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  • 1.
    Härgestam, Maria
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Morian, Hanna
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindgren, Lenita
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Interprofessional team training via telemedicine in medical and nursing education2024Ingår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 24, nr 1, artikel-id 1110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The use of information communication technologies such as telemedicine has increased over the years, offering access to specialized healthcare even in remote locations. However, telemedicine in interprofessional team training is seldom included in medical or nursing programs, and little is known about how to practise these scenarios. This study aimed to explore how medical and nursing students experience teamwork when one team member is participating remotely and digitally.

    Methods: Following interprofessional team training in which one team member participated remotely, focus group interviews were conducted with three teams, each comprising one medical student and two nursing students (n = 9 students in total). The focus group interviews were analysed with thematic content analysis. The Systems Engineering Initiative for Patient Safety model was applied as a theoretical framework and served as a lens in the analysis.

    Results: Three themes were identified in the analysis: challenging the dynamic of leadership, becoming familiar with a new setting, and finding new strategies to communicate.

    Conclusions: The results of this study suggest that future physicians and nurses need to enhance their knowledge of practicing teamwork through telemedicine during their education, as the use of telemedicine continues to grow.

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  • 2.
    Morian, Hanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Creutzfeldt, Johan
    Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Hultin, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Härgestam, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Mapping leadership, communication and collaboration in short-term distributed teams across various contexts: a scoping review2024Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 14, nr 10, artikel-id e081878Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Introduction: Increased globalisation and technological advancements have led to the emergence of distributed teams in various sectors, including healthcare. However, our understanding of how leadership, communication and collaboration influence distributed healthcare teams remains limited.

    Objectives: This study aimed to map knowledge on leadership, communication and collaboration in short-term distributed teams across various fields to gain insights that could benefit healthcare.

    Design: Scoping review.

    Data source: A database search of PubMed, CINAHL, Scopus and PsycINFO was conducted in May 2021 and updated in February 2023 and May 2024.

    Eligibility criteria: Articles were eligible if they involved leadership, communication or collaboration in distributed short-term teams supported by synchronised audio-visual communication technology. Two researchers independently screened titles, abstracts and full texts for inclusion.

    Data extraction and synthesis: Extracted data on leadership, communication and collaboration were synthesised narratively and reported in terms of patterns, advances, gaps, evidence for practice and research recommendations.

    Results: Among 6591 articles, 55 met the eligibility criteria, spanning military, engineering, business, industrial and healthcare contexts. The research focus has shifted over time from adverse effects to solutions for overcoming challenges in distributed teams. Inclusive leadership is vital for engaging all team members. 'Team opacity', the absence of non-verbal cues and reduced awareness of team members' actions, can occur in distributed teams relying on technology. Clear communication is crucial for avoiding misunderstandings and fostering collaboration and adaptability. Developing shared mental models and trust is more challenging, leading to uncertainty and reduced information sharing. There is a lack of studies examining how to apply this knowledge to health professionals' education.

    Conclusion: Our findings highlight the importance of implementing strategies in healthcare to enhance inclusive leadership and improve communication in distributed healthcare settings. More empirical research is needed to understand the intricacy of distributed healthcare settings and identify effective ways to train distributed healthcare teams.

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  • 3.
    Morian, Hanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hultin, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård. Umeå universitet, Medicinska fakulteten, Institutionen för diagnostik och intervention.
    Lindkvist, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Creutzfeldt, Johan
    Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
    Dubois, Hanna
    Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
    Jonsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Amorøe, Torben N.
    Department of Research, Education and Development, Simulation Centre West, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Härgestam, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Teamwork in rural emergency health care: A Simulation-Based Cross-over Study of Co-located and Distributed Teams2024Ingår i: Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, ISSN 1559-2332, E-ISSN 1559-713XArtikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    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.

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  • 4.
    Morian, Hanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Härgestam, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hultin, Magnus
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Jonsson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för epidemiologi och global hälsa.
    Jonsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nordahl Amorøe, Torben
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Simulation Center West, Department of Research, Education, and Development, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Creutzfeldt, Johan
    Department of Clinical Science, Intervention, and Technology, Karolinska Institute, Stockholm, Sweden; Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
    Reliability and validity testing of team emergency assessment measure in a distributed team context2023Ingår i: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, artikel-id 1110306Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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