Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: A prospective randomised simulator-based trial

Background Cardiac arrests are handled by teams rather than by individual health-care workers. Recent investigations demonstrate that adherence to CPR guidelines can be less than optimal, that deviations from treatment algorithms are associated with lower survival rates, and that deficits in performance are associated with shortcomings in the process of team-building. The aim of this study was to explore and quantify the effects of ad-hoc team-building on the adherence to the algorithms of CPR among two types of physicians that play an important role as first responders during CPR: general practitioners and hospital physicians. Methods To unmask team-building this prospective randomised study compared the performance of preformed teams, i.e. teams that had undergone their process of team-building prior to the onset of a cardiac arrest, with that of teams that had to form ad-hoc during the cardiac arrest. 50 teams consisting of three general practitioners each and 50 teams consisting of three hospital physicians each, were randomised to two different versions of a simulated witnessed cardiac arrest: the arrest occurred either in the presence of only one physician while the remaining two physicians were summoned to help ("ad-hoc"), or it occurred in the presence of all three physicians ("preformed"). All scenarios were videotaped and performance was analysed post-hoc by two independent observers. Results Compared to preformed teams, ad-hoc forming teams had less hands-on time during the first 180 seconds of the arrest (93 ± 37 vs. 124 ± 33 sec, P < 0.0001), delayed their first defibrillation (67 ± 42 vs. 107 ± 46 sec, P < 0.0001), and made less leadership statements (15 ± 5 vs. 21 ± 6, P < 0.0001). Conclusion Hands-on time and time to defibrillation, two performance markers of CPR with a proven relevance for medical outcome, are negatively affected by shortcomings in the process of ad-hoc team-building and particularly deficits in leadership. Team-building has thus to be regarded as an additional task imposed on teams forming ad-hoc during CPR. All physicians should be aware that early structuring of the own team is a prerequisite for timely and effective execution of CPR.

Performance Availability and Anticipatory Change Planning of Intralogistics Systems: A Simulation-Based Approach

In recent years, the ability to respond to real time changes in operations and reconfigurability in equipment are likely to become essential characteristics for next generation intralogistics systems as well as the level of automation, cost effectiveness and maximum throughput. In order to cope with turbulences and the increasing level of dynamic conditions, future intralogistics systems have to feature short reaction times, high flexibility in processes and the ability to adapt to frequent changes. The increasing autonomy and complexity in processes of today’s intralogistics systems requires new and innovative management approaches, which allow a fast response to (un)anticipated events and adaptation to changing environment in order to reduce the negative consequences of these events. The ability of a system to respond effectively a disruption depends more on the decisions taken before the event than those taken during or after. In this context, anticipatory change planning can be a usable approach for managers to make contingency plans for intralogistics systems to deal with the rapidly changing marketplace. This paper proposes a simulation-based decision making framework for the anticipatory change planning of intralogistics systems. This approach includes the quantitative assessments based on the simulation in defined scenarios as well as the analysis of performance availability that combines the flexibility corridors of different performance dimensions. The implementation of the approach is illustrated on a new intralogistics technology called the Cellular Transport System.

Assessing the Influence of Brain-based Instructional Methods and Its Impact on Systemic Change for Learning Communities

Background: As scholars who prepare future school leaders to be innovative instructional leaders for their learning communities, we are on the verge of a curriculum design revolution. The application of brain research findings promotes educational reform efforts to systemically change the way in which children experience school. However, most educators, school leaders, board members, and policy makers are ill prepared to reconsider the implications for assessment, pedagogy, school climate, daily schedules, and use of technology. This qualitative study asked future school leaders to reconsider how school leadership preparedness programs prepared them to become instructional leaders for the 21st century. The findings from this study will enhance the field of school leadership, challenging the current emphasis placed on standardized testing, traditional school calendars, assessments, monocultural instructional methods, and meeting the needs of diverse learning communities. [See PDF for complete abstract]

Social skills as predictors of communication, performance and quality of collaboration in project-based learning

The assumption that social skills are necessary ingredients of collaborative learning is well established but rarely empirically tested. In addition, most theories on collaborative learning focus on social skills only at the personal level, while the social skill configurations within a learning group might be of equal importance. Using the integrative framework, this study investigates which social skills at the personal level and at the group level are predictive of task-related e-mail communication, satisfaction with performance and perceived quality of collaboration. Data collection took place in a technology-enhanced long-term project-based learning setting for pre-service teachers. For data collection, two questionnaires were used, one at the beginning and one at the end of the learning cycle which lasted 3 months. During the project phase, the e-mail communication between group members was captured as well. The investigation of 60 project groups (N = 155 for the questionnaires; group size: two or three students) and 33 groups for the e-mail communication (N = 83) revealed that personal social skills played only a minor role compared to group level configurations of social skills in predicting satisfaction with performance, perceived quality of collaboration and communication behaviour. Members from groups that showed a high and/or homogeneous configuration of specific social skills (e.g., cooperation/compromising, leadership) usually were more satisfied and saw their group as more efficient than members from groups with a low and/or heterogeneous configuration of skills.

Assessing distractors and teamwork during surgery: developing an event-based method for direct observation

OBJECTIVE: To develop a behavioural observation method to simultaneously assess distractors and communication/teamwork during surgical procedures through direct, on-site observations; to establish the reliability of the method for long (>3 h) procedures. METHODS: Observational categories for an event-based coding system were developed based on expert interviews, observations and a literature review. Using Cohen's κ and the intraclass correlation coefficient, interobserver agreement was assessed for 29 procedures. Agreement was calculated for the entire surgery, and for the 1st hour. In addition, interobserver agreement was assessed between two tired observers and between a tired and a non-tired observer after 3 h of surgery. RESULTS: The observational system has five codes for distractors (door openings, noise distractors, technical distractors, side conversations and interruptions), eight codes for communication/teamwork (case-relevant communication, teaching, leadership, problem solving, case-irrelevant communication, laughter, tension and communication with external visitors) and five contextual codes (incision, last stitch, personnel changes in the sterile team, location changes around the table and incidents). Based on 5-min intervals, Cohen's κ was good to excellent for distractors (0.74-0.98) and for communication/teamwork (0.70-1). Based on frequency counts, intraclass correlation coefficient was excellent for distractors (0.86-0.99) and good to excellent for communication/teamwork (0.45-0.99). After 3 h of surgery, Cohen's κ was 0.78-0.93 for distractors, and 0.79-1 for communication/teamwork. DISCUSSION: The observational method developed allows a single observer to simultaneously assess distractors and communication/teamwork. Even for long procedures, high interobserver agreement can be achieved. Data collected with this method allow for investigating separate or combined effects of distractions and communication/teamwork on surgical performance and patient outcomes.

Ethnically-based rejection sensitivity and academic achievement: The danger of retracting into one’s heritage culture

This study examined the relation between ethnically based rejection sensitivity and academic achievement in a sample of 936 immigrant students in Germany and Switzerland. The theory of race-based rejection sensitivity that originated in North America was extended to immigrant students in Europe. The rough political climate against immigrants in Europe makes it probable that immigrant youth face particular difficulties and are affected by ethnically based rejection sensitivity, at least as much as—or even more than—minority youth in the United States. Using a standardized literacy performance test and multilevel analyses, we found that ethnically based rejection sensitivity was negatively related to academic achievement for immigrant students. This relation was partially mediated by a strong contingency of the students' self-worth on the heritage culture, as well as by a low number of native German or Swiss majority-group friends. We interpret these processes as immigrant students' efforts to cope with ethnically based rejection sensitivity by retracting into their heritage culture and avoiding majority-group contact, which unfortunately, however, at the same time also results in lower academic achievement. Copyright © 2014 John Wiley & Sons, Ltd.

The influence of gender-stereotyped perfumes on leadership attribution

The classification of perfumes as ‘women's’ and ‘men's’ fragrances is based on certain gender stereotypes. In two experiments, female and male participants were asked to assume the role of a manager. In Experiment 1, they read an application for the position of a junior manager written by a male or female job applicant. Application papers were prepared with a typically masculine perfume, a typically feminine perfume or no perfume at all (control group). In Experiment 2, participants conducted a job interview with a female or male applicant (a confederate) who had applied the respective perfume or no perfume. Persons with a typically masculine perfume were ‘employed’ with a higher degree of certainty compared to persons with a typically feminine perfume.

A qualitative analysis of leadership styles and the selection of quality improvement in primary care practice

In the Practice Change Model, physicians act as key stakeholders, people who have both an investment in the practice and the capacity to influence how the practice performs. This leadership role is critical to the development and change of the practice. Leadership roles and effectiveness are an important factor in quality improvement in primary care practices.^ The study conducted involved a comparative case study analysis to identify leadership roles and the relationship between leadership roles and the number and type of quality improvement strategies adopted during a Practice Change Model-based intervention study. The research utilized secondary data from four primary care practices with various leadership styles. The practices are located in the San Antonio region and serve a large Hispanic population. The data was collected by two ABC Project Facilitators from each practice during a 12-month period including Key Informant Interviews (all staff members), MAP (Multi-method Assessment Process), and Practice Facilitation field notes. This data was used to evaluate leadership styles, management within the practice, and intervention tools that were implemented. The chief steps will be (1) to analyze if the leader-member relations contribute to the type of quality improvement strategy or strategies selected (2) to investigate if leader-position power contributes to the number of strategies selected and the type of strategy selected (3) and to explore whether the task structure varies across the four primary care practices.^ The research found that involving more members of the clinic staff in decision-making, building bridges between organizational staff and clinical staff, and task structure are all associated with the direct influence on the number and type of quality improvement strategies implemented in primary care practice.^ Although this research only investigated leadership styles of four different practices, it will offer future guidance on how to establish the priorities and implementation of quality improvement strategies that will have the greatest impact on patient care improvement. ^

The relationship between surgical residents' perception of leadership and patient safety culture

Introduction. Patient safety culture is the integration of interrelated practices that once developed is supported by both the culture and leadership of the organization (Sagan, 1993). The purpose of this study is to describe and examine the relationship between surgical residents’ perception of their leadership and the resulting organizational safety culture within their clinical setting. This assessment is important to understanding the extent that leadership style affects the perception of the safety culture.^ Methods. A secondary dataset was used which included data from 68 surgical residents from two survey instruments, Organizational Description Questionnaire (ODQ) and Patient Safety Climate In Healthcare Organizations (PSCHO) Survey. Multiple regressions followed by hierarchical regressions with the introduction of the Post Graduate Year (PGY) variable examined the association between the leadership styles, Transactional and Transformational and the organizational safety culture variables, Overall Emphasis on Safety, Senior management engagement, Organizational resources for safety. Independent t-tests were conducted to assess whether males and females differ among the organizational safety culture variables and either leadership style.^ Results. The surgical residents perceived their organizational leadership to have greater emphasis placed on transformational leadership culture style relative to transactional leadership culture style. The only significant association found was between Transformational leadership and Organizational resources for safety. PGY had no significant effect on the leadership or the safety culture perceived. No significant difference was found between females and males in regards to the safety culture or the leadership style.^ Discussion. These results have implications as they support the premise for the study which is surgical residents perceive their existing leadership and organizational culture to be more transformational in nature than transactional. Significance was found between the leadership perceived and one of the safety culture variables, Organizational resources for safety. The foundation for this association lies in the fact that surgical residents are the personnel which are a part of the organizational resources. Although PGY differentiation did not seem to play a difference in the leadership perceived this could be attributed to the small sample size. No gender difference were found which supports the assumption that within such a highly specialized group such as surgical residents there is no gender differences since the highly specialized field draws a certain type of person with distinct characteristics. In future research these survey tools can be used to gauge the survey audiences’ perception and safety interventions can be developed based on the results. ^

Competence Monitoring in Project Teams by using Web based portfolio management systems

This paper reports a learning experience related to the acquisition of project management competences. Students from three different universities and backgrounds, cooperate in a common project that drives the learning-teaching process. Previous related works on this initiative have already evaluated the goodness of this multidisciplinary, project-based learning approach in the context of a new educative paradigm. Yet the innovative experience has allowed the authors to define a rubric in order to measure specific competences in project management. The study shows the rubric’s main aspects as well as competence acquisition evaluation alternatives, based in the metrics defined. Key indicators and specific reports obtained from data base fields in the web tool will support this work. As a result, new competences can be assessed, such ones like teamwork, problem solving, communication and leadership. Final goal is to provide an overall competence map to the students at the same time they improve their skills.

Knowledge pipeline in freight pipeline industry: competence- based model for open innovation

There is growing concern over the challenges for innovation in Freight Pipeline industry. Since the early works of Chesbrough a decade ago, we have learned a lot about the content, context and process of open innovation. However, much more research is needed in Freight Pipeline Industry. The reality is that few corporations have institutionalized open innovation practices in ways that have enabled substantial growth or industry leadership. Based on this, we pursue the following question: How does a firm’s integration into knowledge networks depend on its ability to manage knowledge? A competence-based model for freight pipeline organizations is analysed, this model should be understood by any organization in order to be successful in motivating professionals who carry out innovations and play a main role in collaborative knowledge creation processes. This paper aims to explain how can open innovation achieve its potential in most Freight Pipeline Industries.

Knowledge Management and Leadership in the Higher Education: A First Approach

Today, it is more and more important to develop competences in the learning process of the university students (that is to say, to acquire knowledge but also skills, abilities, attitudes and values). This is because professional practice requires that the future graduates design and market products, defend the interests of their clients, be introduced in the Administration or, even, in the Politics. Universities must form professionals that become social and opinion leaders, consultants, advisory, entrepreneurs and, in short, people with capacity to solve problems. This paper offers a tool to evaluate the application for the professor of different styles of management in the process of the student’s learning. Its main contribution consists on advancing toward the setting in practice of a model that overcomes the limitations of the traditional practices based on the masterful class, and that it has been applied in Portugal and Spain.

Understanding the Leadership Capacity and Practice of Assistant Principals

The purpose of this study was to explore the leadership capacities and practices of assistant principals. The research also sought to determine what relationships existed between capacity and practice and to see if there was a difference based on experience, context and personal characteristics. Since the majority of principals first serve as assistant principals, their work and experiences as assistant principals will have significant consequences (Kwan, 2009). The literature has long held and continues to challenge the notion that the role of assistant principal is adequate preparation for the principalship (Chan, Webb, & Bowen, 2003; Harris, Muijs, & Crawford, 2003; Kwan, 2009; Mertz, 2000; Webb & Vulliamy, 1995). Based on empirical findings, this study has affirmed the need to further research and refine the role of the assistant principal. The results indicate that in addition to strengths, there are explicit gaps and missed opportunities in the leadership practices of assistant principals that impact the potential for building a leadership pipeline within schools. The work of the assistant principal is characterized by a proliferation of duties rather than a strategic set of practices that support distributed leadership and sustainability.

Knowledge spirals, situational leadership and informal learning applied on b-learning methodology

The methodology “b-learning” is a new teaching scenario and it requires the creation, adaptation and application of new learning tools searching the assimilation of new collaborative competences. In this context, it is well known the knowledge spirals, the situational leadership and the informal learning. The knowledge spirals is a basic concept of the knowledge procedure and they are based on that the knowledge increases when a cycle of 4 phases is repeated successively.1) The knowledge is created (for instance, to have an idea); 2) The knowledge is decoded into a format to be easily transmitted; 3) The knowledge is modified to be easily comprehensive and it is used; 4) New knowledge is created. This new knowledge improves the previous one (step 1). Each cycle shows a step of a spiral staircase: by going up the staircase, more knowledge is created. On the other hand, the situational leadership is based on that each person has a maturity degree to develop a specific task and this maturity increases with the experience. Therefore, the teacher (leader) has to adapt the teaching style to the student (subordinate) requirements and in this way, the professional and personal development of the student will increase quickly by improving the results and satisfaction. This educational strategy, finally combined with the informal learning, and in particular the zone of proximal development, and using a learning content management system own in our University, gets a successful and well-evaluated learning activity in Master subjects focused on the collaborative activity of preparation and oral exhibition of short and specific topics affine to these subjects. Therefore, the teacher has a relevant and consultant role of the selected topic and his function is to guide and supervise the work, incorporating many times the previous works done in other courses, as a research tutor or more experienced student. Then, in this work, we show the academic results, grade of interactivity developed in these collaborative tasks, statistics and the satisfaction grade shown by our post-graduate students.

Fashion opinion leadership, innovativeness and attitude toward advertising among Portuguese consumers

In the context of the fashion market, this study aims to analyze opinion leadership and, specifically, to verify the correlation that may exist between opinion leadership, fashion innovativeness and attitude towards fashion advertising. It is also intended to identify two different consumer groups: opinion leaders and fashion followers based on “opinion leadership” construct. Data collection was done through a self-administered questionnaire with a convenience sample of 203 graduate and postgraduate students of two universities of Porto, the second major city of Portugal. Results show a positive correlation between fashion innovativeness, fashion opinion leadership, and attitude towards fashion advertising. It was possible to identify two groups of consumers: fashion influencers, who exhibit a moderate sense of innovativeness and a positive attitude towards fashion advertising; and fashion followers who don’t consider themselves neither innovators nor opinion leaders, but have a moderate positive attitude towards fashion advertising.