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Surgical services are settings where resilient performance (RP) is necessary to cope with a wide range of variabilities. Although RP can benefit from a supportive built environment (BE), prior studies have focused on the operating room, giving scant attention to support areas. This study takes a broader perspective, aiming at developing BE design knowledge supportive of RP at the surgical service as a whole.

Seven BE design prescriptions developed in a previous work in the context of internal logistics of hospitals, and thus addressing interactions between workspaces, were used as a point of departure. The prescriptions were used as a data analysis framework in a case study of the surgical service of a medium-sized private hospital. The scope of the study included surgical and support areas, in addition to workflows involving patients and family members, staff, equipment, sterile instruments and materials, supplies, and waste. Data collection included document analysis, observations, interviews, and meetings with hospital staff.

Results identified 60 examples of using the prescriptions, 77% of which were related to areas other than the operating rooms. The developed design knowledge is framed as a set of prescriptions, examples, and their association to workflows and areas, indicating where it should be applied.

The design knowledge is new in surgical services and offers guidance to both BE and logistics designers.

The purpose of this paper is to evaluate the effectiveness of negotiation training delivered to senior clinicians, managers and executives, by exploring whether staff members implemented negotiation skills in their workplace following the training, and if so, how and when.

This is a qualitative study involving face-to-face interviews with 18 senior clinicians, managers and executives who completed a two-day intensive negotiation skills training course. Interviews were transcribed verbatim, and inductive interpretive analysis techniques were used to identify common themes. Research setting was a large tertiary care hospital and health service in regional Australia.

Participants generally reported positive affective and utility reactions to the training, and attempted to implement at least some of the skills in the workplace. The main enabler was provision of a Negotiation Toolkit to assist in preparing and conducting negotiations. The main barrier was lack of time to reflect on the principles and prepare for upcoming negotiations. Participants reported that ongoing skill development and retention were not adequately addressed; suggestions for improving sustainability included provision of refresher training and mentoring.

Limitations include self-reported data, and interview questions positively elicited examples of training translation.

The training was well matched to participant needs, with negotiation a common and daily activity for most healthcare professionals. Implementation of the skills showed potential for improving collaboration and problem solving in the workplace. Practical examples of how the skills were used in the workplace are provided.

To the authors’ knowledge, this is the first international study aimed at evaluating the effectiveness of an integrative bargaining negotiation training program targeting executives, senior clinicians and management staff in a large healthcare organization.

The complex and occasionally chaotic nature of health care has been previously described in the literature, as has the broadening recognition that different management approaches are required for different types of problems rather than a “one size fits all” approach. The CYNEFIN framework from Snowden outlines a consistent cognitive approach that offers the leader and leadership team an ability to urgently apply the correct actions to a given situation. This paper proposes a variant CYNEFIN approach for healthcare.

Consistent and accurate decision-making within health care is the hallmark of an effective and pragmatic leader and leadership team. An awareness of how one’s cognitive biases and heuristics may adversely impact on this cognitive process is paramount, as is an understanding of the calibration between fast and slow thinking.

The authors propose a variant CYNEFIN approach for health care of “act-probe-sense-respond” to resolve complex and time-critical emergency scenarios, using the differing contexts of a cardiac arrest and an evolving crisis management problem as examples. The variant serves as a pragmatic sense-making framework for the health-care leader and leadership team that can be adopted for many time-critical crisis situations.

The variant serves as a pragmatic sense-making framework for the health-care leader that can be adopted for many crisis situations.

Life studies are a rich source for further research on the role of the Afro‐American woman in society. They are especially useful to gain a better understanding of the Afro‐American experience and to show the joys, sorrows, needs, and ideals of the Afro‐American woman as she struggles from day to day.

The purpose of this paper is to report on a process evaluation of a randomised controlled trial (RCT) intervention study that tested the effectiveness of classroom- and simulation-based crew resource management courses, alone and in combination, and identifies organisational barriers and facilitators to implementation of team training programmes in healthcare.

The RCT design consisted of a before and after study with a team training intervention. Quantitative data were gathered on utility and affective reactions to training, and on teamwork knowledge, attitudes, and behaviours of the learners. A sample of participants was interviewed at the conclusion of the study. Interview responses were analysed, alongside qualitative elements of the classroom course critique, to search for evidence, context, and facilitation clues to the implementation process.

The RCT method provided scientifically robust data that supported the benefits of classroom training. Qualitative data identified a number of facilitators to implementation of team training, and shed light on some of the ways that learning was diffused throughout the organisation. Barriers to successful implementation were also identified, including hospital time and resource constraints and poor organisational communication.

Quantitative randomised methods have intermittently been used to evaluate team training interventions in healthcare. Despite two decades of team training trials, however, the authors do not know as well as the authors would like what goes on inside the “black box” of such RCTs. While results are usually centred on outcomes, this study also provides insight into the context and mechanisms associated with those outcomes and identifies barriers and facilitators to successful intervention implementation.

The purpose of this paper is to describe a successful model of shared medical leadership within an academic division of an urban children’s hospital.

Experience and outcomes were tracked over a three-year period during which two physicians shared the role of interim division chief of pediatric endocrinology and diabetes, resulting in a working model of shared leadership.

An evolutionary trajectory occurred over three years in which the strengths of the leaders were combined to optimize decision making in a complex medical division. Improvements in team satisfaction and additional positive outcomes were achieved.

Benefits of and challenges tackled by the strategic approach to shared leadership are identified to inform other medical institutions, particularly those with many team members or combined programs that include strong clinical and research components.

Little has been written within medical literature regarding shared leadership. The shared leadership model described in this paper can be implemented by others in a complex academic setting and will hopefully lead to more robust divisions.

This paper aims to explore if health professionals share understanding of teamwork that supports collaborative ward rounds.

A purpose-designed survey was conducted in two acute medical and two rehabilitation wards from a metropolitan teaching hospital. Medical officers, nurses and allied health professionals participated. To understand characteristics that support collaborative ward rounds, questions developed from literature and industry experience asked: what are the enablers and challenges to teamwork; and what are clinicians’ experiences of positive teamwork? Descriptive and thematic analyses were applied to the dimensions of effective teamwork as a framework for deductive coding.

Seventy-seven clinicians participated (93% response rate). Findings aligned with dimensions of teamwork framework. There was no meaningful difference between clinicians or specialty. Enablers to teamwork were: effective communication, shared understanding of patient goals, and colleague’s roles. Challenges were ineffective communication, individual personalities, lack of understanding about roles and responsibilities, and organisational structure. Additional challenges included: time; uncoordinated treatment planning; and leadership. Positive teamwork was influenced by leadership and team dynamics.

Ward rounds benefit from a foundation of collaborative teamwork. Different dimensions of teamwork present during ward rounds support clinicians’ shared understanding of roles, expectations and communication.

Rounds such as structured rounding, aim to improve teamwork. Inverting this concept to first develop effective collaboration will support team adaptability and resilience. This enables teams to transition between the multiple rounding processes undertaken in a single ward. The emphasis becomes high-quality teamwork rather than a single rounding process.

This article seeks to provide an overview of the development, construction and evaluation of an information literacy testing instrument connected with the VOILA! online information literacy tutorials, developed by librarians at Hunter College libraries for students enrolled in the college's first‐year orientation seminar (ORSEMs).

The VOILA! online information literacy tutorial, developed by librarians at Hunter College, has a test as one of its components. All incoming students registered in the college's orientation seminars (ORSEMs) are required to go through the VOILA! tutorials and take the test. The longitudinal development and evaluation of the test are reviewed, including initial statement of competencies, test creation, test construction (assessment type, question formulation and question type) and test evolution. Validity and reliability are also discussed in detail. Finally, a review of the test results including general statistics and the connection of student performance to test construction is provided.

Test construction was given a great deal of attention during the development of VOILA!, as librarians wanted an instrument that was valid and reliable. The importance of iterative test design and attention to the details of test construction is stressed in the article, and the methodology used to determine validity and reliability is presented. Those interested in testing information literacy skills must be able to examine the instrument, the results and the design process in a way that contributes meaningfully to the preparation of students to undertake research at the college level.

Librarians will continue to modify the VOILA! test in keeping with evaluation results, and the assessment will continue. Thus the results presented may not fully represent the final evaluative outcome.

This research is useful for information professionals who are interested in test design, construction and evaluation. The longitudinal study presents clear, practical information that can be used as a case study for other libraries interested in this area. The VOILA! test itself is included as an Appendix, and can be used as a model for other libraries to consult.

A literature review revealed a number of articles about testing and information literacy, but very few, if any, articles approached the discussion from a longitudinal test construction standpoint. In this way, the study presents information that is original. The study would be valuable for information professionals who are interested in test design, construction and evaluation.

The sudden arrival of Covid-19 severely disrupted the supply chain of personal protective equipment (PPE) in Australia. This paper aims to examine the development of a geographical cluster, which, through the application of additive manufacturing (AM), responded to the PPE supply crisis.

This longitudinal case study focuses on an AM cluster, which was developed to supply PPE in a responsive and flexible manner from 2019/2020. The study gathered data over three stages of cluster evolution: pre, during and post-peak Covid-19.

The type and nature of exchanges between organizations involved in the cluster established important insights into success factors for cluster creation and development. Using an established complexity framework, this study identifies the characteristics of establishing a cluster. The importance of cluster alignment created initially by a common PPE supply goal led to an emerging commercial and relational imperative to address the longer-term configuration after the disruption.

Clusters can be a viable option for a technology-driven sector when there is a “buzz” that drives and rapidly diffuses knowledge to support cluster formation. This research identifies the structural, socio-political and emergent dimensions, which need to be considered by stakeholders when aiming at improving competitiveness using clusters.

Covid-19 has rapidly and unexpectedly disrupted the supply chain for many industries. Responding to challenges, businesses will investigate different pathways to improve the overall resilience including on-/near-shoring. The results provide insights into how clusters are formed, grow and develop and the differentiating factors that result in successful impacts of clusters on local economies.