthy sedentary behavior at the office. Some aspects of walking meetings are however hard to assess using traditional research approaches that do not account well for the embodied experience of walking meetings. We conducted a series of 16 bodystorming sessions, featuring unusual walking meeting situations to engage participants (N=45) in a reflective experience. After each bodystorming, participants completed three tasks: a body map, an empathy map, and a rating of workload using the NASA-TLX scale. These embodied explorations provide insights on key themes related to walking meetings: material and tools, physical and mental demand, connection with the environment, social dynamics, and privacy. We discuss the role of technology and opportunities for technology-mediated walking meetings. We draw implications for the design of walking meeting technologies or services to account for embodied experiences, and the individual, social, and environmental factors at play.
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Background Interprofessional education is promoted as a means of enhancing future collaborative practice in healthcare. We developed a learning activity in which undergraduate medical, nursing and allied healthcare students practice interprofessional collaboration during a student-led interprofessional team meeting. Design and delivery During their clinical rotation at a family physician’s practice, each medical student visits a frail elderly patient and prepares a care plan for the patient. At a student-led interprofessional team meeting, medical, nursing and allied healthcare students jointly review these care plans. Subsequently, participating students reflect on their interprofessional collaboration during the team meeting, both collectively and individually. Every 4 weeks, six interprofessional team meetings take place. Each team comprises 9–10 students from various healthcare professions, and meets once. To date an average of 360 medical and 360 nursing and allied healthcare students have participated in this course annually. Evaluation Students mostly reported positive experiences, including the opportunity to learn with, from and about other healthcare professions in the course of jointly reviewing care plans, and feeling collectively responsible for the care of the patients involved. Additionally, students reported a better understanding of the contextual factors at hand. The variety of patient cases, diversity of participating health professions, and the course material need improvement. Conclusion Students from participating institutions confirmed that attending a student-led interprofessional team meeting had enabled them to learn with, from and about other health professions in an active role. The use of real-life cases and the educational design contributed to the positive outcome of this interprofessional learning activity.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting.
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University teacher teams can work toward educational change through the process of team learning behavior, which involves sharing and discussing practices to create new knowledge. However, teachers do not routinely engage in learning behavior when working in such teams and it is unclear how leadership support can overcome this problem. Therefore, this study examines when team leadership behavior supports teacher teams in engaging in learning behavior. We studied 52 university teacher teams (281 respondents) involved in educational change, resulting in two key findings. First, analyses of multiple leadership types showed that team learning behavior was best supported by a shared transformational leadership style that challenges the status quo and stimulates team members’ intellect. Mutual transformational encouragement supported team learning more than the vertical leadership source or empowering and initiating structure styles of leadership. Second, moderator analyses revealed that task complexity influenced the relationship between vertical empowering team leadership behavior and team learning behavior. Specifically, this finding suggests that formal team leaders who empower teamwork only affected team learning behavior when their teams perceived that their task was not complex. These findings indicate how team learning behavior can be supported in university teacher teams responsible for working toward educational change. Moreover, these findings are unique because they originate from relating multiple team leadership types to team learning behavior, examining the influence of task complexity, and studying this in an educational setting. https://www.scienceguide.nl/2021/06/leren-van-docentteams-vraagt-om-gezamenlijk-leiderschap/
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Aim To provide insight into the basic characteristics of decision making in the treatment of symptomatic severe aortic stenosis (SSAS) in Dutch heart centres with specific emphasis on the evaluation of frailty, cognition, nutritional status and physical functioning/functionality in (instrumental) activities of daily living [(I)ADL]. Methods A questionnaire was used that is based on the European and American guidelines for SSAS treatment. The survey was administered to physicians and non-physicians in Dutch heart centres involved in the decision-making pathway for SSAS treatment. Results All 16 Dutch heart centres participated. Before a patient case is discussed by the heart team, heart centres rarely request data from the referring hospital regarding patients’ functionality (n = 5), frailty scores (n = 0) and geriatric consultation (n = 1) as a standard procedure. Most heart centres ‘often to always’ do their own screening for frailty (n = 10), cognition/mood (n = 9), nutritional status (n = 10) and physical functioning/functionality in (I)ADL (n = 10). During heart team meetings data are ‘sometimes to regularly’ available regarding frailty (n = 5), cognition/mood (n = 11), nutritional status (n = 8) and physical functioning/functionality in (I)ADL (n = 10). After assessment in the outpatient clinic patient cases are re-discussed ‘sometimes to regularly’ in heart team meetings (n = 10). Conclusions Dutch heart centres make an effort to evaluate frailty, cognition, nutritional status and physical functioning/functionality in (I)ADL for decision making regarding SSAS treatment. However, these patient data are not routinely requested from the referring hospital and are not always available for heart team meetings. Incorporation of these important data in a structured manner early in the decision-making process may provide additional useful information for decision making in the heart team meeting.
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With artificial intelligence (AI) systems entering our working and leisure environments with increasing adaptation and learning capabilities, new opportunities arise for developing hybrid (human-AI) intelligence (HI) systems, comprising new ways of collaboration. However, there is not yet a structured way of specifying design solutions of collaboration for hybrid intelligence (HI) systems and there is a lack of best practices shared across application domains. We address this gap by investigating the generalization of specific design solutions into design patterns that can be shared and applied in different contexts. We present a human-centered bottom-up approach for the specification of design solutions and their abstraction into team design patterns. We apply the proposed approach for 4 concrete HI use cases and show the successful extraction of team design patterns that are generalizable, providing re-usable design components across various domains. This work advances previous research on team design patterns and designing applications of HI systems.
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