Background: Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods: Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results: All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion: We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.
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In the digital age, information problem solving (IPS) competence is essential for professionals to use online information effectively. Despite its importance, starting professionals often struggle with processing and presenting information, which are critical phases during authentic IPS tasks. Therefore, higher education institutions are tasked with preparing students to navigate these complex phases of IPS after graduation. However, most previous studies have focused on the “search” and “select” phases of simple, short-duration IPS tasks, which do not reflect the complex information challenges faced in professional settings. To address this gap, this study aimed to identify and categorize the strategies higher education students currently use to process and present information for a semester-long authentic professional task. A thematic analysis of cued retrospective reporting sessions was conducted with 24 senior students while they created a website for professional practice. Students demonstrated 49 IPS strategies, which were categorized into twelve IPS activities across three generic activity phases: “process,” “synthesize,” and “create.” Within these phases, three patterns of co-occurring strategies were observed: reproductive, arranging, and elaborative. Based on these findings, existing IPS process models were empirically refined. The observed variation in strategies highlights the importance of building on students’ strengths when teaching IPS. Teaching them to adapt the strategies to various authentic task contexts could help enhance students’ IPS competence and strategic flexibility in real-world settings. Future research should explore the applicability of the updated IPS model across different authentic task contexts to refine instructional approaches further.
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In clinical practice, formal elements of art products are regularly used in art therapy observation to obtain insight into clients’ mental health and provide directions for further treatment. Due to the diversity of formal elements used in existing studies and the inconsistency in the interpretation, it is unclear which formal elements contribute to insight into clients’ mental health. In this qualitative study using Constructivist Grounded Theory, eight art therapists were interviewed in-depth to identify which formal elements they observe, how they describe mental health and how they associate formal elements with mental health. Findings of this study show that art therapists in this study observe the combination of movement, dynamic, contour and repetition (i.e., primary formal elements) with mixture of color, figuration and color saturation (i.e., secondary formal elements). Primary and secondary elements interacting together construct the structure and variation of the art product. Art therapists rarely interpret these formal elements in terms of symptoms or diagnosis. Instead, they use concepts such as balance and adaptability (i.e., self-management, openness, flexibility, and creativity). They associate balance, specifically being out of balance, with the severity of the clients’ problem and adaptability with clients’ strengths and resources. In the conclusion of the article we discuss the findings’ implications for practice and further research.
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Examining in-class activities to facilitate academic achievement in higher educationThere is an increasing interest in how to create an effective and comfortable indoor environment for lecturers and students in higher education. To achieve evidence-based improvements in the indoor environmental quality (IEQ) of higher education learning environments, this research aimed to gain new knowledge for creating optimal indoor environmental conditions that best facilitate in-class activities, i.e. teaching and learning, and foster academic achievement. The academic performance of lecturers and students is subdivided into short-term academic performance, for example, during a lecture and long-term academic performance, during an academic course or year, for example. First, a systematic literature review was conducted to reveal the effect of indoor environmental quality in classrooms in higher education on the quality of teaching, the quality of learning, and students’ academic achievement. With the information gathered on the applied methods during the literature review, a systematic approach was developed and validated to capture the effect of the IEQ on the main outcomes. This approach enables research that aims to examine the effect of all four IEQ parameters, indoor air quality, thermal conditions, lighting conditions, and acoustic conditions on students’ perceptions, responses, and short-term academic performance in the context of higher education classrooms. Next, a field experiment was conducted, applying the validated systematic approach, to explore the effect of multiple indoor environmental parameters on students and their short-term academic performance in higher education. Finally, a qualitative case study gathered lecturers’ and students’ perceptions related to the IEQ. Furthermore, how these users interact with the environment to maintain an acceptable IEQ was studied.During the systematic literature review, multiple scientific databases were searched to identify relevant scientific evidence. After the screening process, 21 publications were included. The collected evidence showed that IEQ can contribute positively to students’ academic achievement. However, it can also affect the performance of students negatively, even if the IEQ meets current standards for classrooms’ IEQ conditions. Not one optimal IEQ was identified after studying the evidence. Indoor environmental conditions in which students perform at their best differ and are task depended, indicating that classrooms should facilitate multiple indoor environmental conditions. Furthermore, the evidence provides practical information for improving the design of experimental studies, helps researchers in identifying relevant parameters, and lists methods to examine the influence of the IEQ on users.The measurement methods deduced from the included studies of the literature review, were used for the development of a systematic approach measuring classroom IEQ and students’ perceived IEQ, internal responses, and short-term academic performance. This approach allowed studying the effect of multiple IEQ parameters simultaneously and was tested in a pilot study during a regular academic course. The perceptions, internal responses, and short-term academic performance of participating students were measured. The results show associations between natural variations of the IEQ and students’ perceptions. These perceptions were associated with their physiological and cognitive responses. Furthermore, students’ perceived cognitive responses were associated with their short-term academic performance. These observed associations confirm the construct validity of the composed systematic approach. This systematic approach was then applied in a field experiment, to explore the effect of multiple indoor environmental parameters on students and their short-term academic performance in higher education. A field study, with a between-groups experimental design, was conducted during a regular academic course in 2020-2021 to analyze the effect of different acoustic, lighting, and indoor air quality (IAQ) conditions. First, the reverberation time was manipulated to 0.4 s in the intervention condition (control condition 0.6 s). Second, the horizontal illuminance level was raised from 500 to 750 lx in the intervention condition (control condition 500 lx). These conditions correspond with quality class A (intervention condition) and B (control condition), specified in Dutch IEQ guidelines for school buildings (2015). Third, the IAQ, which was ~1100 ppm carbon dioxide (CO2), as a proxy for IAQ, was improved to CO2 concentrations under 800 ppm, meeting quality class A in both conditions. Students’ perceptions were measured during seven campaigns with a questionnaire; their actual cognitive and short-term academic performances were evaluated with validated tests and an academic test, composed by the lecturer, as a subject-matter-expert on the taught topic, covered subjects discussed during the lecture. From 201 students 527 responses were collected and analyzed. A reduced RT in combination with raised HI improved students’ perceptions of the lighting environment, internal responses, and quality of learning. However, this experimental condition negatively influenced students’ ability to solve problems, while students' content-related test scores were not influenced. This shows that although quality class A conditions for RT and HI improved students’ perceptions, it did not influence their short-term academic performance. Furthermore, the benefits of reduced RT in combination with raised HI were not observed in improved IAQ conditions. Whether the sequential order of the experimental conditions is relevant in inducing these effects and/or whether improving two parameters is already beneficial, is unknownFinally, a qualitative case study explored lecturers’ and students’ perceptions of the IEQ of classrooms, which are suitable to give tutorials with a maximum capacity of about 30 students. Furthermore, how lecturers and students interact with this indoor environment to maintain an acceptable IEQ was examined. Eleven lecturers of the Hanze University of Applied Sciences (UAS), located in the northern part of the Netherlands, and twenty-four of its students participated in three focus group discussions. The findings show that lecturers and students experience poor thermal, lighting, acoustic, and IAQ conditions which may influence teaching and learning performance. Furthermore, maintaining acceptable thermal and IAQ conditions was difficult for lecturers as opening windows or doors caused noise disturbances. In uncomfortable conditions, lecturers may decide to pause earlier or shorten a lecture. When students experienced discomfort, it may affect their ability to concentrate, their emotional status, and their quality of learning. Acceptable air and thermal conditions in classrooms will mitigate the need to open windows and doors. This allows lecturers to keep doors and windows closed, combining better classroom conditions with neither noise disturbances nor related distractions. Designers and engineers should take these end users’ perceptions into account, often monitored by facility management (FM), during the renovation or construction of university buildings to achieve optimal IEQ conditions in higher education classrooms.The results of these four studies indicate that there is not a one-size fits all indoor environmental quality to facilitate optimal in-class activities. Classrooms’ thermal environment should be effectively controlled with the option of a local (manual) intervention. Classrooms’ lighting conditions should also be adjustable, both in light color and light intensity. This enables lecturers to adjust the indoor environment to facilitate in-class activities optimally. Lecturers must be informed by the building operator, for example, professionals of the Facility Department, how to change classrooms’ IEQ settings. And this may differ per classroom because each building, in which the classroom is located, is operated differently apart from the classroom location in the building, exposure to the environment, and its use. The knowledge that has come available from this study, shows that optimal indoor environmental conditions can positively influence lecturers’ and students’ comfort, health, emotional balance, and performance. These outcomes have the capacity to contribute to an improved school climate and thus academic achievement.
