Department of Psychological Sciences Papers and Publications

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What Instagram Means to Me: Links Between Social Anxiety, Instagram Contingent Self-worth, and Automated Textual Analysis of Linguistic Authenticity
(Springer Nature, 2024) Brandao, Beatriz M.; Denny, Bryan T.
While research has shown mixed effects of social media on mental health and well-being, little is known about the association between social media attitudes and objective measures of social interaction, such as linguistic authenticity. This study examined the relationship between self-reported social anxiety, linguistic authenticity, and Instagram contingent self-worth (ICSW). A total of 149 adults with active Instagram accounts completed online questionnaires and shared their Instagram comment data. Automated linguistic analysis of authenticity was performed on participants’ comment data using validated algorithms. Multiple linear regression showed that ICSW significantly moderated the relationship between social anxiety and linguistic authenticity, whereby higher levels of social anxiety marginally predicted lower linguistic authenticity at high levels of ICSW. As social media use continues to rise, this study emphasizes the need to explore the impact of social media interactions on emotional and social well-being.
Deep Learning Analysis of Surgical Video Recordings to Assess Nontechnical Skills
(American Medical Association, 2024) Harari, Rayan Ebnali; Dias, Roger D.; Kennedy-Metz, Lauren R.; Varni, Giovanna; Gombolay, Matthew; Yule, Steven; Salas, Eduardo; Zenati, Marco A.
Assessing nontechnical skills in operating rooms (ORs) is crucial for enhancing surgical performance and patient safety. However, automated and real-time evaluation of these skills remains challenging.To explore the feasibility of using motion features extracted from surgical video recordings to automatically assess nontechnical skills during cardiac surgical procedures.This cross-sectional study used video recordings of cardiac surgical procedures at a tertiary academic US hospital collected from January 2021 through May 2022. The OpenPose library was used to analyze videos to extract body pose estimations of team members and compute various team motion features. The Non-Technical Skills for Surgeons (NOTSS) assessment tool was employed for rating the OR team’s nontechnical skills by 3 expert raters.NOTSS overall score, with motion features extracted from surgical videos as measures.A total of 30 complete cardiac surgery procedures were included: 26 (86.6%) were on-pump coronary artery bypass graft procedures and 4 (13.4%) were aortic valve replacement or repair procedures. All patients were male, and the mean (SD) age was 72 (6.3) years. All surgical teams were composed of 4 key roles (attending surgeon, attending anesthesiologist, primary perfusionist, and scrub nurse) with additional supporting roles. NOTSS scores correlated significantly with trajectory (r = 0.51, P = .005), acceleration (r = 0.48, P = .008), and entropy (r = −0.52, P = .004) of team displacement. Multiple linear regression, adjusted for patient factors, showed average team trajectory (adjusted R2 = 0.335; coefficient, 10.51 [95% CI, 8.81-12.21]; P = .004) and team displacement entropy (adjusted R2 = 0.304; coefficient, −12.64 [95% CI, −20.54 to −4.74]; P = .003) were associated with NOTSS scores.This study suggests a significant link between OR team movements and nontechnical skills ratings by NOTSS during cardiac surgical procedures, suggesting automated surgical video analysis could enhance nontechnical skills assessment. Further investigation across different hospitals and specialties is necessary to validate these findings.
How to Make an Internal Team Coach: An Integration of Research
(MDPI, 2024) Fernández Castillo, Gabriela; Linhardt, Rylee; Salas, Eduardo
Team coaching has been found to increase group effort, improve interpersonal processes, and increase team knowledge and learning. However, the team coaching literature is renowned for its inability to define team coaching itself—making it difficult to solidify its place in the world of team science. So far, there is no consensus on what specific training would serve internal leaders best, and how they would connect to the team coaching literature. We know leadership and team training are effective in improving organizational outcomes, but the gap in the literature lies in identifying what specific competencies internal team coaches need, and what training could fulfill these. In this piece, we seek to (1) identify what competencies internal team leaders need based on the outcomes we know team coaching yields, (2) identify specific behaviors that can fulfill these competencies, and (3) integrate the literature to form an evidence-based guide on what training to provide to internal team coaches. By doing so, we hope to provide a definitive understanding of what internal team coaches need to be successful.
Examining Links Between Distinct Affective States and Tobacco Lapse During a Cessation Attempt Among African Americans: A Cohort Study
(Oxford University Press, 2024) Jones, Dusti R; Potter, Lindsey N; Lam, Cho Y; Schlechter, Chelsey R; Nahum-Shani, Inbal; Fagundes, Christopher; Wetter, David W
Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse.This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit.Participants were 220 adults who identified as African American (50% female, ages 18–74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes.After adjusting for previous time’s lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse.The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.
CXCL10 is a crucial chemoattractant for efficient intranasal delivery of mesenchymal stem cells to the neonatal hypoxic-ischemic brain
(Springer Nature, 2024) Hermans, Eva C.; Donega, Vanessa; Heijnen, Cobi J.; de Theije, Caroline G.M.; Nijboer, Cora H.
Hypoxic-Ischemic Encephalopathy (HIE) is a leading cause of mortality and morbidity in newborns. Recent research has shown promise in using intranasal mesenchymal stem cell (MSC) therapy if administered within 10 days after Hypoxia-Ischemia (HI) in neonatal mice. MSCs migrate from the nasal cavity to the cerebral lesion in response to chemotactic cues. Which exact chemokines are crucial for MSC guidance to the HI lesion is currently not fully understood. This study investigates the role of CXCL10 in MSC migration towards the HI-injured brain.
Beyond communication: an update on transforming healthcare teams
(Frontiers Media S.A., 2024) Fernández Castillo, Gabriela; Khalid, Maha; Salas, Eduardo
In 2018, Salas et al. (2018b) offered ten observations on the science of teams in healthcare. This perspective article offers a quick update, providing a new set of observations based on the latest findings. As a point-of-departure for these observations, we use one of medicine's most cited culprits of error: communication (see Table 1* for a complete list of articles discussing communication; see also Etherington et al., 2019;Street Jr. et al., 2020;Tiwary et al., 2019) -and our belief that while important, a sole focus on it fails to take a holistic approach.Upon surveying recent literature (i.e., 2018 -2023), we found that 89% of articles discuss communication in some way, and 28% mention communication as one of the leading causes of medical error (i.e., Chamberland et al., 2018;* Real et al., 2018;* Seidlein et al., 2022;* Wu et al., 2020). However, in the following piece, our stance is that despite communication having been repeatedly cited as "the" medical culprit, it may not be the source of all contention (Clapper & Ching, 2020). More recent findings identify other challenges, such as accountability (e.g., Randall Curtis et al., 2018), conflict management (e.g., Bajwa et al., 2020;* Keller et al., 2019*), decision-making (e.g., Papermaster & Champion, 2021*), reflecting on progress, and coaching as the primary challenges healthcare teams face (Zajac et al., 2021). Moreover, communication is a multi-faceted competency that also requires a holistic view.In our review...
Social inattentional blindness to idea stealing in meetings
(Springer Nature, 2024) Masters-Waage, Theodore C.; Kinias, Zoe; Argueta-Rivera, Jazmin; Stewart, Dillon; Ivany, Rachel; King, Eden; Hebl, Mikki
Using a virtual reality social experiment, participants (N = 154) experienced being at the table during a decision-making meeting and identified the best solutions generated. During the meeting, one meeting participant repeated another participant’s idea, presenting it as his own. Although this idea stealing was clearly visible and audible, only 30% of participants correctly identified who shared the idea first. Subsequent analyses suggest that the social environment affected this novel form of inattentional blindness. Although there was no experimental effect of team diversity on noticing, there was correlational evidence of an indirect effect of perceived team status on noticing via attentional engagement. In sum, this paper extends the inattentional blindness phenomenon to a realistic professional interaction and demonstrates how features of the social environment can reduce social inattention.
Boring But Demanding: Using Secondary Tasks to Counter the Driver Vigilance Decrement for Partially Automated Driving
(Sage, 2024) Mishler, Scott; Chen, Jing
Objective We investigated secondary–task–based countermeasures to the vigilance decrement during a simulated partially automated driving (PAD) task, with the goal of understanding the underlying mechanism of the vigilance decrement and maintaining driver vigilance in PAD. Background Partial driving automation requires a human driver to monitor the roadway, but humans are notoriously bad at monitoring tasks over long periods of time, demonstrating the vigilance decrement in such tasks. The overload explanations of the vigilance decrement predict the decrement to be worse with added secondary tasks due to increased task demands and depleted attentional resources, whereas the underload explanations predict the vigilance decrement to be alleviated with secondary tasks due to increased task engagement. Method Participants watched a driving video simulating PAD and were required to identify hazardous vehicles throughout the 45-min drive. A total of 117 participants were assigned to three different vigilance-intervention conditions including a driving-related secondary task (DR) condition, a non-driving-related secondary task (NDR) condition, and a control condition with no secondary tasks. Results Overall, the vigilance decrement was shown over time, reflected in increased response times, reduced hazard detection rates, reduced response sensitivity, shifted response criterion, and subjective reports on task-induced stress. Compared to the DR and the control conditions, the NDR displayed a mitigated vigilance decrement. Conclusion This study provided convergent evidence for both resource depletion and disengagement as sources of the vigilance decrement. Application The practical implication is that infrequent and intermittent breaks using a non-driving related task may help alleviate the vigilance decrement in PAD systems.
The primacy of morphology in English braille spelling: an analysis of bridging contractions
(Springer Nature, 2024) Englebretson, Robert; Holbrook, M. Cay; Treiman, Rebecca; Fischer-Baum, Simon
This study examines the use of braille contractions in a corpus of spelling tests from braille-reading children in grades 1-4, with particular attention to braille contractions that create mismatches with morphological structure. Braille is a tactile writing system that enables people who are blind or visually impaired to read and write. In English and many other languages, reading and writing braille is not simply a matter of transliterating between print letters and their braille equivalents; Unified English Braille (the official braille system used in the United States, Canada, the United Kingdom, and several other English-speaking countries) contains 180 contractions—one or more braille cells that represent whole words or strings of letters. In some words, the prescriptive rules for correct braille usage cause contractions to bridge morphological boundaries and to obscure the spellings of stems and affixes. We demonstrate that, when the prescriptive rules for correct braille usage flout morphological structure, young braille spellers generally follow the morphology rather than the orthographic rules. This work establishes that morphology matters for young braille learners. We discuss the potential impact of our findings on braille research, development, and pedagogy, and we suggest ways in which our findings contribute to understanding the nature of orthographic morphemes and the place of braille in the reading sciences.
Consecutive Shifts: A Repeated Measure Study to Evaluate Stress, Biomarkers, Social Support, and Fatigue in Medical/Surgical Nurses
(MDPI, 2023) Cockerham, Mona; Kang, Duck-Hee; Beier, Margaret E.
Nurses report that they are required to work during their scheduled breaks and generally experience extended work times and heavy workloads due to staffing shortages. This study aimed to examine changes in personal, work-related, and overall stress, as well as biological responses and fatigue experienced by nurses during three consecutive 12 h workdays (i.e., the typical “three-twelves” schedule). We also considered the moderating effects of social resources. This prospective study of 81 medical/surgical nurses who completed questionnaires and provided saliva samples at four designated intervals (i.e., pre-shift and post-shift on workdays 1 and 3). Fatigue reported by night shift nurses increased significantly over three consecutive workdays (p = 0.001). Day shift nurses said they encountered more social support than those on the night shift (p = 0.05). Social support moderated the relationship between work-related stress at baseline and reported fatigue on day 3.
Fear of missing out and depressive symptoms during the COVID-19 pandemic
(Wiley, 2023) LeRoy, Angie S.; Lai, Vincent D.; Tsay-Jones, Arya; Fagundes, Christopher P.
During the early stages of the COVID-19 pandemic, governments issued public health safety measures (e.g., “stay-at-home” ordinances), leaving many people “missing out” on integral social aspects of their own lives. The fear of missing out, popularly shortened as, “FoMO,” is a felt sense of unease one experiences when they perceive they may be missing out on rewarding and/or enjoyable experiences. Among 76 participants (ages M = 69.36, SD = 5.34), who were at risk for hospitalization or death if infected with COVID-19, we found that FoMO was associated with depressive symptoms at Time 1, even when controlling for perceived stress, loneliness, and fear of COVID-19. However, FoMO did not predict future depressive symptoms, about 1 week later, when controlling for Time 1 depressive symptoms. These findings provide further evidence that FoMO is associated with depressive symptoms in a short period of time even when accounting for other powerful social factors such as loneliness. Future research should explore the potential causal relationships between FoMO and depression, especially those that may establish temporal precedence.
Emotion regulation during encoding reduces negative and enhances neutral mnemonic discrimination in individuals with depressive symptoms
(Elsevier, 2023) Hayes, Brandon K.; Harikumar, Amritha; Ferguson, Lorena A.; Dicker, Eva E.; Denny, Bryan T.; Leal, Stephanie L.
Individuals with depression exhibit dysfunctional emotion regulation, general episodic memory deficits, and a negativity bias, where negative experiences are better remembered. Recent work suggests that the negativity bias in depression may be driven by enhanced mnemonic discrimination, a memory measure that relies on hippocampal pattern separation – a computation that processes experiences with overlapping features as unique. Previously, we found that individuals with depressive symptoms show enhanced negative and impaired neutral mnemonic discrimination. The current study aimed to investigate emotion regulation as an approach toward modifying memory encoding of negative and neutral events in individuals with depressive symptoms. Here we show that applying psychological distancing (a cognitive reappraisal strategy characterized by taking a third-person perspective toward negative events) during encoding was associated with reduced negative and enhanced neutral mnemonic discrimination during retrieval in individuals with depressive symptoms. These results suggest that applying emotion regulation techniques during encoding may provide an effective approach toward altering dysfunctional memory in those with depressive symptoms. Given that pharmacological treatments often fail to treat depression, emotion regulation provides a powerful and practical approach toward modifying cognitive and emotional processes. Future neuroimaging studies will be important to determine how emotion regulation impacts the neural mechanisms underlying these findings.
A novel face-name mnemonic discrimination task with naturalistic stimuli
(Elsevier, 2023) Mannion, Renae; Harikumar, Amritha; Morales-Calva, Fernanda; Leal, Stephanie L.
Difficulty remembering faces and names is a common struggle for many people and gets more difficult as we age. Subtle changes in appearance from day to day, common facial characteristics across individuals, and overlap of names may contribute to the difficulty of learning face-name associations. Computational models suggest the hippocampus plays a key role in reducing interference across experiences with overlapping information by performing pattern separation, which enables us to encode similar experiences as distinct from one another. Thus, given the nature of overlapping features within face-name associative memory, hippocampal pattern separation may be an important underlying mechanism supporting this type of memory. Furthermore, cross-species approaches find that aging is associated with deficits in hippocampal pattern separation. Mnemonic discrimination tasks have been designed to tax hippocampal pattern separation and provide a more sensitive measure of age-related cognitive decline compared to traditional memory tasks. However, traditional face-name associative memory tasks do not parametrically vary overlapping features of faces and names to tax hippocampal pattern separation and often lack naturalistic facial features (e.g., hair, accessories, similarity of features, emotional expressions). Here, we developed a face-name mnemonic discrimination task where we varied face stimuli by similarity, race, sex, and emotional expression as well as the similarity of name stimuli. We tested a sample of healthy young and older adults on this task and found that both age groups showed worsening performance as face-name interference increased. Overall, older adults struggled to remember faces and face-name pairs more than young adults. However, while young adults remembered emotional faces better than neutral faces, older adults selectively remembered positive faces. Thus, the use of a face-name association memory task designed with varying levels of face-name interference as well as the inclusion of naturalistic face stimuli across race, sex, and emotional expressions provides a more nuanced approach relative to traditional face-name association tasks toward understanding age-related changes in memory.
Buscando la Calma Dentro de la Tormenta: A Brief Review of the Recent Literature on the Impact of Anti-Immigrant Rhetoric and Policies on Stress Among Latinx Immigrants
(Sage, 2023) Rojas Perez, Oscar Fernando; Silva, Michelle Alejandra; Galvan, Thania; Moreno, Oswaldo; Venta, Amanda; Garcini, Luz; Paris, Manuel
The mental health burden associated with anti-immigrant rhetoric and ever-changing immigration policies is undeniable, though the psychological and emotional sequalae may remain invisible for years to come. Exclusionary immigration policies, as a form of structural racism, have also led to an epidemic of stress-related health within the Latinx community, particularly the Latinx immigrant community, across the United States. Recent examples of anti-Latinx and anti-immigrant rhetoric and policies include the 45th President's implementation of the Zero Tolerance policy, Migrant Protection Protocols, and Title 42. The recognition of previous and existing anti-immigrant policies, and the impact on Latinx immigrants, is critical in understanding the manifestation of psychological stress to prevent it from becoming chronic. For mental health providers, attention to existing policies that can be detrimental to the Latinx immigrant community is essential to understanding their mental health trajectory and applying frameworks that honor an individual's psychological stress to prevent pathologizing the immigrant experience and negative health outcomes. The objective of the present brief review is to shed light on recent research and offer recommendations for practice (eg, educating the Latinx community about the link between the immigrant experience and psychological stress) and policy (eg, drafting of legislation aimed at rescinding harmful immigration policies) regarding the relation between aggressive anti-immigration rhetoric and psychological stress among Latinx immigrants in the United States.
Unpacking reappraisal: a systematic review of fMRI studies of distancing and reinterpretation
(Oxford University Press, 2023) Denny, Bryan T; Jungles, Mallory L; Goodson, Pauline N; Dicker, Eva E; Chavez, Julia; Jones, Jenna S; Lopez, Richard B
In recent decades, a substantial volume of work has examined the neural mechanisms of cognitive reappraisal. Distancing and reinterpretation are two frequently used tactics through which reappraisal can be implemented. Theoretical frameworks and prior evidence have suggested that the specific tactic through which one employs reappraisal entails differential neural and psychological mechanisms. Thus, we were motivated to assess the neural mechanisms of this distinction by examining the overlap and differentiation exhibited by the neural correlates of distancing (specifically via objective appraisal) and reinterpretation. We analyzed 32 published functional magnetic resonance imaging (fMRI) studies in healthy adults using multilevel kernel density analysis. Results showed that distancing relative to reinterpretation uniquely recruited right bilateral dorsolateral PFC (DLPFC) and left posterior parietal cortex, previously associated with mentalizing, selective attention and working memory. Reinterpretation relative to distancing uniquely recruited left bilateral ventrolateral PFC (VLPFC), previously associated with response selection and inhibition. Further, distancing relative to reinterpretation was associated with greater prevalence of bilateral amygdala attenuation during reappraisal. Finally, a behavioral meta-analysis showed efficacy for both reappraisal tactics. These results are consistent with prior theoretical models for the functional neural architecture of reappraisal via distancing and reinterpretation and suggest potential future applications in region-of-interest specification and neural network analysis in studies focusing on specific reappraisal tactics.
Enhancing team success in the neonatal intensive care unit: challenges and opportunities for fluid teams
(Frontiers Media S.A., 2023) Bell, Elizabeth A.; Rufrano, Gabrielle A.; Traylor, Allison M.; Ohning, Bryan L.; Salas, Eduardo
Fluid teams, characterized by frequent changes in team membership, are vital in the neonatal intensive care unit (NICU) due to high patient acuity and the need for a wide range of specialized providers. However, many challenges can hinder effective teamwork in this setting. This article reviews the challenges related to fluid teamwork in the NICU and discusses recommendations from team science to address each challenge. Drawing from the current literature, this paper outlines three challenges that can hinder fluid teamwork in the NICU: incorporating patient families, managing hierarchy among team members, and facilitating effective patient handoffs. The review concludes with recommendations for managing NICU teamwork differently using strategies from team science.
Perceived antidepressant efficacy associated with reduced negative and enhanced neutral mnemonic discrimination
(Frontiers Media S.A., 2023) Phillips, Taylor O.; Castro, Madelyn; Vas, Rishi K.; Ferguson, Lorena A.; Harikumar, Amritha; Leal, Stephanie L.
IntroductionWhile antidepressants are one of the first-line treatments for depression, the mechanisms underlying antidepressant action are unclear. Furthermore, the extent to which antidepressants impact emotional and cognitive dysfunction in depression requires more fine-grained approaches toward measuring these impacts in humans. Depression is associated with emotion and mood dysregulation in addition to cognitive deficits. Depressed individuals experience general memory impairment as well as a negativity bias in episodic memory, where negative events are better remembered than positive or neutral events. One potential mechanism hypothesized to underlie the negativity bias in memory is dysfunctional hippocampal pattern separation, in which depressed individuals tend to show impaired general pattern separation but enhanced negative pattern separation. Mnemonic discrimination tasks have been designed to tax hippocampal pattern separation in humans and provide a powerful approach to develop a mechanistic account for cognitive dysfunction in depression. While antidepressants have been examined primarily in rodent models in the context of hippocampal pattern separation, this has yet to be examined in humans.MethodsHere, we investigated how antidepressant usage and their perceived efficacy was associated with emotional mnemonic discrimination, given our prior work indicating a negativity bias for mnemonic discrimination in individuals with greater depressive symptoms.ResultsWe found that individuals who reported a greater improvement in their depressive symptoms after taking antidepressants (responders) showed reduced negative and enhanced neutral mnemonic discrimination compared to those with little to no improvement (non-responders). Perceived antidepressant efficacy was the strongest predictor of a reduction in the negativity bias for mnemonic discrimination, even when controlling for current depressive symptoms, antidepressant type, and other relevant factors.DiscussionThese results suggest that antidepressants, when effective, can shift memory dynamics toward healthy function.
Emotional modulation of memorability in mnemonic discrimination
(Elsevier, 2024) Morales-Calva, Fernanda; Leal, Stephanie L.
Although elements such as emotion may serve to enhance or impair memory for images, some images are consistently remembered or forgotten by most people, an intrinsic characteristic of images known as memorability. Memorability explains some of the variability in memory performance, however, the underlying mechanisms of memorability remain unclear. It is known that emotional valence can increase the memorability of an experience, but how these two elements interact is still unknown. Hippocampal pattern separation, a computation that orthogonalizes overlapping experiences as distinct from one another, may be a candidate mechanism underlying memorability. However, these two literatures have remained largely separate. To explore the interaction between image memorability and emotion on pattern separation, we examined performance on an emotional mnemonic discrimination task, a putative behavioral correlate of hippocampal pattern separation, by splitting stimuli into memorable and forgettable categories as determined by a convolutional neural network as well as by emotion, lure similarity, and time of testing (immediately and 24-hour delay). We measured target recognition, which is typically used to determine memorability scores, as well as lure discrimination, which taxes hippocampal pattern separation and has not yet been examined within a memorability framework. Here, we show that more memorable images were better remembered across both target recognition and lure discrimination measures. However, for target recognition, this was only true upon immediate testing, not after a 24-hour delay. For lure discrimination, we found that memorability interacts with lure similarity, but depends on the time of testing, where memorability primarily impacts high similarity lure discrimination when tested immediately but impacts low similarity lure discrimination after a 24-hour delay. Furthermore, only lure discrimination showed an interaction between emotion and memorability, in which forgettable neutral images showed better lure discrimination compared to more memorable images. These results suggest that careful consideration is required of what makes an image memorable and may depend on what aspects of the image are more memorable (e.g., gist vs. detail, emotional vs. neutral).
Associations between teamwork and implementation outcomes in multidisciplinary cross-sector teams implementing a mental health screening and referral protocol
(Springer Nature, 2023) McGuier, Elizabeth A.; Aarons, Gregory A.; Byrne, Kara A.; Campbell, Kristine A.; Keeshin, Brooks; Rothenberger, Scott D.; Weingart, Laurie R.; Salas, Eduardo; Kolko, David J.
Teams play a central role in the implementation of new practices in settings providing team-based care. However, the implementation science literature has paid little attention to potentially important team-level constructs. Aspects of teamwork, including team interdependence, team functioning, and team performance, may affect implementation processes and outcomes. This cross-sectional study tests associations between teamwork and implementation antecedents and outcomes in a statewide initiative to implement a standardized mental health screening/referral protocol in Child Advocacy Centers (CACs).
Handoffs and the challenges to implementing teamwork training in the perioperative environment
(Frontiers Media S.A., 2023) Paquette, Shannon; Kilcullen, Molly; Hoffman, Olivia; Hernandez, Jessica; Mehta, Ankeeta; Salas, Eduardo; Greilich, Philip E.
Perioperative handoffs are high-risk events for miscommunications and poor care coordination, which cause patient harm. Extensive research and several interventions have sought to overcome the challenges to perioperative handoff quality and safety, but few efforts have focused on teamwork training. Evidence shows that team training decreases surgical morbidity and mortality, and there remains a significant opportunity to implement teamwork training in the perioperative environment. Current perioperative handoff interventions face significant difficulty with adherence which raises concerns about the sustainability of their impact. In this perspective article, we explain why teamwork is critical to safe and reliable perioperative handoffs and discuss implementation challenges to the five core components of teamwork training programs in the perioperative environment. We outline evidence-based best practices imperative for training success and acknowledge the obstacles to implementing those best practices. Explicitly identifying and discussing these obstacles is critical to designing and implementing teamwork training programs fit for the perioperative environment. Teamwork training will equip providers with the foundational teamwork competencies needed to effectively participate in handoffs and utilize handoff interventions. This will improve team effectiveness, adherence to current perioperative handoff interventions, and ultimately, patient safety.

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