Corporate social responsibility in professional team sport organisations : towards a theory of decision-making

Research question: 

Can primary care team-based transition to insulin improve outcomes in adults with type 2 diabetes: the stepping up to insulin cluster randomized controlled trial protocol

Type 2 diabetes (T2D) brings significant human and healthcare costs. Its progressive nature means achieving normoglycaemia is increasingly difficult, yet critical to avoiding long term vascular complications. Nearly one-half of people with T2D have glycaemic levels out of target. Insulin is effective in achieving glycaemic targets, yet initiation of insulin is often delayed, particularly in primary care. Given limited access to specialist resources and the size of the diabetes epidemic, primary care is where insulin initiation must become part of routine practice. This would also support integrated holistic care for people with diabetes. Our Stepping Up Program is based on a general practitioner (GP) and practice nurse (PN) model of care supported appropriately by endocrinologists and credentialed diabetes educator-registered nurses. Pilot work suggests the model facilitates integration of the technical work of insulin initiation within ongoing generalist care.

Handover of patient information from the crisis assessment and treatment team to the inpatient psychiatric unit.

Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital. No previous research has investigated the handover between crisis assessment and treatment teams and inpatient psychiatric units, despite the importance of handover to care planning. The aim of the present study was to identify the nature and types of information transferred during these handovers, and to explore how these guides initial care planning. An observational, exploratory study design was used. A 20-item handover observation tool was used to observe 19 occasions of handover. A prospective audit was undertaken on clinical documentation arising from the admission. Clinical information, including psychiatric history and mental state, were handed over consistently; however, information about consumer preferences was reported less consistently. The present study identified a lack of attention to consumer preferences at handover, despite the current focus on recovery-oriented models for mental health care, and the centrality of respecting consumer preferences within the recovery paradigm.

Evaluation of postgraduate critical care nursing students' attitudes to, and engagement with, Team-Based Learning: a descriptive study

The aim of this study was to evaluate postgraduate critical care nursing students' attitudes to, and engagement with, Team-Based Learning (TBL).

Enhancing and assessing group and team learning in architecture and related design contexts

EXECUTIVE SUMMARYTeamwork skills are essential in the design industry where practitioners negotiate often-conflicting design options in multi-disciplinary teams. Indeed, many of the bodies that accredit design courses explicitly list teamwork skills as essential attributes of design graduates e.g., the Australian Institute of Architects (AIA), Royal Institute of British Architects (RIBA), the National Council of Architectural Registration Boards (NCARB) of the United States and the Institution of Engineers, Australia (IEAust). In addition to the need to meet the demands of the accrediting bodies, there are many reasons for the ubiquitous use of teamwork assignments in design schools. For instance, teamwork learning is seen as being representative of work in practice where design is nearly always a collaborative activity. Learning and teaching in teamwork contexts in design education are not without particular challenges. In particular, two broad issues have been identified: first, many students leave academia without having been taught the knowledge and skills of how to design in teams; second, teaching, assessment and assignment design need to be better informed by a clear understanding of what leads to effective teamwork and the learning of teamwork skills. In recognition of the lack of a structured approach to integrating teamwork learning into the curricula of design programs, this project set out to answer three primary research questions: • How do we teach teamwork skills in the context of design? • How do we assess teamwork skills?• How do design students best learn teamwork skills?In addition, four more specific questions were investigated:1. Is there a common range of learning objectives for group-and-team-work in architecture and related design disciplines that will enable the teaching of consistent and measurable outcomes?2. Do group and team formation methods, learning styles and team-role preferences impact students’ academic and course satisfaction outcomes?3. What combinations of group-and-team formation methods, teaching and assessment models significantly improve learning outcomes?4. For design students across different disciplines with different learning styles and cultural origins, are there significant differences in performance, student satisfaction (as measured through questionnaires and unit evaluations), group-and-team working abilities and student participation?To elucidate these questions, a design-based research methodology was followed comprising an iterative series of enquiries: (a) A literature review was completed to investigate: what constitutes effective teamwork, what contributes to effectiveness in teams, what leads to positive design outcomes for teams, and what leads to effective learning in teams. The review encompassed a range of contexts: from work-teams in corporate settings, to professional design teams, to education outside of and within the design disciplines. The review informed a theoretical framework for understanding what factors impact the effectiveness of student design teams. (b) The validity of this multi-factorial Framework of Effectiveness in Student Design Teams was tested via surveys of educators’ teaching practices and attitudes, and of students’ learning experiences. 638 students and 68 teachers completed surveys: two pilot surveys for participants at the four partner institutions, which then informed two national surveys completed by participants from the majority of design schools across Australia. (c) The data collected provided evidence for 22 teamwork factors impacting team effectiveness in student design teams. Pedagogic responses and strategies to these 22 teamwork factors were devised, tested and refined via case studies, focus groups and workshops. (d) In addition, 35 educators from a wide range of design schools and disciplines across Australia attended two National Teaching Symposiums. The first symposium investigated the wider conceptualisation of teamwork within the design disciplines, and the second focused on curriculum level approaches to structuring the teaching of teamwork skills identified in the Framework.The Framework of Effectiveness in Student Design Teams identifies 22 factors impacting effective teamwork, along with teaching responses and strategies that design educators might use to better support student learning. The teamwork factors and teaching strategies are categorised according to three groups of input (Task Characteristics, Individual Level Factors and Team Level Factors), two groups of processes (Teaching Practice & Support Structures and Team Processes), and three categories of output (Task Performance, Teamwork Skills, and Attitudinal Outcomes). Eight of the 22 teamwork factors directly relate to the skills that need to be developed in students, one factor relates to design outputs, and the other thirteen factors inform pedagogies that can be designed for better learning outcomes. In Table 10 of Section 4, we outline which of the 22 teamwork factors pertain to each of five stakeholder groups (curriculum leaders, teachers, students, employers and the professional bodies); thus establishing who will make best use the information and recommendations we make. In the body of this report we summarise the 22 teamwork factors and teaching strategies informed by the Framework of Effectiveness in Student Design Teams, and give succinct recommendations arising from them. This material is covered in depth by the project outputs. For instance, the teaching and assessment strategies will be expanded upon in a projected book on Teaching Teamwork in Design. The strategies are also elucidated by examples of good practice presented in our case studies, and by Manuals on Teamwork for Teachers and Students. Moreover, the project website (teamwork-in-design.com index.html=""> visited by representatives of stakeholder groups in Australia and Canada), is seeding a burgeoning community of practice that promises dissemination, critical evaluation and the subsequent refinement of our materials, tools, strategies and recommendations. The following three primary outputs have been produced by the project in answer to the primary research questions:1. A theoretical Framework of Effectiveness in Student Design Teams;2. Manuals on Teamwork for Teachers and Students (available from the website);3. Case studies of good/innovative practices in teaching and assessing teamwork in design;In addition, five secondary outputs/outcomes have been produced that provide more nuanced responses:4. Detailed recommendations for the professional accrediting bodies and curriculum leaders;5. Online survey data (from over 700 participants), plus Team Effectiveness Scale to determine the factors influencing effective learning and successful outputs for student design teams;6. A community of practice in policy, programs, practice and dialogue;7. A detailed book proposal (with sample chapter), submitted to prospective publishers, on Teaching Teamwork in Design; 8. An annotated bibliography (accessed via the project website) on learning, teaching and assessing teamwork.The project has already had an international impact. As well as papers presented in Canada and New Zealand, the surveys were participated in by six Canadian schools of architecture, whose teaching leaders also provided early feedback on the project aims and objectives during visits made to them by the project leader. In addition, design schools in Vancouver, Canada, and San Diego in the USA have already utilised the Teacher’s Manual, and in February 2014 the project findings were discussed at Tel Aviv University in a forum focusing on the challenges for sustainability in architectural education.teamwork-in-design.com>

Barriers and enablers to learning during team-based clinical simulations: reflective interviews with final year undergraduate nursing students

Background: Contemporary approaches to clinical simulation can enhance educational outcomes. However, simulation approaches do have limitations with possible compromises for learning and teaching. This paper aims to identify barriers
and enablers to learning in simulated clinical settings.
Methods: A generic qualitative design was applied. Semi-structured group video debriefing interviews were held with Australian final-year nursing students who completed three patient deterioration scenarios with a standardized patient.
Audio-recorded interviews were transcribed and analysed to identify emergent themes.
Results: Interviews with 15 teams of three students (n = 45) from three universities were analysed. Learning enablers were ‘Realism of the simulated environment’; ‘Practicing: we should do this at uni’; ‘Learning from reflection and expert feedback’, and ‘How to become competent: know the gaps’. Barriers to learning included ‘Increased stress from inexperience; ‘Expectations when pretending’ and ‘Lack of assistance’. Skills practice in team-based settings with applicable reflection and debriefing was regarded as beneficial. Simulated patients enhanced fidelity but were unable to replicate actual clinical signs. High stress levels were perceived as a barrier to learning.
Conclusions: Applicably designed high fidelity simulations with video-based reflective review offer repeated rehearsal of clinical situations to enable learning. This educational strategy may reduce the time it takes undergraduate students to
reach competency.

Cultural and professional growth through a team based internship

In 2012, 26 students from Deakin University Australian were provided with the opportunity to undertake a two-week placement with businesses in Kuala Lumpur in Malaysia. In teams of four or five, the students immersed themselves in their organisations to solve a business problem. The program was conducted again in 2013 and plans are underway to conduct the program in 2014. This paper will describe the program and the way it operates. It will provide the learnings from the two iterations it has been conducted and detail what factors contribute to a successful experience. The paper will describe the outcomes and provide evidence of the program’s success from both a student and business perspective.

Developing professional attributes in critical care nurses using Team-Based Learning.

Australian nurses prepare for specialty practice by undertaking postgraduate theoretical and clinical education in partnership models between universities and hospitals. In our global healthcare system, nurses require advanced critical thinking and strong communication skills to provide safe, high quality patient care. Yet, few education programs focus on developing these skills. Team-Based Learning (TBL) is a specific educational strategy that encourages and rewards students to think critically and solve clinical problems individually and in teams. The aim of this study was to investigate critical care nursing students' perceptions and experiences of TBL after it was introduced into the second half of their postgraduate specialty course. Following Ethics Committee approval, thirty-two students were invited to participate in an extended response questionnaire on their perceptions of TBL as part of a larger study. Data were analyzed thematically. Postgraduate students perceived their professional growth was accelerated due to the skills and knowledge acquired through TBL. Four themes underpinned the development and accelerated acquisition of specialty nurse attributes due to TBL: Engagement, Learning Effectiveness, Critical Thinking, and Motivation to Participate. Team-Based Learning offered deep and satisfying learning experiences for students. The early acquisition of advanced critical thinking, teamwork and communication skills, and specialty practice knowledge empowered nurses to provide safe patient care with confidence.

Placing sensors for area coverage in a complex environment by a team of robots

Existing solutions to carrier-based sensor placement by a single robot in a bounded unknown Region of Interest (ROI) do not guarantee full area coverage or termination. We propose a novel localized algorithm, named Back-Tracking Deployment (BTD). To construct a full coverage solution over the ROI, mobile robots (carriers) carry static sensors as payloads and drop them at the visited empty vertices of a virtual square, triangular, or hexagonal grid. A single robot will move in a predefined order of directional preference until a dead end is reached. Then it back-tracks to the nearest sensor adjacent to an empty vertex (an "entrance" to an unexplored/uncovered area) and resumes regular forward movement and sensor dropping from there. To save movement steps, the back-tracking is carried out along a locally identified shortcut. We extend the algorithm to support multiple robots that move independently and asynchronously. Once a robot reaches a dead end, it will back-track, giving preference to its own path. Otherwise, it will take over the back-track path of another robot by consulting with neighboring sensors. We prove that BTD terminates within finite time and produces full coverage when no (sensor or robot) failures occur. We also describe an approach to tolerate failures and an approach to balance workload among robots. We then evaluate BTD in comparison with the only competing algorithms SLD [Chang et al. 2009a] and LRV [Batalin and Sukhatme 2004] through simulation. In a specific failure-free scenario, SLD covers only 40-50% of the ROI, whereas BTD covers it in full. BTD involves significantly (80%) less robot moves and messages than LRV.

Validation of a trunk-mounted accelerometer to measure peak impacts during team sport movements

This study assessed the validity of an accelerometer to measure impacts in team sports. 76 participants completed a team sport circuit. Accelerations were collected concurrently at 100 Hz using an accelerometer and a 36-camera motion analysis system. The largest peak accelerations per movement were compared in 2 ways: i) pooled together and filtered at 13 different cut-off frequencies (range 6-25 Hz) to identify the optimal filtering frequency, and ii) the optimal cut-off frequency split into the 7 movements performed (n=532). Raw and 25-16 Hz filtering frequencies significantly overestimated and 6 Hz underestimated motion analysis peak accelerations (P <0.007). The 12 Hz filtered accelerometer data revealed the strongest relationship with motion analysis data (accuracy - 0.01±0.27 g, effect size - 0.01, agreement - 0.55 to 0.53 g, precision 0.27 g, and relative error 5.5%; P=1.00). The accelerometer underestimated peak accelerations during tackling and jumping, and overestimated during walking, jogging, sprinting and change of direction. Lower agreement and reduced precision were associated with sprinting, jumping and tackling. The accelerometer demonstrated an acceptable level of concurrent validity compared to a motion analysis system when filtered at a cut-off frequency of 12 Hz. The results advocate the use of accelerometers to measure movements in team sport.

Epidemiology of early Rapid Response Team activation after emergency department admission

BACKGROUND: Rapid Response Team (RRT) calls can often occur within 24h of hospital admission to a general ward. We seek to determine whether it is possible to identify these patients before there is a significant clinical deterioration. METHODS: Retrospective case-controlled study comparing patient characteristics, vital signs, and hospital outcomes in patients triggering RRT activation within 24h of ED admission (cases) with matched ED admissions not receiving a RRT call (controls). RESULTS: Over 12 months, there were 154 early RRT calls. Compared with controls, cases had a higher heart rate (HR) at triage (92 vs. 84beats/min; p=0.008); after 3h in the ED (91 vs. 80beats/min; p=0.0007); and at ED discharge (91 vs. 81beats/min; p=0.0005). Respiratory rate (RR) was also higher at triage (21.2 vs. 19.2breaths/min; p=0.001). On multiple variable analysis, RR at triage and HR before ward transfer predicted early RRT activation: OR 1.07 [95% CI 1.02-1.12] for each 1breath/min increase in RR; and 1.02 [95% CI 1.002-1.030] for each beat/minute increase in HR, respectively. Study patients required transfer to the intensive care in approximately 20% of cases and also had a greater mortality: (21% vs. 6%; OR 4.65 [95% CI 1.86-11.65]; p=0.0003) compared with controls. CONCLUSIONS: Patients that trigger RRT calls within 24h of admission have a fourfold increase in risk of in-hospital mortality. Such patients may be identified by greater tachycardia and tachypnoea in the ED.

Monitoring neuromuscular fatigue in team-sport athletes using a cycle-ergometer test

PURPOSE: To compare a novel sprint test on a cycle ergometer with a countermovement-jump (CMJ) test for monitoring neuromuscular fatigue after Australian rules football match play. METHODS: Twelve elite under-18 Australian rules football players (mean ± SD age 17.5 ± 0.6 y, stature 184.7 ± 8.8 cm, body mass 75.3 ± 7.8 kg) from an Australian Football League club's Academy program performed a short sprint test on a cycle ergometer along with a single CMJ test 1 h prematch and 1, 24, and 48 h postmatch. The cycle-ergometer sprint test involved a standardized warm-up, a maximal 6-s sprint, a 1-min active recovery, and a 2nd maximal 6-s sprint, with the highest power output of the 2 sprints recorded as peak power (PP). RESULTS: There were small to moderate differences between postmatch changes in cycle-ergometer PP and CMJ PP at 1 (ES = 0.49), 24 (ES = -0.85), and 48 h postmatch (ES = 0.44). There was a substantial reduction in cycle-ergometer PP at 24 h postmatch (ES = -0.40) compared with 1 h prematch. CONCLUSIONS: The cycle-ergometer sprint test described in this study offers a novel method of neuromuscular-fatigue monitoring in team-sport athletes and specifically quantifies the concentric component of the fatigue-induced decrement of force production in muscle, which may be overlooked by a CMJ test.