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Background: Interprofessional simulation-based education (IPSE) holds the potential to prepare healthcare students to handle the complexity of healthcare. However, complexity and resilience are traditionally not addressed deliberately in IPSE. The aim of this study was to explore the effect of resilience-focused debriefing (RFD) that addresses complexity and resilience, on reflection and teamwork in IPSE for pre-graduate healthcare students.

Methods: In a convergent mixed methods intervention study, 149 nursing and medical students in their last semester participated in a full-day IPSE course with five progressively challenging scenarios. Fifteen facilitators were instructed to use RFD. Qualitative date, comprised of transcripts from nine debriefings, were analysed using topic analysis. An intervention check was performed to assess the use of RFD. Quantitative data comprised pre-post ratings of team performance in videorecorded scenarios (1 and 5) from 18 groups using the Team Emergency Assessment Measure (TEAM). Additionally, a study-specific rating scale was employed to assess the extent of participants’ perceived challenges during scenarios.

Results: RFD helped facilitators to guide the students’ attention to the complexity of teamwork and how to manage such complex situations successfully by adapting crisis resource management principles and performing resilient actions (e.g., attunement, adaptive leadership), both as individuals and as teams. Applying RFD brought the students’ attention to how they were able to succeed despite the difficulties they encountered. Although the assessed team performance was on an acceptable level, students initially had difficulties in recognizing and learning from actions that led to successful outcomes. The significant decrease in the degree of challenges experienced suggests that students developed a greater tolerance for complexity. Nevertheless, the quantitative data showed that there was no pre-post difference in team performance as assessed by TEAM.

Conclusions: RFD can be used to increase healthcare students’ attention to the complexity of interprofessional teamwork in acute dynamic situations and help them recognize and learn from both successful actions and overcoming challenging situations. Although we did not find a significant gain in team performance, the integrated results suggest that RFD may potentially improve interprofessional teamwork. Further research is warranted to develop instruments measuring team performance that are sensitive to various aspects of resilience, as well as to deepen the understanding of RFD in the simulation-based education.

Background: Practical nursing skills are complex actions performed daily in nursing practice. Structured learning and repeated practice help students develop clinical competence. Clinical placements are pivotal in learning, with factors such as educational context, preceptor availability, and time constraints shaping students’ learning opportunities.

Objectives: To describe nursing students’ opportunities to perform practical skills during clinical placements.

Design and Setting: A quantitative cross-sectional study conducted in 2023 involved 706 nursing students from Denmark, Norway, and Sweden. Data were collected via a questionnaire and analyzed using descriptive statistics.

Results: Students reported substantial variations in the practical skills performed during clinical placements. Overall, the frequency of skills performance was low across all years and domains, including practical nursing skills concerning respiration, circulation, elimination, nutrition, activity, skin care, and medication. Supervision was generally available, though some skills lacked adequate preceptor involvement.

Conclusions: The study highlights disparities in nursing students’ opportunities to practice essential skills during clinical placements. The lack of practice across a wide range of skills may compromise the quality and thoroughness of nursing education, affecting the students’ professional preparedness.

Background: Simulation-based medical education (SMBE) is a well-established and effective method for clinical training, yet its implementation is often resource-intensive and logistically demanding. Virtual reality (VR) has emerged as a promising educational tool, offering immersive, multisensory simulations that may support both procedural and cognitive skill development. In educational context where students must prepare for complex scenarios, VR may serve as a preparatory educational tool. Thus, exploring such simulation formats is well justified to enhance training outcomes.

Aim: To explore medical students’ experiences of using VR as preparation for a subsequent non-VR trauma simulation.

Methods: Thirty-two medical students in their seventh semester who were assigned to use a VR application prior to a scheduled non-VR trauma simulation, participated in this study. Eight focus-group interviews were conducted immediately after the trauma simulation. Data were analysed using qualitative content analysis.

Results: The findings were categorised into four categories: Perceived educational effect, Practical user experience, Comparison of VR and other educational forms, and Areas for improvement in the VR application. The students described the VR application as an engaging and motivating learning method that supported autonomous preparation. However, the VR application was not perceived as sufficient to replace traditional educational formats. Key limitations included low interactivity, limited realism, and lack of cognitive flexibility. The participants proposed improvements, such as dynamic patient responses, expanded roles, and increased complexity in order to better reflect clinical practice.

Conclusions: The VR application shows potential as a flexible and accessible preparatory complement to SMBE. However, in its current form, it was not perceived as a suitable standalone learning method. The identified limitations relate to the design and scope of the specific VR application studied rather than to inherent limitations of VR technology. Student perspectives offer important insights into how preparatory VR may support motivation, early cognitive rehearsal and familiarization with simulation workflows, and should be actively considered in the development of VR-based educational tools.

OBJECTIVES: To explore interprofessional team members' experiences of teamwork at an intensive care unit.

DESIGN: Qualitative content analysis of focus group interviews with members from the intensive care teams.

SETTING: University hospital in Sweden.

PARTICIPANTS: In total, 31 participants were interviewed. Enrolled nurses (n=7), critical care registered nurses (n=16), and intensive care physicians (n=8) employed at an intensive care unit were divided into nine focus groups organised according to the profession.

RESULTS: The overall theme, Balancing behaviour and knowledge in teamwork, emerged from the two categories of creating a safe atmosphere when working in an unknown environment and counteracting and mitigating destructive team dynamics. The theme captures how well-functioning teamwork must take into account members not acting as team players while also building a secure environment when working in new surroundings outside the intensive care unit. The categories describe how mutual respect, effective teamwork and a safe atmosphere were fostered through support without taking over tasks and countering power structures.

CONCLUSIONS: Navigating teamwork during critical situations is inherently complex, making it essential to understand team interactions and factors influencing individual behaviour. To ensure patient safety, the interprofessional team must recognise, understand and manage diverse behaviours and knowledge in dynamic settings. This research contributes to existing knowledge on teamwork in the intensive care context by providing insights into how knowledge and behaviour in teamwork can be optimised to enhance patient safety.

Introduction: Challenges in mutual awareness in interprofessional collaboration (IPC) along with relational and cultural barriers among professionals disrupt flow and delay decision-making in trauma care. Thus, this study explores team behaviours within IPC in trauma teams during trauma alerts from the perspective of radiographers.

Methods: A qualitative approach was used with a critical incident technique (CIT) design applying interviews with radiographers within three hospitals in Sweden from May 2022 to May 2023. CIT analysis was conducted with an abductive approach, applying an IPC core competency framework.

Results: The results present collaborative requirements in trauma care from radiographers' perspective narrating a distribution of team behaviours within trauma team collaboration and fundamental skills in IPC. Behaviours within interprofessional values and ethics were the most reported incidents related to valuing radiographers' contributions to IPC in acute trauma care.

Conclusion: Exploring behaviour through critical incidents associated with core competencies of IPC highlights the importance of interprofessional values as a foundation for successful IPC in the trauma team. The results show deficiencies in inclusive behaviour, influenced by the hierarchical environment of IPC. Power imbalances in this setting are traced to differences in perceived value and shared understanding among team members, possibly rooted in professional identity and culture. A dedicated leader is argued, as the recognition of radiographers' scope of practice in trauma imaging, emphasising the significance of shared decision-making.

Clinical Implications: The findings highlight organisational and relational coordination challenges for optimising competencies in IPC. IPC's success requires reinforcing values and ethics by empowering members' contributions and shared decision-making. This involves clarifying and recognising responsibilities, particularly for radiographers, ensuring their role in trauma imaging is respected and integrated into decision-making.

Introduction: Despite the increasing use of distributed healthcare teams, performance evaluation is largely lacking. This study examined rural emergency health care in Sweden to determine the effect of teams being either co-located or distributed with remote physicians accessible via telemedicine.

Method: In this crossover study, 17 three-person teams were video recorded during co-located and distributed simulated scenarios. Team performance in the video recordings was evaluated using the TEAM instrument.

Results: Co-located scenarios had significantly higher Total ratings for the instrument (items 1–11), in the teamwork domain (items 3–9), and in overall performance (item 12) compared with distributed scenarios (P < 0.005). Item-level analysis revealed that co-located teams were better at completing tasks on time (item 4) and showed greater adaptability to changing situations (item 7).

Conclusions: The higher rating of the performance of co-located teams underscores the challenges facing distributed teams. Given that distributed healthcare teams are a reality in rural areas in northern Sweden, education and training must be adapted to address these challenges. This adaptation is crucial for ensuring high-quality patient care by distributed teams.

Introduction: In Scandinavia, where severe trauma is rare but potentially life-threatening, trauma teams must maintain high performance despite infrequent activations. Although advancements in trauma care have reduced mortality, severe multi-trauma still carries a high mortality risk of death, requiring rapid, coordinated responses from teams of diverse professionals. This study explores the interdependence between various trauma team members, with a particular focus on how radiographers' roles are understood, integrated, and relied upon in trauma care.

Methods: A qualitative design was employed, with data collected from four Swedish hospitals through interviews and observations. Braun and Clarke's reflexive thematic analysis method guided the iterative process to identify and generate patterns in the data.

Results: The analysis generated an overarching theme of Team integration through behavioural interdependence, along with three specific themes: (I) Collaborative interdependence: enhancing team synergy through dynamic role adaption; (II) Social interdependence: fostering trust through interpersonal relationships; and (III) Goal interdependence: aligning objectives for unified success.

Conclusion: The findings highlight the importance of team-enhancing behaviours to build high-performing trauma teams. Radiographers contribute through adaptive collaboration, technical expertise, and relational engagement. Equally important are the supportive behaviours of team members and leaders—such as clear communication, inclusion in decision-making, and recognition of radiographers' expertise—which enable radiographers to perform effectively. Clearly defined roles and shared objectives reinforce their value in trauma care.

Implications for practice: Effective team guidance and psychological safety are essential for improving team dynamics and outcomes. Regular, structured team reflections and joint exercises that include all professional roles, especially radiographers, and emphasise shared goals, shared knowledge, and mutual respect, can strengthen interdependence. This approach enhances team performance and supports safer, more efficient care.

Introduction: The temporary trauma teams in trauma alerts consist of a diverse group of unique professionals requiring interprofessional collaboration and coordination to achieve efficient, high-quality care. The uncertain situation and complex care environment impose high demands on team dynamics such as individual attitudes and team behaviours. Within interprofessional teams, interaction and coordination reflect the collective success of collaboration and the achievement of goals. Interactions with radiographers have increased in trauma teams given computed tomography's prominent role in providing crucial knowledge for decision-making in trauma care. This study aimed to explore radiographers' experiences of interprofessional collaboration during trauma alerts.

Method: The study was designed with focus group methodology, including 17 radiographers participating in five focus groups, analysed with an inductive focus group analysis. Results: An overarching theme, "On the edge of decision-making", emerged along with three sub-themes: "Feeling included requires acknowledgement", "Exclusion precludes shared knowledge", and "Experience and mutual awareness facilitate team interaction".

Conclusions: Interprofessional collaboration from the radiographer's perspective within trauma teams requires a sense of inclusion and the ability to interact with the team. Exclusion from vital decision-making obstructs radiographers' comprehension of situations and thereby the interdependence in interprofessional collaboration.

Implications for practice: Common platforms are needed for knowledge sharing and team practices, including radiographers’ areas of responsibility and relational coordination to foster interprofessional relationships. Through these means interdependence through awareness and shared knowledge can be facilitated on trauma teams.

Medical multi-professional teams are increasingly collaborating via telemedicine. In distributed team settings, members are geographically separated and collaborate through technology. Developing improved training strategies for distributed teams and finding appropriate instruments to assess team performance is necessary. The Team Emergency Assessment Measure (TEAM), an instrument validated in traditional collocated acute-care settings, was tested for validity and reliability in this study when used for distributed teams. Three raters assessed video recordings of simulated team training scenarios (n = 18) among teamswith varying levels of proficiency working with a remotely located physician via telemedicine. Inter-rater reliability, determined by intraclass correlation, was 0.74–0.92 on the TEAM instrument’s three domains of leadership, teamwork, and task management. Internal consistency (Cronbach’s alpha) ranged between 0.89–0.97 for the various domains. Predictive validity was established by comparing scores with proficiency levels. Finally, concurrent validity was established by high correlations, >0.92, between scores in the three TEAM domains and the teams’overall performance. Our results indicate that TEAM can be used in distributed acute-care team settings and consequently applied in future-directed learning and research on distributed healthcare teams.

Introduction: Newly trained nurses experience a lack of preparedness in practical skills, and research shows  that students and newly trained nurses have deficiencies in performing practical skills such as venous blood specimen collection. There is a lack of knowledge regarding the level of accuracy reached by students after training at clinical training centres and before entering clinical practice. The aim of this study was to assess the performance of venous blood specimen collection among nursing students after regular education and training at the clinical training centre but before starting an internship. 

Methods: Twenty-three nursing students were observed and video-recorded. An observation protocol was developed based on a validated questionnaire measuring adherence to valid guidelines, and a model for practical skills performance. Data were analysed using descriptive statistics. 

Results: A large variation was found in students’ performance with respect to information provided to the patient, patient identification procedures, and tourniquet procedures. The students gave adequate information in 39% of cases, accurately performed patient identification in 83% of cases, and accurately performed the tourniquet procedure in 22% of cases. 

Conclusions: Many nursing students are not prepared to practice on real patients. It is therefore important for university lecturers to develop more efficient teaching methods and to communicate students’ skill levels to the supervisor at the clinic, in order for the clinical training to be adapted to a suitable level. There is a need for further research on how to close the gap between the university and internship in order to ensure patient safety.