Proactive communication in multi-agent teamwork

Sharing common goals and acting cooperatively are critical issues in multiagent teamwork. Traditionally, agents cooperate with each other by inferring others' actions implicitly or explicitly, based on established norms for behavior or on knowledge about the preferences or interests of others. This kind of cooperation either requires that agents share a large amount of knowledge about the teamwork, which is unrealistic in a distributed team, or requires high-frequency message exchange, which weakens teamwork efficiency, especially for a team that may involve human members. In this research, we designed and developed a new approach called Proactive Communication, which helps to produce realistic behavior and interactions for multiagent teamwork. We emphasize that multi-agent teamwork is governed by the same principles that underlie human cooperation. Psychological studies of human teamwork have shown that members of an effective team often anticipate the needs of other members and choose to assist them proactively. Human team members are also naturally capable of observing the environment and others so they can establish certain parameters for performing actions without communicating with others. Proactive Communication endows agents with observabilities and enables agents use them to track othersâ mental states. Additionally, Proactive Communication uses statistical analysis of the information production and need of team members and uses these data to capture the complex, interdependent decision processes between information needer and provider. Since not all these data are known, we use their expected values with respect to a dynamic estimation of distributions. The approach was evaluated by running several sets of experiments on a Multi- Agent Wumpus World application. The results showed that endowing agents with observability decreased communication load as well as enhanced team performance. The results also showed that with the support of dynamic distributions, estimation, and decision-theoretic modeling, teamwork efficiency were improved

Infusion of TeamSTEPPS

Infusion of TeamSTEPPS studied the transformational change within a surgical department at a military treatment facility. TeamSTEPPS has been implemented in many hospitals to help with team development, communication, and patient safety. Infusion of TeamSTEPPS maintains the integrity of the program and gains additional buy-in from the team members by involving them in the infusion process. The process involved a gap analysis in understanding the team\u27s integrated components of TeamSTEPPS and looked at infusing the unobserved components. The project revealed a significate change in team satisfaction and an increase in operating room utilization rates. Patient safety reporting increased during this period. The team felt empowered to speak up on the behave the patient and the organization. The Infusion of TeamSTEPPS influenced the culture of the operating room

Skills for generalist and specialist nurses working in the prevention and control of infections in Brazil

Objetivo: definir as competências para a prevenção e o controle de infecções relacionadas à assistência à saúde que devem ser desenvolvidas pelo enfermeiro generalista e pelo enfermeiro especialista em controle de infecções no Brasil. Método: empregou-se a técnica Delphi, desenvolvida em quatro rodadas. Participaram do estudo 31 enfermeiros e oito médicos com expertise em prevenção e controle de infecções. Para a coleta de dados, utilizaram-se instrumentos com perguntas abertas cujas respostas foram tratadas por meio da técnica de análise de conteúdo e instrumentos estruturados para avaliar a importância de cada competência por meio de escala Likert, sendo os dados analisados e apresentados de forma descritiva, uso de mediana e de coeficiente de variação. Resultados: as competências foram organizadas em 04 centrais, 14 genéricas e 17 específicas, com nome e a descrição de cada competência. Conclusão: a definição das competências para a prevenção e o controle de Infecções Relacionadas à Assistência à Saúde é o primeiro passo para se iniciar o repensar acerca do processo de ensino e aprendizagem na formação inicial dos enfermeiros. Os dados encontrados auxiliam na reestruturação do ensino, além de fundamentar programas de educação permanente em saúde.Objetivo: definir las competencias para la prevención y el control de infecciones relacionadas a la asistencia a la salud que deben ser desarrolladas por el enfermero generalista y por el enfermero especialista en controle de infecciones en Brasil. Método: se empleó la técnica Delphi, desarrollada en cuatro rodadas. Participaron del estudio 31 enfermeros y ocho médicos, con experiencia en prevención y control de infecciones. Para la recolección de datos se utilizaron instrumentos con preguntas abiertas, cuyas respuestas fueron tratadas por medio de la técnica de análisis de contenido, e instrumentos estructurados para evaluar la importancia de cada competencia por medio de escala Likert, siendo los dados analizados y presentados de forma descriptiva, uso de mediana y de coeficiente de variación. Resultados: las competencias fueron organizadas en 04 centrales, 14 genéricas y 17 específicas, con nombre y la descripción de cada competencia. Conclusión: la definición de las competencias para la prevención y el control de Infecciones Relacionadas a la Asistencia a la Salud es el primer paso para iniciarse el repensar acerca del proceso de enseñanza y aprendizaje en la formación inicial de los enfermeros. Los datos encontrados auxilian en la reestructuración de la enseñanza además de fundamentar programas de educación permanente en salud.Objective: to define the competencies for the prevention and control of healthcare-related infections that should be developed by the generalist nurse and the specialist nurse in infection control in Brazil. Method: the Delphi technique, developed in four rounds, was used. Thirty-one nurses and eight physicians participated in the study, with expertise in infection prevention and control. Data were collected using open-ended questionnaires, whose answers were treated using the content analysis technique. Structured instruments were used to evaluate the importance of each competency using a Likert scale. Data were analyzed and presented in a descriptive way, use of median and coefficient of variation. Results: the competences were organized in 4 core, 14 generic and 17 specific, with name and description of each competency. Conclusion: the definition of competencies for the prevention and control of healthcare-related infections is the first step to begin the rethinking of the teaching and learning process in the initial training of nurses. The data found in the present study may help to restructure education and support permanent education programs in health

Skills for generalist and specialist nurses working in the prevention and control of infections in Brazil

Objective: to define the competencies for the prevention and control of healthcare-related infections that should be developed by the generalist nurse and the specialist nurse in infection control in Brazil. Method: the Delphi technique, developed in four rounds, was used. Thirty-one nurses and eight physicians participated in the study, with expertise in infection prevention and control. Data were collected using open-ended questionnaires, whose answers were treated using the content analysis technique. Structured instruments were used to evaluate the importance of each competency using a Likert scale. Data were analyzed and presented in a descriptive way, use of median and coefficient of variation. Results: the competences were organized in 4 core, 14 generic and 17 specific, with name and description of each competency. Conclusion: the definition of competencies for the prevention and control of healthcare-related infections is the first step to begin the rethinking of the teaching and learning process in the initial training of nurses. The data found in the present study may help to restructure education and support permanent education programs in health

Does Social Presence Increase Perceived Competence? Evaluating Conversational Agents in Advice Giving Through a Video-Based Survey

Conversational agents (CA) have drawn increasing interest from HCI research. They have become popular in different aspects of our lives, for example, in the form of chatbots as the primary point of contact when interacting with an insurance company online. Additionally, CA find their way into collaborative settings in education, at work, or financial advisory. Researchers and practitioners are searching for ways to enhance the customer's experience in service encounters by deploying CA. Since competence is an important treat of a financial advisor, they only accept CA in their interaction with clients if it does not harm their impression on the client. However, we do not know how the social presence of the CA affects this perceived competence. We explore this by evaluating three prototypes with different social presences. For this, we conducted a video-based online survey. In contrast to prior studies focusing on single human-computer interaction, our study explores CA in a dyadic setting of two humans and one CA. First, our results support the Computers-Are-Social-Actors paradigm as the CA with a strong social presence was perceived as more competent than the other two designs. Second, our data show a positive correlation between CA's and advisor's competence. This implies a positive impact of the CA on the service encounter as the CA and advisor can be seen as a competent team

Travail en mode projet distribué géographiquement : mesure des compétences, de la collaboration et des performances individuelles selon le degré de virtualité

Dans un contexte où le monde du travail s’internationalise et où l’innovation est fondamentale, les organisations d’aujourd’hui doivent structurer le travail en tenant compte des distances géographiques et du besoin de bien performer dans les tâches reliées aux différents projets. Toutefois, le recours à des projets innovants et l’accès à des moyens de communication ne sont pas des conditions suffisantes pour assurer une performance adéquate. Différents facteurs, comme les compétences adaptées au travail virtuel et le degré de virtualité qui sépare les gens, doivent être pris en compte pour favoriser l’atteinte d’une bonne performance. De plus, afin de sélectionner les candidats qui seront en mesure de bien performer dans ce contexte, le recours à des outils d’évaluation appropriés et disponibles dans plusieurs langues est essentiel. Cette thèse présente en premier lieu un processus de traduction, d’adaptation et de validation en français et en anglais d’un outil en allemand visant l’évaluation des compétences requises lorsque le travail est organisé en mode distribué. Un premier article présente les limites fréquemment observées dans les études qui effectuent de telles adaptations. Un deuxième article met ensuite en lumière l’importance relative d’un ensemble de compétences liées à deux types de performances individuelles appropriées au travail en projet virtuel. Les résultats montrent que la créativité, l’autonomie, l’intégrité, la loyauté et la minutie sont directement liées à la performance proactive. Il est cependant nécessaire de prendre en compte l’effet positif de la perception de collaboration et l’effet négatif du degré de virtualité pour comprendre comment les compétences que constituent la motivation à apprendre, l’autonomie, l’intégrité, la loyauté et la minutie agissent sur la performance adaptative. En somme, cette thèse propose d’abord un processus rigoureux permettant l’adaptation, la traduction et la validation d’outils dans plusieurs langues. Ce processus permet d’éviter les limites auxquelles se buteraient des méthodes plus simples dans un contexte international où il est primordial d’avoir une très grande confiance en l’équivalence des instruments. Cette thèse représente également un avancement intéressant en ce qui a trait à la compréhension des différents déterminants de la performance individuelle lorsque le travail est organisé en projets virtuels. Des recommandations sont présentées afin de favoriser la performance individuelle, et des pistes de recherches futures sont également amenées pour continuer à approfondir les connaissances sur le sujet.In a context where workplaces are becoming more internationalized, and where innovation is critical, today's organizations must structure jobs by taking into account geographical distance and the need to perform well in tasks related to different projects. However, innovative projects and access to communication tools are not sufficient conditions to ensure adequate performance. Various factors, such as skills relevant to teleworking and the degree of virtuality that separates people must be factored in to achieve good performance. Furthermore, in order to select candidates who will be able to perform well in this context, the use of appropriate and available assessment tools in several languages is essential. First, this thesis presents a process of translation, adaptation and validation in French and English of a German questionnaire used for the assessment of skills when work is organized in a distributed mode. The first article address limitations that characterize studies that perform such adaptations. A second article then highlights the relative importance of a set of competencies related to two types of individual performance suitable for projects in virtual mode. Results show that creativity, independence, integrity, loyalty and conscientiousness are directly related to proactive performance. However, it is necessary to take into account the positive effect of the perception of collaboration and the negative effect of the degree of virtuality to understand how competencies such as learning motivation, independence, integrity, loyalty and conscientiousness affect adaptive performance. In sum, this thesis first proposes a rigorous process to adapt, translate, and validate instruments in several languages. This process helps avoid common limitations simpler methods are prone to and is better adapted to an international context where it is essential to have great confidence in the equivalences of the instruments. This thesis is also an interesting advancement in regard to understanding the various determinants of individual performance when work is organized in virtual projects. Recommendations are given to foster individual performance, and suggestions for future research are also presented in order to further deepen knowledge on the subject

Improving Therapeutic Relationships among Psychiatric Nursing Staff and Adolescent Patients

This Doctor of Nursing Practice Project examined the effect of an evidence-based staff development education program on the attitudes and knowledge levels of nursing staff regarding the mentally ill adolescent patient population, for which they provide treatment and supervision. A convenience sample of 61 nursing staff members participated in the Improving Therapeutic Relationships among Psychiatric Nursing Staff and Patients project, with 74% of the available sample completing all project surveys. Descriptive statistics were used to compare the scores for the responses of participants to the Community Attitudes toward Mentally Ill (CAMI) pre and post-surveys. Concepts scored by this survey included: benevolence, social restrictiveness, authoritarianism, and community mental health ideology. Bar graphs and tables were used to present the results of the pre and post-surveys, which demonstrated a significant change for some concepts while others remained the constant. Benevolence was the concept most strongly scored but only had two statements that were scored differently when comparing the pre and post-survey scores. The changes indicate nursing staff had a greater understanding of their roles as part of the mental health care team and the responsibility of working together to address the problems of the mentally ill. Social restrictiveness had three statements with significant changes which reflects an increase in the number of nursing staff who strongly agree or agree mentally ill people should have a right to live life as normally as possible. Community Mental Health Ideology concept had two statements with significant changes from pre-intervention to post-intervention indicating most staff strongly agree or agree mentally ill people should live in a community setting. When comparing pre-intervention and post-intervention results, authoritarianism only had one statement with a significant increase in the number of staff who strongly agree or agree it is difficult to identify the problems of a person who is mentally ill. These results demonstrate this evidence-based, targeted education and training program improved and expanded the perspectives and ideas of the nursing staff. This change in thought processes, knowledge, and attitudes can potentially have a direct impact on the development of therapeutic relationships among psychiatric nursing staff and patients

Teaching Professionalism during and Posta Pandemic to Surgical Trainees: A Survey of the Impact of a Workshop on Trainers and Trainees

Introduction: Focussed professionalism training improves surgical trainees’ communication, information gathering, and counselling skills. This study reviews the impact of a professionalism workshop for surgical trainees within a large trust in the United Kingdom developed during the pandemic to support the trainees and help them develop resilienceand appropriate behaviours during the time of increased pressure.Methods: A workshop involving case-based discussions and reflections on professionalism was developed from the themes and methods of training noted to be effective on a literature search of Medline, EMBASE, and PsycINFO databases carried out in May 2020. The impact of Covid on surgical trainees and educator’s professionalism training and the techniques of training preferred by trainees was evaluated by a survey of trainees and trainers after the intervention to evolve future training initiatives. During the workshop, a behavioural marker checklist was used to improve feedback on the observed behaviours.Results: 83 trainers and trainees were surveyed following a professional behaviour workshop training 63 surgeons at various stages of training. Surgical list availability had reduced by at least 5-10 a month for all the trainees within the trust during the pandemic. Most trainees surveyed (49 (60%)) felt that this had reduced the opportunities to train technical skills and develop professional non-technical skills like teamwork and communication skills, adversely impacting the trainee’s clinical performance. The increased support offered by the workshop helped 50 trainees (80%) to improve non-technical skill performance objectively by referencing to behavioural markers and this was felt to have become embedded in practice when surveyed 4 weeks later in 38 trainees (60%). The majority of those surveyed (47 (75%)) felt trainers and trainees had acted professionally during the pandemic and subsequently. The workshop discussions also helped (56 (67%)) trainers and trainees to consider how best to engage professionally with new ways of working as work, and training switched to virtual or telemedicine platforms during the pandemic.Conclusion: Professionalism-based education facilitates surgical trainee development, making them stronger team members and helping to restore team working skills and embrace new working practices

Patient-centred care (PCC) as idea, process and practice

This thesis contributes to the stream of studies that indicate a transformation of the future education of medical professionals to better address patients’ needs and promote a positive attitude towards patientcentredness in medical education. The main goal is to identify the characteristics of patient-centred care (PCC) as ideas, processes, and practices from a medical student’s perspective in Portugal and Sweden. The comparative study aims to answer where the differences between these two students’ groups stand within PCC education, patient-centred beliefs, and self-perceived ability to practice PCC and, specifically, how Portuguese medical students perceive Portuguese PCC practice and potential barriers. Quantitative (questionnaires) and qualitative data collection (curriculum analysis and interviews) are performed. Curriculum analysis indicates that learning about the PCC phenomena in both countries is fragmented across the various courses, considering that in Portugal a significant number (40%) of courses are elective. While the Portuguese curricula focus on the knowledge, the Swedish encourages skills development. Medical students show more caring than sharing attitudes in both countries, and female medical students have a more positive attitude toward PCC. Previous work experience does not affect the attitudes of a medical student to the PCC; nonetheless, it does affect the self-perception of medical student confidence in the information and power-sharing segment and dealing with communicative challenges. Portuguese students consider that the barriers to the implementation of the PCC in Portuguese practice come from the system, doctor, and patient. The implications of the study findings are discussed concerning both wider theoretical perspectives and practical solutions for policymakers and doctors on these aspects of their work. The present study reveals the need for developing an In-Service PCC Guide with all the key elements and activities that reflect the essence of the PCC concept in practice, and that could help medical students when they start their daily practical work with patients; RESUMO: Cuidado centrado no paciente (PCC) como ideia, processo e prática Esta tese contribui para a corrente de estudos que apontam para uma transformação, no futuro, da educação dos profissionais médicos para melhor atender às necessidades do paciente e promover uma atitude positiva em relação à centralização no paciente, da educação médica. O objetivo principal é identificar as características dos cuidados centrados no paciente (PCC), nomeadamente ideias, processos e práticas na perspetiva dos estudantes de medicina em Portugal e na Suécia. O estudo comparativo realizado visa conhecer as diferenças entre esses dois grupos de estudantes relativamente à educação/formação em PCC, as crenças centradas no paciente e capacidade auto percebida de praticar o PCC; e ainda, compreender como os estudantes de medicina portugueses percebem a prática portuguesa do PCC e as potenciais barreiras à mesma. Foram realizadas recolhas de dados quantitativos (questionários) e qualitativos (análise curricular e entrevistas). A análise curricular indica que a aprendizagem sobre o fenómeno PCC nos dois países está fragmentada nos vários cursos, sendo que em Portugal grande parte (40%) ainda integra currículos optativos. Enquanto o currículo de português se concentra no conhecimento, o sueco incentiva o desenvolvimento de habilidades. Os estudantes de medicina mostram atitudes mais carinhosas do que compartilhadas em ambos os países, e as estudantes femininas têm uma atitude mais positiva em relação à PCC. A experiência anterior de trabalho não afeta as atitudes do estudante de medicina em relação à PCC; no entanto, afeta a autopercepção da confiança do estudante de medicina no segmento de partilha de informações e poder e de lidar com os desafios comunicativos. Os estudantes Portugueses consideram que as barreiras à implementação da PCC na prática portuguesa vêm do sistema, do médico e do paciente. As implicações dos resultados do estudo são discutidas em relação a perspetivas teóricas mais amplas e soluções práticas para os formuladores de políticas e para os médicos, sobre esses aspetos de seu trabalho quotidiano. Este estudo revela a necessidade de desenvolver um “In-Service PCC Guide” com todos os elementos e atividades que refletem a essência do conceito de PCC na prática e que possam ajudar os estudantes de medicina quando iniciam o seu trabalho prático quotidiano com os pacientes