The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role. © 2004 Elsevier Ltd. All rights reserved.

An investigation of the prevalence and measurement of teams in organisations:the development and validation of the real team scale

This thesis begins with a review of the literature on team-based working in organisations, highlighting the variations in research findings, and the need for greater precision in our measurement of teams. It continues with an illustration of the nature and prevalence of real and pseudo team-based working, by presenting results from a large sample of secondary data from the UK National Health Service. Results demonstrate that ‘real teams’ have an important and significant impact on the reduction of many work-related safety outcomes. Based on both theoretical and methodological limitations of existing approaches, the thesis moves on to provide a clarification and extension of the ‘real team’ construct, demarcating this from other (pseudo-like) team typologies on a sliding scale, rather than a simple dichotomy. A conceptual model for defining real teams is presented, providing a theoretical basis for the development of a scale on which teams can be measured for varying extents of ‘realness’. A new twelve-item scale is developed and tested with three samples of data comprising 53 undergraduate teams, 52 postgraduate teams, and 63 public sector teams from a large UK organisation. Evidence for the content, construct and criterion-related validity of the real team scale is examined over seven separate validation studies. Theoretical, methodological and practical implications of the real team scale are then discussed.

Knowledge transfer in globally distributed teams:the role of transactive memory

This paper explores the role of transactive memory in enabling knowledge transfer between globally distributed teams. While the information systems literature has recently acknowledged the role transactive memory plays in improving knowledge processes and performance in colocated teams, little is known about its contribution to distributed teams. To contribute to filling this gap, knowledge-transfer challenges and processes between onsite and offshore teams were studied at TATA Consultancy Services. In particular, the paper describes the transfer of knowledge between onsite and offshore teams through encoding, storing and retrieving processes. An in-depth case study of globally distributed software development projects was carried out, and a qualitative, interpretive approach was adopted. The analysis of the case suggests that in order to overcome differences derived from the local contexts of the onsite and offshore teams (e.g. different work routines, methodologies and skills), some specific mechanisms supporting the development of codified and personalized ‘directories’ were introduced. These include the standardization of templates and methodologies across the remote sites as well as frequent teleconferencing sessions and occasional short visits. These mechanisms contributed to the development of the notion of ‘who knows what’ across onsite and offshore teams despite the challenges associated with globally distributed teams, and supported the transfer of knowledge between onsite and offshore teams. The paper concludes by offering theoretical and practical implications.

The blurring boundaries between synchronicity and asynchronicity:new communicative situations in work-related Instant Messaging

Instant messaging is one of the most popular communication technologies in virtual teams, enabling interactions to intertwine whole working days, thus creating the sense of copresence for team members who are geographically dispersed. Through close linguistic analyses of naturally occurring data from a virtual team, this article discusses the implications of two novel communicative situations enabled by instant messaging: presence information and the persistence of transcript. The preliminary findings of this study indicate that these new communicative situations require the flouting or rethinking of previously existing interactional norms and that communicative practices employed by the team members are not yet conventionalized/normalized, the expectations and interpretations of interactional rituals and timing vary highly, even within the same virtual team.

Well-structured teams and the buffering of hospital employees from stress

Membership in well-structured teams, which show clarity in team and individual goals, meet regularly, and recognize diverse skills of their members, is known to reduce stress. This study examined how membership of well-structured teams was associated with lower levels of strain, when testing a work stressors-to-strains relationship model across the three levels of team structure, namely well-structured, poorly structured (do not fulfill all the criteria of well-structured teams) and no team. The work stressors tested, were quantitative overload and hostile environment, whereas strains were measured through job satisfaction and intention to leave job. This investigation was carried out on a random sample of 65,142 respondents in acute/specialist National Health Service hospitals across the UK. Using multivariate analysis of variance, statistically significant differences between means across the three groups of team structure, with mostly moderate effect sizes, were found for the study variables. Those in well-structured teams have the highest levels of job satisfaction and the least intention to leave job. Multigroup structural equation modelling confirmed the model's robustness across the three groups of team structure. Work stressors explained 45%, 50% and 65% of the variance of strains for well-structured, poorly structured and no team membership, respectively. An increase of one standard deviation in work stressors, resulted in an increase in 0.67, 0.70 and 0.81 standard deviations in strains for well-structured, poorly structured and no team membership, respectively. This investigation is an eye-opener for hospitals to work towards achieving well-structured teams, as this study shows weaker stressor-to-strain relationships for members of these teams.

Help in finding the right balance:leadership, work-family balance and employee outcomes

Although much research has examined employees’ experience of the work-family interface, its conceptualization has been rather problematic, ranging from work and family as mutually constraining through to mutually enriching and, more recently, to work-family balance (WFB). Building on Greenhaus and Allen’s (2011) conceptualization of WFB as comprising satisfaction and effectiveness components, I proposed and tested a model of he antecedents and outcomes of WFB. Based on work-family border theory, I hypothesised that family-supportive supervisor behaviours (FSSB) facilitate WFB and hat the relationship is stronger when the organisation also offers formal support (availability of family-friendly practices (FFPs); enhancement effect). Furthermore, I integrated the leadership and work-family interface literatures by proposing authentic eadership as an antecedent of FSSB. Based on role accumulation theories, I proposed life satisfaction and health as outcomes of WFB satisfaction and WFB effectiveness and job performance as an outcome of only WFB effectiveness. I tested my hypotheses with individual-level data in Study 1 (two waves of data; employees from Germany and the UK) and nested data (individuals nested in teams; two waves of data; employee and supervisor ratings; Germany and the UK) in Study 2. The obtained findings largely supported the hypothesized model and showed that both authentic leadership (Study 1) and team authentic leadership (Study 2) predicted FSSB which, in turn, increased WFB satisfaction and WFB effectiveness. Contrary to my prediction, both studies revealed that FSSB and (team) availability of FFPs compensated for each other, only impacting WFB satisfaction/effectiveness if the other form of family support was not available. Furthermore, both components were positively related to life satisfaction and health, while WFB effectiveness was only related to self-rated performance (Study 1) and not supervisor-rated performance (Study 2). Lastly, the serial moderated mediation model hat tested the conditional indirect effect of (team) authentic leadership on the outcomes received mixed support.

Adaptation in knowledge-based teams: An examination of team composition, leader sensegiving, and cognitive, behavioral, and motivational mechanisms

Organizations are increasingly relying on teams to do the work that has traditionally been done by individuals. At the same time, the environments in which these organizations and teams operate have been becoming progressively more complex and uncertain. These trends raise important questions about the factors that enable teams to adapt. In response to these questions, the current study sought to identify the cognitive, behavioral, and motivational processes and emergent states that promote a team's adaptation to unforeseen changes and novel events, and the team compositional characteristics and leadership processes that enabled these processes and emergent states. Two hundred twenty two undergraduate students from a large Southeastern University composed 74 3-person teams, and participated in a computerized decision-making simulation where each team formed the governing body (i.e., Mayor's cabinet) for two separate simulated cities, and made strategic decisions about city operations. Participants were randomly assigned to one of three roles, distributing expertise and creating mutual interdependence. External team leader sensegiving was manipulated through video recorded communications from an external team leader. Results indicate that team cognitive ability, achievement striving, and psychological collectivism, as well as external team leader sensegiving, were all related to the similarity and quality of team members' strategy-focused mental models (cognitive emergent states), and to the amount of information sharing among members (behavioral process). In turn, teams with more similar and higher quality mental models, and who shared greater levels of information, were found to have a greater ability to react and adapt to environmental changes, and to have greater levels of decision-making effectiveness. Results indicate a pattern of relationships consistent with hypotheses, and have important implications for organizations and knowledge-based teams charged with management responsibilities. Organizations should staff teams with the compositional characteristics that enable the development of similar and high quality mental models, and that promote information sharing among teammates. Similarly, organizations which train and develop leaders to engage in sensegiving behaviors enable team adaptability and promote enhanced decision-making effectiveness when faced with unforeseen changes and novel situations.

Design and implementation of a relative localization system for ground and aerial robotic teams

The main focus of this thesis is to address the relative localization problem of a heterogenous team which comprises of both ground and micro aerial vehicle robots. This team configuration allows to combine the advantages of increased accessibility and better perspective provided by aerial robots with the higher computational and sensory resources provided by the ground agents, to realize a cooperative multi robotic system suitable for hostile autonomous missions. However, in such a scenario, the strict constraints in flight time, sensor pay load, and computational capability of micro aerial vehicles limits the practical applicability of popular map-based localization schemes for GPS denied navigation. Therefore, the resource limited aerial platforms of this team demand simpler localization means for autonomous navigation. Relative localization is the process of estimating the formation of a robot team using the acquired inter-robot relative measurements. This allows the team members to know their relative formation even without a global localization reference, such as GPS or a map. Thus a typical robot team would benefit from a relative localization service since it would allow the team to implement formation control, collision avoidance, and supervisory control tasks, independent of a global localization service. More importantly, a heterogenous team such as ground robots and computationally constrained aerial vehicles would benefit from a relative localization service since it provides the crucial localization information required for autonomous operation of the weaker agents. This enables less capable robots to assume supportive roles and contribute to the more powerful robots executing the mission. Hence this study proposes a relative localization-based approach for ground and micro aerial vehicle cooperation, and develops inter-robot measurement, filtering, and distributed computing modules, necessary to realize the system. The research study results in three significant contributions. First, the work designs and validates a novel inter-robot relative measurement hardware solution which has accuracy, range, and scalability characteristics, necessary for relative localization. Second, the research work performs an analysis and design of a novel nonlinear filtering method, which allows the implementation of relative localization modules and attitude reference filters on low cost devices with optimal tuning parameters. Third, this work designs and validates a novel distributed relative localization approach, which harnesses the distributed computing capability of the team to minimize communication requirements, achieve consistent estimation, and enable efficient data correspondence within the network. The work validates the complete relative localization-based system through multiple indoor experiments and numerical simulations. The relative localization based navigation concept with its sensing, filtering, and distributed computing methods introduced in this thesis complements system limitations of a ground and micro aerial vehicle team, and also targets hostile environmental conditions. Thus the work constitutes an essential step towards realizing autonomous navigation of heterogenous teams in real world applications.

Decision Making for Teams of Mobile Robots

In the past years, we could observe a significant amount of new robotic systems in science, industry, and everyday life. To reduce the complexity of these systems, the industry constructs robots that are designated for the execution of a specific task such as vacuum cleaning, autonomous driving, observation, or transportation operations. As a result, such robotic systems need to combine their capabilities to accomplish complex tasks that exceed the abilities of individual robots. However, to achieve emergent cooperative behavior, multi-robot systems require a decision process that copes with the communication challenges of the application domain. This work investigates a distributed multi-robot decision process, which addresses unreliable and transient communication. This process composed by five steps, which we embedded into the ALICA multi-agent coordination language guided by the PROViDE negotiation middleware. The first step encompasses the specification of the decision problem, which is an integral part of the ALICA implementation. In our decision process, we describe multi-robot problems by continuous nonlinear constraint satisfaction problems. The second step addresses the calculation of solution proposals for this problem specification. Here, we propose an efficient solution algorithm that integrates incomplete local search and interval propagation techniques into a satisfiability solver, which forms a satisfiability modulo theories (SMT) solver. In the third decision step, the PROViDE middleware replicates the solution proposals among the robots. This replication process is parameterized with a distribution method, which determines the consistency properties of the proposals. In a fourth step, we investigate the conflict resolution. Therefore, an acceptance method ensures that each robot supports one of the replicated proposals. As we integrated the conflict resolution into the replication process, a sound selection of the distribution and acceptance methods leads to an eventual convergence of the robot proposals. In order to avoid the execution of conflicting proposals, the last step comprises a decision method, which selects a proposal for implementation in case the conflict resolution fails. The evaluation of our work shows that the usage of incomplete solution techniques of the constraint satisfaction solver outperforms the runtime of other state-of-the-art approaches for many typical robotic problems. We further show by experimental setups and practical application in the RoboCup environment that our decision process is suitable for making quick decisions in the presence of packet loss and delay. Moreover, PROViDE requires less memory and bandwidth compared to other state-of-the-art middleware approaches.