Sara A. McComb

Temporal Patterns of Mental Model Convergence: Implications for Distributed Teams Interacting in Electronic Collaboration Spaces

Objective: Our objective is to capture temporal patterns in mental model convergence processes and differences in these patterns between distributed teams using an electronic collaboration space and face-to-face teams with no interface. Background: Distributed teams, as sociotechnical systems, collaborate via technology to work on their task. The way in which they process information to inform their mental models may be examined via team communication and may unfold differently than it does in face-to-face teams. Method: We conducted our analysis on 32 three-member teams working on a planning task. Half of the teams worked as distributed teams in an electronic collaboration space, and the other half worked face-to-face without an interface. Results: Using event history analysis, we found temporal interdependencies among the initial convergence points of the multiple mental models we examined. Furthermore, the timing of mental model convergence and the onset of task work discussions were related to team performance. Differences existed in the temporal patterns of convergence and task work discussions across conditions. Conclusion: Distributed teams interacting via an electronic interface and face-to-face teams with no interface converged on multiple mental models, but their communication patterns differed. In particular, distributed teams with an electronic interface required less overall communication, converged on all mental models later in their life cycles, and exhibited more linear cognitive processes than did face-to-face teams interacting verbally. Application: Managers need unique strategies for facilitating communication and mental model convergence depending on teams’ degrees of collocation and access to an interface, which in turn will enhance team performance.

The concept of shared mental models in healthcare collaboration

AIM To report an analysis of the concept of shared mental models in health care. BACKGROUND Shared mental models have been described as facilitators of effective teamwork. The complexity and criticality of the current healthcare system requires shared mental models to enhance safe and effective patient/client care. Yet, the current concept definition in the healthcare literature is vague and, therefore, difficult to apply consistently in research and practice. DESIGN Concept analysis. DATA SOURCES Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed and MEDLINE (EBSCO Interface), for the years 1997-2013. METHODS Walker and Avants approach to concept analysis was employed and, following Paleys guidance, embedded in extant theory from the team literature. RESULTS Although teamwork and collaboration are discussed frequently in healthcare literature, the concept of shared mental models in that context is not as commonly found but is increasing in appearance. Our concept analysis defines shared mental models as individually held knowledge structures that help team members function collaboratively in their environments and are comprised of the attributes of content, similarity, accuracy and dynamics. CONCLUSION This theoretically grounded concept analysis provides a foundation for a middle-range descriptive theory of shared mental models in nursing and health care. Further research concerning the impact of shared mental models in the healthcare setting can result in development and refinement of shared mental models to support effective teamwork and collaboration.

Merging internal and external processes: Examining the mental model convergence process through team communication.

Mental model convergence is a macrocognitive process critical to team development. Yet, little is known about how the convergence process occurs in a team domain. To date, researchers have examined convergence at specific points in time after performance episodes. While this approach has moved the field forward, research is needed that captures the dynamics of the convergence process as it occurs during collaborative activities. To facilitate this needed research, we present a framework for examining mental model convergence via communicated mental model content. Our framework is theoretically based on research in cognitive science and communication, as well as more recent team mental model research. By explicitly establishing the theoretical connection between mental model convergence and team communication, we extend the extant research that links communication and team cognition and address a gap in the team mental model literature regarding how to examine the mental model convergence process over time.

Team Decision Making in Computer-Supported Cooperative Work: How Initial Computer-Mediated or Face-to-Face Meetings Set the Stage for Later Outcomes*

The success of teams working together over multiple meetings may depend on how processes develop at initial meetings. Computer-mediated tools, in particular, may hinder team process development which may set the stage for shortcomings later. One recommendation is to hold the initial team meeting face to face. Herein, we examine social processes over time and whether computer-mediated teams completing their first session face to face can offset the shortcomings in process development and outcomes in their second session. Using longitudinal data we test the differences in, and relationships among, processes and outputs across teams that met twice as computer mediated, twice as face to face, or as mixed media (first as face to face and second as computer mediated). Results indicate computer-mediated teams reported lower participative decision making than face-to-face teams after the first session and the disparity continued at the second session. Mixed-media teams, however, had improved participative decision making over pure computer-mediated teams in the long run. Further, mixed-media teams reported team satisfaction similar to pure face-to-face teams and delivered a task performance between that of pure computer-mediated and pure face-to-face teams. Interestingly, mixed-media teams experienced increased conflict over time, while conflict in pure media teams decreased. Our results suggest that practitioners may want to require an initial face-to-face session (i.e., more than just a meet and greet) to prepare members to work together in the future.

Survivor in the cancer context: a concept analysis

AIM The aim of this analysis was to define survivor in the cancer context. BACKGROUND Cancer survivor has been used in the cancer lexicon, but may not represent the individuals it defines. DESIGN This concept analysis was completed according to Walker and Avants method. DATA SOURCES PubMed, PsychInfo, CINAHL, JSTOR, Google and medical and public health websites. REVIEW METHODS Thirty sources from multiple disciplines, published between 1987-2013, were analysed for recurrent themes and conceptual meaning. Critical attributes, antecedents and consequences were extrapolated. Model, related and contrary cases were developed based on an amalgamation of clinical observations. Illegitimate, borderline and invented cases were excluded for this reason. RESULTS Survivor in the cancer context is an individual with a history of malignancy, who has lived through a personalized challenge and has ongoing positive and negative consequences. Not all cancer survivors would identify themselves using the term survivor. CONCLUSIONS This contributes to the paradigm shift of cancer as a chronic disease as it establishes the unique nature of the cancer experience while highlighting the long-term concerns related to this set of diseases. The Theory of Uncertainty in Illness provides a framework to understand the individualized nature of being a cancer survivor. Nursing research and practice should address the personal experiences of cancer survivors while still focusing on general survivorship needs.

Developing a stakeholder-assisted agile CONOPS development process

Concepts of Operations (CONOPS) are documents describing the characteristics and intended usage of proposed and existing systems. They provide information about the requirements and future desired states the project aims to achieve. We reviewed 22 recent CONOPS from government and private sector institutions to ascertain the current approach to CONOPS development. Based on the CONOPS review and research literature, we highlight three key areas, stakeholder involvement, shared mental models, and visualization, through which the development process may be improved. Moreover, we suggest that the development process itself may be transformed into an agile process that addresses current shortcomings in the key areas. To do so, we propose an agile CONOPS development process conducted through three iteration-driven phases and present corresponding research and commercial tools that may be leveraged at each phase. As such, putting this agile process into effect may reduce development time, improve effectiveness, and change the perception of the CONOPS from a burdensome documentation procedure to an invaluable resource throughout the system lifecycle.

Where's Farah?: Knowledge silos and information fusion by distributed collaborating teams

The Cognitively-Based Rapid Assessment Methodology (C-RAM) system manages multiple-user interactions as users work with multiple information sources. Further, it allows users to view, exchange, organize, and combine the information available and it facilitates group decision-making. Three-member teams, randomly assigned in either the (a) view others’ whiteboards or (b) cannot view others’ whiteboards conditions, completed an intelligence analysis and mission planning task. Each team member was given access to a virtual whiteboard populated with decision cards (DCards) containing intelligence information constrained to a specific area of expertise. DCards can be assessed (rated) for decision impact and importance and team members have access to all DCards regardless of experimental condition. Team members who can view their teammates’ whiteboards during collaborative activities achieve significantly higher performance. When compared to teams unable to view others’ whiteboards, they move their own DCards less frequently, add fewer additional DCards to their own whiteboards, and rate others’ DCards less frequently. Additionally, rating one’s own DCards is the only process positively related team performance.

The impact of interventions on appointment and clinical outcomes for individuals with diabetes: a systematic review.

BackgroundSuccessful diabetes disease management involves routine medical care with individualized patient goals, self-management education and on-going support to reduce complications. Without interventions that facilitate patient scheduling, improve attendance to provider appointments and provide patient information to provider and care team, preventive services cannot begin. This review examines interventions based upon three focus areas: 1) scheduling the patient with their provider; 2) getting the patient to their appointment, and; 3) having patient information integral to their diabetes care available to the provider. This study identifies interventions that improve appointment management and preparation as well as patient clinical and behavioral outcomes.MethodsA systematic review of the literature was performed using MEDLINE, CINAHL and the Cochrane library. Only articles in English and peer-reviewed articles were chosen. A total of 77 articles were identified that matched the three focus areas of the literature review: 1) on the schedule, 2) to the visit, and 3) patient information. These focus areas were utilized to analyze the literature to determine intervention trends and identify those with improved diabetes clinical and behavioral outcomes.ResultsThe articles included in this review were published between 1987 and 2013, with 46 of them published after 2006. Forty-two studies considered only Type 2 diabetes, 4 studies considered only Type 1 diabetes, 15 studies considered both Type 1 and Type 2 diabetes, and 16 studies did not mention the diabetes type. Thirty-five of the 77 studies in the review were randomized controlled studies. Interventions that facilitated scheduling patients involved phone reminders, letter reminders, scheduling when necessary while monitoring patients, and open access scheduling. Interventions used to improve attendance were letter reminders, phone reminders, short message service (SMS) reminders, and financial incentives. Interventions that enabled routine exchange of patient information included web-based programs, phone calls, SMS, mail reminders, decision support systems linked to evidence-based treatment guidelines, registries integrated with electronic medical records, and patient health records.ConclusionsThe literature review showed that simple phone and letter reminders for scheduling or prompting of the date and time of an appointment to more complex web-based multidisciplinary programs with patient self-management can have a positive impact on clinical and behavioral outcomes for diabetes patients. Multifaceted interventions aimed at appointment management and preparation during various phases of the medical outpatient care process improves diabetes disease management.

Examining the “Exchange” in Leader–Member Exchange

Leader–member exchange (LMX) ratings from 375 supervisor–subordinate pairs were used to examine employee outcomes within the context of leader and member agreement/disagreement on the quality of their exchange relationship. The outcomes of interest included members’ turnover intentions and actual turnover within the 6 months following the initial survey. Results indicate that outcomes varied across the different dyadic relationships. Furthermore, the LMX variable (i.e., the leader’s rating, member’s rating, or both) that was significantly related to intent to turnover and actual turnover when both LMX variables were added to the model simultaneously was contingent on the nature of the LMX relationship being examined.

Transitioning patients to survivorship care: a systematic review.

UNLABELLED Problem Identification: In 2005, the Institute of Medicine (IOM) released a seminal report on cancer survivorship that discussed the goals and structure of cancer survivorship care with the recommendation to use a survivorship care plan (SCP). However, the manner in which these recommendations are operationalized and their relationship to patient outcomes are unknown. LITERATURE SEARCH A systematic literature search was conducted using PubMed, CINAHL®, and the Cochrane Database. Articles were selected if they included a provider-mediated intervention and were published after 2005, for a total of nine articles.Data Evaluation: The studies were evaluated according to the purposes of survivorship care, the use of an SCP, and models of care recommended by the IOM. CONCLUSIONS The outcomes of the studies were not conclusive in supporting a specific model of survivorship care or the use of a SCP. Two of the nine studies adhered to the IOM goals of survivorship care and SCP recommendations in their interventions. IMPLICATIONS FOR PRACTICE The design and testing of nurse-led survivorship programs is imperative, as nurses may be effective in ensuring consistent, patient-centered education for cancer survivors.