Simulated Patient as Co-facilitators: Benefits and Challenges of the Interprofessional Team OSCE (Submission #9350).

Hypothesis: The quality of care for chronic patients depends on the collaborative skills of the healthcare providers.1,2 The literature lacks reports of the use of simulation to teach collaborative skills in non-acute care settings. We posit that simulation offers benefits for supporting the development of collaborative practice in non-acute settings. We explored the benefits and challenges of using an Interprofessional Team - Objective Structured Clinical Examination (IT-OSCE) as a formative assessment tool. IT-OSCE is an intervention which involves an interprofessional team of trainees interacting with a simulated patient (SP) enabling them to practice collaborative skills in non-acute care settings.5 A simulated patient are people trained to portray patients in a simulated scenario for educational purposes.6,7 Since interprofessional education (IPE) ultimately aims to provide collaborative patient-centered care.8,9 We sought to promote patient-centeredness in the learning process. Methods: The IT-OSCE was conducted with four trios of students from different professions. The debriefing was co-facilitated by the SP with a faculty. The participants were final-year students in nursing, physiotherapy and medicine. Our research question focused on the introduction of co-facilitated (SP and faculty) debriefing after an IT-OSCE: 1) What are the benefits and challenges of involving the SP during the debriefing? and 2) To evaluate the IT-OSCE, an exploratory case study was used to provide fine grained data 10, 11. Three focus groups were conducted - two with students (n=6; n=5), one with SPs (n=3) and one with faculty (n=4). Audiotapes were transcribed for thematic analysis performed by three researchers, who found a consensus on the final set of themes. Results: The thematic analysis showed little differentiation between SPs, student and faculty perspectives. The analysis of transcripts revealed more particularly, that the SP's co-facilitation during the debriefing of an IT-OSCE proved to be feasible. It was appreciated by all the participants and appeared to value and to promote patient-centeredness in the learning process. The main challenge consisted in SPs feedback, more particularly in how they could report accurate observations to a students' group rather than individual students. Conclusion: In conclusion, SP methodology using an IT-OSCE seems to be a useful and promising way to train collaborative skills, aligning IPE, simulation-based team training in a non-acute care setting and patient-centeredness. We acknowledge the limitations of the study, especially the small sample and consider the exploration of SP-based IPE in non-acute care settings as strength. Future studies could consider the preparation of SPs and faculty as co-facilitators. References: 1. Borrill CS, Carletta J, Carter AJ, et al. The effectiveness of health care teams in the National Health Service. Aston centre for Health Service Organisational Research. 2001. 2. Reeves S, Lewin S, Espin S, Zwarenstein M. Interprofessional teamwork for health and social care. Oxford: Wiley-Blackwell; 2010. 3. Issenberg S, McGaghie WC, Petrusa ER, Gordon DL, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning - a BEME systematic review. Medical Teacher. 2005;27(1):10-28. 4. McGaghie W, Petrusa ER, Gordon DL, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Medical Education. 2010;44(1):50-63. 5. Simmons B, Egan-Lee E, Wagner SJ, Esdaile M, Baker L, Reeves S. Assessment of interprofessional learning: the design of an interprofessional objective structured clinical examination (iOSCE) approach. Journal of Interprofessional Care. 2011;25(1):73-74. 6. Nestel D, Layat Burn C, Pritchard SA, Glastonbury R, Tabak D. The use of simulated patients in medical education: Guide Supplement 42.1 - Viewpoint. Medical teacher. 2011;33(12):1027-1029. Disclosures: None (C) 2014 by Lippincott Williams & Wilkins, Inc.

Passion for Ski Mountaineering and Relationship Quality: The Mediating Role of Team Cohesion

Vallerand and colleagues (2003) developed a dualistic model of passion, wherein two types of passion are proposed: harmonious and obsessive passions that predict adaptive and less adaptive interpersonal outcomes, respectively. The present study examined the mediating role of team cohesion between passion and relationship satisfaction and interpersonal conflict with teammates. We hypothesized that harmonious and obsessive passions would be positively and negatively related to team cohesion, respectively, which, in turn should be associated with high relationship satisfaction and low interpersonal conflict with teammates. Ski mountaineers (N = 559) participating in the "Patrouille des Glaciers" completed an initial questionnaire assessing harmonious and obsessive passions for ski mountaineering and team cohesion before the race. After the race, a second questionnaire was completed and assessed participants' relationship quality with teammates and team conflict during the race. Results from path analyses supported the hypothesized model. Future research directions are discussed in light of the dualistic model of passion and team cohesion literature.

Defining a Performance Measurement System for Technology Marketing Team by Using the Balanced Scorecard Method

This thesis was produced for the Technology Marketing unit at the Nokia Research Center. Technology marketing was a new function at Nokia Research Center, and needed an established framework with the capacity to take into account multiple aspects for measuring the team performance. Technology marketing functions had existed in other parts of Nokia, yet no single method had been agreed upon for measuring their performance. The purpose of this study was to develop a performance measurement system for Nokia Research Center Technology Marketing. The target was that Nokia Research Center Technology Marketing had a framework for separate metrics; including benchmarking for starting level and target values in the future planning (numeric values were kept confidential within the company). As a result of this research, the Balanced Scorecard model of Kaplan and Norton, was chosen for the performance measurement system for Nokia Research Center Technology Marketing. This research selected the indicators, which were utilized in the chosen performance measurement system. Furthermore, performance measurement system was defined to guide the Head of Marketing in managing Nokia Research Center Technology Marketing team. During the research process the team mission, vision, strategy and critical success factors were outlined.

The effects of social networks on work-team effectiveness

This is a study of team social networks, their antecedents and outcomes. In focusing attention on the structural configuration of the team this research contributes to a new wave of thinking concerning group social capital. The research site was a random sample of Finnish work organisations. The data consisted of 499 employees in 76 teams representing 48 different organisations. A systematic literature review and quantitative methods were used in conducting the research: the former primarily to establish the current theoretical position on the relationships among the variables and the latter to test these relationships. Social network analysis was the primary method used in identifying the social-network relations among the work-team members. The first and key contribution of this study is that it relates the structuralnetwork properties of work teams to behavioural outcomes, attitudinal outcomes and, ultimately, team performance. Moreover, it shows that addressing attitudinal outcomes is also important in terms of team performance; attitudinal outcomes (team identity) mediated the relationship between the team’s performance and its social network. The second contribution is that it examines the possible antecedents of the social structure. It is thus one response to Salancik’s (1995) call for a network theory in that it explains why certain network characteristics exist. Itdemonstrates that irrespective of whether or not a team is heterogeneous in terms of age or gender, educational diversity may protect it from centralisation. However, heterogeneity in terms of gender turned out to have a negative impact on density. Thirdly, given the observation that the benefits of (team) networks are typically theorised and modelled without reference to the nature of the relationships comprising the structure, the study directly tested whether team knowledge mediated the effects of instrumental and expressive network relationships on team performance. Furthermore, with its focus on expressive networks that link the workplace to a more informal world, which have been rather neglected in previous research, it enhances knowledge of teams andnetworks. The results indicate that knowledge sharing fully mediates the influence of complementarities between dense and fragmented instrumental network relationships, thus providing empirical validation of the implicit understanding that networks transfer knowledge. Fourthly, the study findings suggest that an optimal configuration of the work-team social-network structure combines both bridging and bonding social relationships.

Innovatiivisuus johtoryhmätyöskentelyssä

Tutkimus tarkastelee innovatiivisuutta johtoryhmätyöskentelyssä. Tutkimuksen tavoitteena on selvittää innovatiivisen tiimityön prosessiin liittyviä tekijöitä johtoryhmätyöskentelyssä ja kuinka näitä tekijöitä voidaan kehittää. Tässä tutkimuksessa innovatiivisen tiimityön prosessiin liittyvät seuraavat tekijät: tiimin innovoinnin säännöt, refleksiivisyys, johtajuus, ristiriitojen johtaminen, eri tiimien yhteistyö, tiimin ulkopuoliset suhteet sekä vähemmistön ja enemmistön näkökulmat. Tutkimus toteutettiin laadullisena tapaustutkimuksena ja aineistonkeruumenetelmänä oli teemahaastattelu. Tutkimuksessa haastateltiin kymmentä johtoryhmän jäsentä. Kohderyhmänä oli Kymenlaakson ammattikorkeakoulun johtoryhmä. Tutkimuksen tulokset tukevat teoriassa esitettyjä määritelmiä ja luovat pohjan johtoryhmätyöskentelyn innovatiivisuuden kehittämiseen. Innovatiivisuus johtoryhmätyöskentelyssä perustuu johtoryhmätyöskentelyn erityispiirteiden huomioon ottamiseen, joita ovat johtoryhmän toiminnan reunaehdot ja johtoryhmän rooli toimia toimitusjohtajan avustajana päätöksenteossa. Johtajan rooli innovointiin ja avoimuuteen rohkaisevan läpinäkyvyyden kulttuurin luomisessa on merkittävä.

Making Sense of Shared Leadership. A case study of leadership processes and practices without formal leadership structure in the team context

Leadership is essential for the effectiveness of the teams and organizations they are part of. The challenges facing organizations today require an exhaustive review of the strategic role of leadership. In this context, it is necessary to explore new types of leadership capable of providing an effective response to new needs. The presentday situations, characterized by complexity and ambiguity, make it difficult for an external leader to perform all leadership functions successfully. Likewise, knowledge-based work requires providing professional groups with sufficient autonomy to perform leadership functions. This study focuses on shared leadership in the team context. Shared leadership is seen as an emergent team property resulting from the distribution of leadership influence across multiple team members. Shared leadership entails sharing power and influence broadly among the team members rather than centralizing it in the hands of a single individual who acts in the clear role of a leader. By identifying the team itself as a key source of influence, this study points to the relational nature of leadership as a social construct where leadership is seen as social process of relating processes that are co-constructed by several team members. Based on recent theoretical developments concerned with relational, practice-based and constructionist approaches to the study of leadership processes, this thesis proposes the study of leadership interactions, working processes and practices to focus on the construction of direction, alignment and commitment. During the research process, critical events, activities, working processes and practices of a case team have been examined and analyzed with the grounded theory –approach in the terms of shared leadership. There are a variety of components to this complex process and a multitude of factors that may influence the development of shared leadership. The study suggests that the development process of shared leadership is a common sense -making process and consists of four overlapping dimensions (individual, social, structural, and developmental) to work with as a team. For shared leadership to emerge, the members of the team must offer leadership services, and the team as a whole must be willing to rely on leadership by multiple team members. For these individual and collective behaviors to occur, the team members must believe that offering influence to and accepting it from fellow team members are welcome and constructive actions. Leadership emerges when people with differing world views use dialogue and collaborative learning to create spaces where a shared common purpose can be achieved while a diversity of perspectives is preserved and valued. This study also suggests that this process can be supported by different kinds of meaning-making and process tools. Leadership, then, does not reside in a person or in a role, but in the social system. The built framework integrates the different dimensions of shared leadership and describes their relationships. This way, the findings of this study can be seen as a contribution to the understanding of what constitutes essential aspects of shared leadership in the team context that can be of theoretical value in terms of advancing the adoption and development process of shared leadership. In the real world, teams and organizations can create conditions to foster and facilitate the process. We should encourage leaders and team members to approach leadership as a collective effort that the team can be prepared for, so that the response is rapid and efficient.

Perfil hematológico de equinos submetidos à prova de Team Penning

As variações nos parâmetros hematológicos são utilizadas com intuito de avaliar o grau de treinamento ou estado clínico do animal. A avaliação hematológica de eqüinos em repouso tem sido objeto de estudo, a fim de estabelecer uma relação com treinamento ou capacidade atlética. Objetivou-se avaliar o perfil hematológico de eqüinos submetidos à prova de Team Penning, correlacionando o sexo e freqüência da atividade física. Mediante punção da veia jugular externa coletaram-se dois mL de sangue de 29 eqüinos, 18 machos e 11 fêmeas, em repouso (Momento I) e após o exercício (Momento II). As amostras de sangue foram processadas em analisador hematológico automático veterinário (ABC VET - Horiba ABX Diagnostics). Os animais foram divididos em Grupos A, B, C e D, de acordo com o número de participações na prova. Observou-se que os valores de volume globular, hemoglobina, hemácias, leucócitos, neutrófilos em bastonetes e segmentados, e monócitos aumentaram após o exercício físico, ao contrário do número de linfócitos e eosinófilos, que reduziram. Não existiram diferenças significativas (p<0,05) entre machos e fêmeas ao confrontar as relações antes/depois. Além disso, evidenciou-se que o valor da relação MI/MII para volume globular, hemoglobina e número de hemácias variou de acordo com a freqüência do exercício. Conclui-se que a prova de Team Peninng ocasiona alterações hematológicas em eqüinos, com interferência da freqüência do exercício, independente do sexo.

Learning information technology business in a changing industry landscape. Introducing Team Entrepreneurship in Renewing Bachelor Education in Renewing Bachelor Education in Information

Speed, uncertainty and complexity are increasing in the business world all the time. When knowledge and skills become quickly irrelevant, new challenges are set for information technology (IT) education. Meta-learning skills – learning how to learn rapidly - and innovation skills have become more essential than single technologies or other specific issues. The drastic changes in the information and communications technology (ICT) sector have caused a need to reconsider how IT Bachelor education in Universities of Applied Sciences should be organized and employed to cope with the change. The objective of the study was to evaluate how a new approach to IT Bachelor education, the ICT entrepreneurship study path (ICT-ESP) fits IT Bachelor education in a Finnish University of Applied Sciences. This kind of educational arrangement has not been employed elsewhere in the context of IT Bachelor education. The study presents the results of a four-year period during which IT Bachelor education was renewed in a Finnish University of Applied Sciences. The learning environment was organized into an ICT-ESP based on Nonaka’s knowledge theory and Kolb’s experiental learning. The IT students who studied in the ICT-ESP established a cooperative and learned ICT by running their cooperative at the University of Applied Sciences. The students (called team entrepreneurs) studied by reading theory in books and other sources of explicit information, doing projects for their customers, and reflecting in training sessions on what was learnt by doing and by studying the literature. Action research was used as the research strategy in this study. Empirical data was collected via theme-based interviews, direct observation, and participative observation. Grounded theory method was utilized in the data analysis and the theoretical sampling was used to guide the data collection. The context of the University of Applied Sciences provided a good basis for fostering team entrepreneurship. However, the results showed that the employment of the ICT-ESP did not fit into the IT Bachelor education well enough. The ICT-ESP was cognitively too tough for the team entrepreneurs because they had two different set of rules to follow in their studies. The conventional courses engaged lot of energy which should have been spent for professional development in the ICT-ESP. The amount of competencies needed in the ICT-ESP for professional development was greater than those needed for any other ways of studying. The team entrepreneurs needed to develop skills in ICT, leadership and self-leadership, team development and entrepreneurship skills. The entrepreneurship skills included skills on marketing and sales, brand development, productization, and business administration. Considering the three-year time the team entrepreneurs spent in the ICT-ESP, the challenges were remarkable. Changes to the organization of IT Bachelor education are also suggested in the study. At first, it should be admitted that the ICT-ESP produces IT Bachelors with a different set of competencies compared to the conventional way of educating IT Bachelors. Secondly, the number of courses on general topics in mathematics, physics, and languages for team entrepreneurs studying in the ICTESP should be reconsidered and the conventional course-based teaching of the topics should be reorganized to support the team coaching process of the team entrepreneurs with their practiceoriented projects. Third, the upcoming team entrepreneurs should be equipped with relevant information about the ICT-ESP and what it would require in practice to study as a team entrepreneur. Finally, the upcoming team entrepreneurs should be carefully selected before they start in the ICT-ESP to have a possibility to eliminate solo players and those who have a too romantic view of being a team entrepreneur. The results gained in the study provided answers to the original research questions and the objectives of the study were met. Even though the IT degree programme was terminated during the research process, the amount of qualitative data gathered made it possible to justify the interpretations done.

Reflexivity in sovereign debt markets

Finanssi-instrumentin hinta määräytyy sen fundamenttitekijöiden perusteella, eikä päinvastoin. Tämä tutkimus osoittaa, että myös instrumentin hinta voi vaikuttaa fundamenttitekijöihin. Yhteys havainnollistetaan tapaustukimuksella Kreikan velkakriisistä. Hinnan ja fundamenttien välistä yhteyttä arvioidaan ja käänteisen kausaliteetin olemassaolo testataan. Tulokset tukevat ajatusta, jonka mukaan tarvitsemme dynaamisempia valuaatiomenetelmiä, jotka ottavat huomioon myös mahdolliset itseään vahvistavat hintakierteet.

1998 Brock Baseball Team

1998 Brock Badger men's baseball team photo. Front Row (L to R): Bill Gillen, Ryan Villers, Greg Arbour, Mark Cheeseman, Andrew Tinnish, Rick Bottomley, Matt Fletcher, Brad Namtzu, Darryl Presley, Dan Pino, Grant Giffen, Mike Caruso, Mark Reilly Back Row (L to R): Jeff Lounsbury (Head Coach), Jayar Green, Creston Rudolph, Ryan Fisher, Jamie Trull, Stefan Strecker, Andrew Robb, Jeremy Walker, Ryan Johns, Matt Stezycki, Steve Lester, Fabio Del Rio, Jarrod Haase, Jess Dixon, Rick Falconer (Pitching Coach) Absent: Marc Purdy, Ian Bala, Marc LePage (Asst. Coach), Waybe Briggs-Jude (Asst. Coach)

1999 Brock Baseball Team

Men's baseball team after winning the 1999 national championships.