Surgical patient safety remains a concern worldwide as, despite World Health Organization recommendations and implementation of its Surgical Safety Checklist, adverse events continue to occur. The aim of this qualitative study was to explore the views and experiences of perioperative nurses regarding the factors that impact surgical patient safety. Data were collected through five focus groups involving a total of 50 perioperative nurses recruited from four public hospitals in Spain. Content analysis of the focus groups yielded four main (...) themes: personal qualities of the perioperative nurse, the surgical environment, safety culture, and perioperative nursing care plans. One of the main findings concerned barriers to the exercise of leadership by nurses, especially regarding completion of the Surgical Safety Checklist. Some of the key factors that impacted the ability of perioperative nurses to fulfil their duties and ensure patient safety were the stress associated with working in the operating room, time pressures, and ineffective communication in the multidisciplinary team. Targeting these aspects through training initiatives could contribute to the professional development of perioperative nurses and reduce the incidence of adverse events by enhancing the surgical safety culture. (shrink)

Background: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves. Objectives: This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice. Research design: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic (...) text interpretation. Ethical consideration: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee. Findings: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care. Conclusion: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations. (shrink)

Background Non-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate. Aim To learn what ethical issues operating room nurses perceive as important regarding non-technical skills. Research design Qualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke’s six phases for thematic analysis. Participants and research context Eleven experienced perioperative/operating room nurses (...) working in an operating unit at a Norwegian university hospital. Ethical considerations Approval was given by The Norwegian Social Science Data Service in care of the hospital’s Data Protection Officer. Findings Three main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety. Discussion Defending the patient’s dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other’s tasks and responsibilities and to talk to one another in a friendly manner. Conclusion Being respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good ‘flow’ within the operating room team. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Operating Through HatredAndrew G. Shuman“You’re not cutting my ***ing neck. The cancer is in my ***ing mouth.”While many patient encounters are memorable, Mr. K’s introduction to the head and [End Page 20] neck surgical oncology clinic is indelibly imprinted into the minds of all of the clinicians present on that certain autumn morning. This was, quite simply, a man who resonated hate. He was rude and disruptive. He insisted (...) on an expedited workup “without any waiting.” He questioned the ethnicity and nationality of his care providers. He told me, in no uncertain terms, that he did not appreciate my Jewish heritage—the swastika tattooed on his bicep underscored the point. He bragged about his recent incarceration for armed robbery. While my colleagues and I were tempted to simply refuse to assume his care, Mr. K had a bad problem—his recurrent tongue cancer required a major operation in order to offer him any hope for cure.Mr. K initially received an abbreviated course of radiation at an outside institution, which was limited by his non–compliance. While one might debate the wisdom of this decision in retrospect—in general, surgery is preferred for his type of tumor—the die was already cast. A heroic attempt at surgical salvage was now his only curative option. He previously sought care elsewhere... only to be fired by this original surgeon when Mr. K physically threatened him in the outpatient office during preoperative consultation. [It was the doctor’s fault for insulting him in the first place, Mr. K maintained... and no charges were filed.] We were, indeed, his last resort. Other than his recurrent cancer, Mr. K was robust; he was in his sixth decade, physically fit, and on the whole, fairly healthy. In the classic surgical lexicon, he was a reasonable surgical candidate. But was it reasonable to operate on such a person?I remember thinking, at the time, about our obligation to care for such an individual. Of course, being a medical professional carries with it many obligations, including a judicious assumption of personal risk. And, working in a tertiary care center begets the responsibility to assist referring clinicians in the management of difficult cases. Although professional obligations certainly have their limits, defining their bounds is decidedly more difficult. Paramount is creating an atmosphere of mutual trust and acceptance. Naturally, this was easier said than done in regard to Mr. K.Perhaps against our better judgment, we agreed to operate under the condition that he abide by strict behavioral ground rules, on our terms. We agreed upon the extent of the necessary operation (which indeed involved cutting his ***ing neck, much to his chagrin and reluctant acceptance). Mr. K promised to follow instructions for postoperative care. He assured us that he would not swear or yell (again). And, in the presence of hospital security, who reinforced our institutional policies regarding patient behavior, he guaranteed that he would not be verbally or physically violent or inappropriate, and would not make disparaging comments to other patients or staff. It seemed, at least, that we had an understanding.Needless to say, these rules were broken shortly after he awoke from surgery. I vividly remember being summoned from the OR when he threatened to murder his impressionable and terrified nurse a few days later, who would not acquiesce to his unreasonable demands. From that point onward, hospital security was deployed to his room regularly, and anything resembling a potential weapon was safeguarded. Any semblance of a mutual doctor–patient bond was shattered. At this point, everyone’s goal was simply to get Mr. K home.My visceral reactions to his behavior, while intense, were not unexpected, and fell in line with those of the entire team of clinicians caring for him. His antics brought his healthcare team together in collective unity (and condemnation). However, my surgical colleagues and I also felt somewhat guilty and responsible. While surgeons can choose to assume some degree of inherent personal danger in caring for a violent and angry patient, we also put the safety and soundness of the entire perioperative team in jeopardy, without necessarily seeking their input. But once we had decided to... (shrink)

We are revolutionary offspring of indomitable spirit. We are born rebels. We came to this world to rebel against the bourgeoisie and carry the great proletarian revolutionary banner. Sons will justifiably succeed the power seized by their fathers' generation. This is called passing it on from generation to generation.

List of books published by Moshe Idel in European languages.

Acknowledgement for the support of publication of JSRI no. 3.

"Law week soccer competition: 16-19 May 2005." Ethos: Official Publication of the Law Society of the Australian Capital Territory, (198), pp. 25.

Cross jurisdictional collaboration efforts and emergency vaccine plans that are consistent with Tribal sovereignty are essential to public health emergency preparedness. The widespread adoption of clearly written federal, state, and local vaccine plans that address fundamental assumptions in vaccine distribution to Tribal nations is imperative for future pandemic response.

When faced with adverse circumstances, there may be a tendency for individuals, agencies, and governments to search for a target to assign blame. Our focus will be on the novel coronavirus outbreak, where racial groups, political parties, countries, and minorities have been blamed for spreading, producing or creating the virus. Blame—here defined as attributing causality, responsibility, intent, or foresight to someone/something for a fault or wrong—has already begun to damage modern society and medical practice in the context of the COVID-19 (...) outbreak. Evidence from past and current pandemics suggest that this tendency to seek blame affects international relations, promotes unwarranted devaluation of health professionals, and prompts a spike of racism and discrimination. By drawing on social and cognitive psychology theories, we provide a framework that helps to understand the effect of blame in pandemics, when people blame, whom they blame, and how blame detrimentally affects the COVID-19 response. Ultimately, we provide a path to inform health messaging to reduce blaming tendencies, based on social psychological principles for health communication. (shrink)

Bowman-Smart et al. (2023) argue for a framework to examine the ethical issues associated with genetic screening for non-medical traits in the context of noninvasive prenatal testing (NIPT). Such s...

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical (...) and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. (shrink)

Background Retraction is a mechanism for alerting readers to unreliable material and other problems in the published scientific and scholarly record. Retracted publications generally remain visible and searchable, but the intention of retraction is to mark them as “removed” from the citable record of scholarship. However, in practice, some retracted articles continue to be treated by researchers and the public as valid content as they are often unaware of the retraction. Research over the past decade has identified a number of (...) factors contributing to the unintentional spread of retracted research. The goal of the Reducing the Inadvertent Spread of Retracted Science: Shaping a Research and Implementation Agenda (RISRS) project was to develop an actionable agenda for reducing the inadvertent spread of retracted science. This included identifying how retraction status could be more thoroughly disseminated, and determining what actions are feasible and relevant for particular stakeholders who play a role in the distribution of knowledge. -/- Methods These recommendations were developed as part of a year-long process that included a scoping review of empirical literature and successive rounds of stakeholder consultation, culminating in a three-part online workshop that brought together a diverse body of 65 stakeholders in October–November 2020 to engage in collaborative problem solving and dialogue. Stakeholders held roles such as publishers, editors, researchers, librarians, standards developers, funding program officers, and technologists and worked for institutions such as universities, governmental agencies, funding organizations, publishing houses, libraries, standards organizations, and technology providers. Workshop discussions were seeded by materials derived from stakeholder interviews (N = 47) and short original discussion pieces contributed by stakeholders. The online workshop resulted in a set of recommendations to address the complexities of retracted research throughout the scholarly communications ecosystem. -/- Results The RISRS recommendations are: (1) Develop a systematic cross-industry approach to ensure the public availability of consistent, standardized, interoperable, and timely information about retractions; (2) Recommend a taxonomy of retraction categories/classifications and corresponding retraction metadata that can be adopted by all stakeholders; (3) Develop best practices for coordinating the retraction process to enable timely, fair, unbiased outcomes; and (4) Educate stakeholders about pre- and post-publication stewardship, including retraction and correction of the scholarly record. -/- Conclusions Our stakeholder engagement study led to 4 recommendations to address inadvertent citation of retracted research, and formation of a working group to develop the Communication of Retractions, Removals, and Expressions of Concern (CORREC) Recommended Practice. Further work will be needed to determine how well retractions are currently documented, how retraction of code and datasets impacts related publications, and to identify if retraction metadata (fails to) propagate. Outcomes of all this work should lead to ensuring retracted papers are never cited without awareness of the retraction, and that, in public fora outside of science, retracted papers are not treated as valid scientific outputs. (shrink)

In this article, we discuss the continued circulation and use of retracted science as a complex problem: Multiple stakeholders throughout the publishing ecosystem hold competing perceptions of this problem and its possible solutions. We describe how we used a participatory design process model to co-develop recommendations for addressing this problem with stakeholders in the Alfred P. Sloan-funded project, Reducing the Inadvertent Spread of Retracted Science (RISRS). After introducing the four core RISRS recommendations, we discuss how the issue of retraction-related stigma (...) gives rise to recommendation #4, Educate stakeholders about retraction and pre- and post-publication stewardship of the scholarly record. This recommendation is important for training publishing professionals and realizing this recommendation will require further collaborative design work across scholarly communications. We highlight ongoing stakeholder work which is now re-starting the design cycle. We conclude with a discussion of ongoing activities facilitating uptake and refinement of RISRS research and the implementation agenda. (shrink)

Purpose Engagement of healthcare professionals with patients from diverse cultural and religious backgrounds is crucial in our multicultural society, where miscommunication and errors in medical history taking can lead to incorrect treatment. In particular, Muslim patients may present unique considerations due to their specific cultural and religious beliefs, which can significantly impact treatment outcomes. This study focuses on perioperative medication therapy for patients undergoing upper and lower gastrointestinal tract and pancreatic tumor surgery, specifically examining whether Islamic beliefs were duly (...) considered in medication selection compared to a matching patient cohort. Materials and methods Data from January 2004 to July 2023 were analyzed. Muslim patients were identified using the onomastic method and matched with non-Muslim patients at a 1:3 ratio based on age, gender, and procedure. Analysis included examination of subcutaneous, oral, and intravenous medications, with attention to ingredients and compatibility with Islamic principles. Results Among 5272 patients, only 5 met the study’s inclusion criteria as Muslim patients, undergoing procedures such as anterior rectum resection, gastrectomy, and pancreatic head resection. Their religious affiliations were not documented in the admission records. According to the matched-pair analysis, consistent treatment was performed regardless of religious beliefs. All patients received subcutaneous medication, primarily enoxaparin, instead of fondaparinux, an Islam-compliant alternative. Intravenous heparin was used once for short period. Contrary to Islamic dietary restrictions and the availability of alternatives, capsules containing animal-derived gelatin and other non-compliant medications were administered orally. Conclusion This study underscores the importance of acknowledging Muslim patients’ cultural and religious backgrounds in the perioperative setting, as failure to do so may lead healthcare professionals to overlook their potential alternative medication needs, which are essential for providing tailored medical care in modern societies. Integration of diversity-related topics into medical curricula is essential for better preparing physicians for clinical practice and ensuring patient-centered care. (shrink)

This study focuses on investigating habits in perioperative nursing culture, which are often simply accepted and not normally considered or discussed. A hermeneutical approach was chosen as the means of understanding perioperative nurses' experiences of and reflections on operating theatre culture. Focus group discussions were used to collect data, which was analysed using hermeneutical text analysis. The results revealed three main categories of habits present in perioperative nursing culture: habits that promote ethical values (by temporary friendship with (...) patients, showing respect for each other, and spending time on reflection on ethics and caring); habits that hinder progress (by seeing the patient as a surgical case, not acknowledging colleagues, and not talking about ethics); and habits that set the cultural tone (the hidden power structure and achieving more in less time). (shrink)

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research (...) study exploring the experiences of perioperative nurses participating in multi‐organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses’ experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience‐based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. (shrink)

Cognition in work teams has been predominantly understood and explained in terms of shared cognition with a focus on the similarity of static knowledge structures across individual team members. Inspired by the current zeitgeist in cognitive science, as well as by empirical data and pragmatic concerns, we offer an alternative theory of team cognition. Interactive Team Cognition (ITC) theory posits that (1) team cognition is an activity, not a property or a product; (2) team cognition (...) should be measured and studied at the team level; and (3) team cognition is inextricably tied to context. There are implications of ITC for theory building, modeling, measurement, and applications that make teams more effective performers. (shrink)

Teams are considered to be extremely complex dynamic entities that suffer at the hand of constant evolution of their structure to meet and adapt to the varying situational demands they come face-to-face with (Kozlowski & Ilgen, 2006). Agencies, industries, and government institutions are currently placing greater attention to the adaption of team dynamics and teamwork as they are important to key organizational outcomes. As greater attention is being placed on the maturation of team dynamics, the incorporation of efficient (...) methodological tools to understand how teams are being measured over time becomes critical. Thus, the purpose of this paper is to present a review of relevant academic articles detailing the science behind methodological tools and general approaches to study team dynamics over time. We provide an overview of the methodological tools used to understand team dynamics with accordance to specific temporal elements. Drawing from Kozloski, Gully, Nason, and Smith (1999) process model of team development, we highlight relevant emergent team constructs within each stage. As well, for each stage, we discuss the what and how to measure team dynamics. Our analyses bring to light relevant, novel and complex approaches being used by researchers to examine specific constructs within different team developmental phases (e.g., agent-based simulations, computational modeling) and the importance of transitioning from a single source methodology approach. Implications and future research are also discussed. (shrink)

We investigate how two different types of conflict (task conflict and relationship conflict) at two different levels (individual-level and team-level) influence individual team commitment. The analysis was conducted using data we collected from 193 employees in 31 branch offices of a Korean commercial bank. The relationships at multiple levels were tested using hierarchical linear modeling (HLM). The results showed that individual-level relationship conflict was negatively related to team commitment while individual-level task conflict was not. In addition, both (...) team-level task and relationship conflict were negatively associated with team commitment. Finally, only team-level relationship conflict significantly moderated the relationship between individual-level relationship conflict and team commitment. We further derive theoretical implications of these findings. (shrink)

Teams have been a ubiquitous structure for conducting work and business for most of human history. However, today’s organizations are markedly different than those of previous generations. The explosion of innovative ideas and novel technologies mandate changes in job descriptions, roles, responsibilities, and how employees interact and collaborate. These advances have heralded a new era for teams and teamwork in which previous teams research and practice may not be fully appropriate for meeting current requirements and demands. In this article, we (...) describe how teams have been historically defined, unpacking five important characteristics of teams, including membership, interdependence, shared goals, dynamics, and an organizationally bounded context, and relating how these characteristics have been addressed in the past and how they are changing in the present. We then articulate the implications these changes have on how we study teams moving forward by offering specific research questions. (shrink)

This article describes the nature of ethical dilemmas in perioperative nursing practice. Using the Critical Incident Technique, common ethical dilemmas experienced by periop erative nurses are explored. The aim of the study was to elicit the ethical dilemmas that arise in perioperative nurses' practice. The study has a descriptive design and the data are critical incidents described by 48 anaesthetic nurses and 76 operating theatre nurses. An analysis of the critical incidents gave four domains of ethical dilemmas: those (...) arising as value conflicts in the intraoperative phase of surgery; those emanating from the patient's right of self- determination ; those arising in caring for patients; and those resulting from the alloca tion of scarce resources and the demands of increased effectiveness. (shrink)

In a recent article in this journal, Duijf claims to have proved that team reasoning can be viewed as a payoff transformation. His formalization mimics team reasoning but ignores its essential agency switch. The possibility of such a payoff transformation was never in doubt, does not imply that team reasoning can be viewed as a payoff transformation, and makes no sense in a game in which payoffs represent players’ utilities. A theorem is proved here that a simpler (...) and more intuitive payoff transformation can mimic any theory that predicts what strategies players will choose in a well-defined game. (shrink)

We consider motivations for acknowledging that people participate in multiple levels of economic agency. One of these levels is characterized in terms of subjective utility to the individual; another, frequently observed, level is characterized in terms of utility to social groups with which people identify. Following Bacharach, we describe such groups as ‘teams’. We review Bacharach’s theory of such identification in his account of ‘team reasoning’. While this conceptualization is useful, it applies only to processes supported by deliberation. As (...) this is only one of a range of causal mechanisms underlying behaviour by humans and other strategic agents, a more general account is desirable. We then argue that Stirling’s account of ‘conditional games’ achieves the desired generalization. (shrink)

Complex work in teams requires coordination across team members and their technology as well as the ability to change and adapt over time to achieve effective performance. To support such complex interactions, recent efforts have worked toward the design of adaptive human-autonomy teaming systems that can provide feedback in or near real time to achieve the desired individual or team results. However, while significant advancements have been made to better model and understand the dynamics of team interaction (...) and its relationship with task performance, appropriate measures of team coordination and computational methods to detect changes in coordination have not yet been widely investigated. Having the capacity to measure coordination in real time is quite promising as it provides the opportunity to provide adaptive feedback that may influence and regulate teams’ coordination patterns and, ultimately, drive effective team performance. A critical requirement to reach this potential is having the theoretical and empirical foundation from which to do so. Therefore, the first goal of the paper is to review approaches to coordination dynamics, identify current research gaps, and draw insights from other areas, such as social interaction, relationship science, and psychotherapy. The second goal is to collate extant work on feedback and advance ideas for adaptive feedback systems that have potential to influence coordination in a way that can enhance the effectiveness of team interactions. In addressing these two goals, this work lays the foundation as well as plans for the future of human-autonomy teams that augment team interactions using coordination-based measures. (shrink)

Examined as an isolated situation, and through the lens of a rare and feared disease, Mr. Duncan's case seems ripe for second-guessing the physicians and nurses who cared for him. But viewed from the perspective of what we know about errors and team communication, his case is all too common. Nearly 440,000 patient deaths in the U.S. each year may be attributable to medical errors. Breakdowns in communication among health care teams contribute in the majority of these errors. The (...) culture of health care does not seem to foster functional, effective communication between and among professionals. Why? And more importantly, why do we not do something about it? (shrink)

In the context of the current uncertain, complex, and interdependent work systems, teams have become organizations’ substantial working unit, which in turn challenges the traditional view of employee performance and ultimately results in the emergence of team member work role performance. Employee team-oriented work role behaviors with proficiency, adaptivity, and proactivity, which are integrated by the new construct, are so crucial to team effectiveness that many organizations keenly expect to achieve team member work role performance through (...) implementing a dispersed pay-for-performance plan within a team. This study seeks to address the organizational practitioners’ main concern that whether pay dispersion among team members could actually help realize team member work role performance and further examines why and when an employee could respond to HPD within a team by engaging in team member work role behaviors from the perspective of the performance-shaping basis and team member’s workplace benign envy. Drawing on emotion-related theory, social comparison theory, legitimacy theory, expectation theory, and relative deprivation theory, it proposes that performance-based HPD could not only positively impact team member work role performance via workplace benign envy but also exert a direct-positive effect. Moreover, the activating effect of performance-based HPD on workplace benign envy and the mediating role are much stronger when a team member’s pay position is higher. The multi-source data including objective information and subjective perception among 362 ordinary employees within 66 Chinese organizational teams primarily supported the moderated mediation model. Yet, the direct-positive effect was not established. (shrink)

Prior research has demonstrated a strong relationship between team performance and team members’ team efficacy beliefs and perceptions of social integration. Performing well increases the feelings of collective ability that comprise team efficacy and the feelings of psychological connectedness that make up social integration, while performing poorly erodes them. In this article, we draw from the social cognitive base of ethical leadership theory to argue that ethical leadership moderates the relationship between team performance and (...) class='Hi'>team efficacy beliefs, and between team performance and social integration, such that these important team attitudes are buffered against the negative effects of poor performance when leaders act ethically. Alternatively, when leaders act less ethically, team efficacy and social integration break down following poor performance. We test our hypotheses in a field study of U.S. military teams actively engaged in competition. The data support our arguments. We find that ethical leadership weakens the relationships among team performance and team efficacy and social integration, respectively, such that ethical leaders preserve team efficacy and social integration when their teams do not perform well. (shrink)

This paper proposes a concept of intentional cooperation for mutual benefit. This concept uses a form of team reasoning in which team members aim to achieve common interests, rather than maximising a common utility function, and in which team reasoners can coordinate their behaviour by following pre-existing practices. I argue that a market transaction can express intentions for mutually beneficial cooperation even if, extensionally, participation in the transaction promotes each party’s self-interest.

Virtue-based research in business ethics has increased over the last two decades, but most of the research has focused on the actions of an individual person. In this article, we examine the associations among team-level virtues using data from two studies. Specifically, we investigate whether transparency (usually thought to be an organizational-or collective-level construct), behavioral integrity (usually thought to be an individuallevel construct), and trust (usually thought to be an individual-level construct) can be conceptualized and operate at the (...) class='Hi'>team level of analysis and, if so, what their relationships are to team performance. Using Partial Least Squares (PLS) analysis, we found in both studies that team transparency was positively related to team behavioral integrity, which in turn was positively related to team trust. We also found evidence of a positive relationship between team trust and team performance. Implications of these findings for future teams and ethics research are discussed. (shrink)

Standard game theory cannot explain the selection of payoff-dominant outcomes that are best for all players in common-interest games. Theories of team reasoning can explain why such mutualistic cooperation is rational. They propose that teams can be agents and that individuals in teams can adopt a distinctive mode of reasoning that enables them to do their part in achieving Pareto-dominant outcomes. We show that it can be rational to play payoff-dominant outcomes, given that an agent group identifies. We compare (...) team reasoning to other theories that have been proposed to explain how people can achieve payoff-dominant outcomes, especially with respect to rationality. Some authors have hoped that it would be possible to develop an argument that it is rational to group identify. We identify some large—probably insuperable—problems with this project and sketch some more promising approaches, whereby the normativity of group identification rests on morality. (shrink)

Background: In recent years, operating theatre nurse students’ education focused on ethics, basic values and protecting and promoting the patients' dignity in perioperative practice. Health professionals are frequently confronted with ethical issues that can impact on patient’s care during surgery. Objective: The objective of this study was to present what operating theatre nursing students perceived and interpreted as undignified caring in perioperative practice. Research design: The study has a descriptive design with a hermeneutic approach. Data were collected using (...) Flanagan’s critical incident technique. Participants and research context: Operating theatre nurse students from Sweden and Norway participated and collected data in 2011, after education in ethics and dignity. Data consisting of 47 written stories and the text were analysed with hermeneutical text interpretation. Ethical considerations: The study was approved by the Karlstad University's Research Ethics Committee. Findings: The findings show careless behaviour and humiliating actions among health professionals. Health professionals commit careless acts by rendering the patient invisible, ignoring the patient’s worry and pain and treating the patient as an object. They also humiliate the patient when speaking in negative terms about the patient’s body, and certain health professionals blame the patients for the situation they are in. Health professionals lack the willingness and courage to protect the patient’s dignity in perioperative practice. Discussion: In the discussion, we have illuminated how professional ethics may be threatened by more pragmatic and utilitarian arguments contained in regulations and transplant act. Conclusion: The findings reveal that patients were exposed to unnecessary suffering; furthermore, the operating theatre nurse students suffered an inner ethical conflict due to the undignified caring situations they had witnessed. (shrink)

Team semantics is a highly general framework for logics which describe dependencies and independencies among variables. Typically, the dependencies considered in this context are properties of sets of configurations or data records. We show how team semantics can be further generalized to support languages for the discussion of interventionist counterfactuals and causal dependencies, such as those that arise in manipulationist theories of causation. We show that the “causal teams” we introduce in the present paper can be used for (...) modelling some classical counterfactual scenarios which are not captured by the usual causal models. We then analyse the basic properties of our counterfactual languages and discuss extensively the differences with respect to the Lewisian tradition. (shrink)

Background: Clinical ethics committees have been broadly implemented in university hospitals, general hospitals and nursing homes. To ensure the quality of ethics consultations, evaluation should be mandatory. Research question/aim: The aim of this article is to evaluate the perspectives of all people involved and the process of implementation on the wards. Research design and participants: The data were collected in two steps: by means of non-participating observation of four ethics case consultations and by open-guided interviews with 28 participants. Data analysis (...) was performed according to grounded theory. Ethical considerations: The study received approval from the local Ethics Commission (registration no.: 32/11/10). Findings: ‘Communication problems’ and ‘hierarchical team conflicts’ proved to be the main aspects that led to ethics consultation, involving two factors: unresolvable differences arise in the context of team conflicts on the ward and unresolvable differences prevent a solution being found. Hierarchical asymmetries, which are common in the medical field, support this vicious circle. Based on this, minor or major disagreements regarding clinical decisions might be seen as ethical conflicts. The expectation on the clinical ethics committee is to solve this (communication) problem, but the participants experienced that hierarchy is maintained by the clinical ethics committee members. Discussion: The asymmetrical structures of the clinical ethics committee reflect the institutional hierarchical nature. They endure, despite the fact that the clinical ethics committee should be able to detect and overcome them. Disagreements among care givers are described as one of the most difficult ethically relevant situations and should be recognised by the clinical ethics committee. On the contrary, discussion of team conflicts and clinical ethical issues should not be combined, since the first is a mandate for team supervision. Conclusion: To avoid dominance by physicians and an excessively factual character of the presentation, the case or conflict could be presented by both physicians and nurses, a strategy that strengthens the interpersonal and emotional aspects and also integrates both professional perspectives. (shrink)

To advance understanding of the mechanisms allowing for team coordination (TC) in complex motor actions, we conducted a qualitative study with eight elite hand-to-hand circus acrobats. Data collection consisted of field observations, an open-ended interview with the participants’ head coach, and focus group interviews with all acrobats. Data analysis yielded three higher order themes: TC, collective efficacy (CE), and TC-CE linkage. Teammates’ shared and complementary mental models, as well as implicit and explicit communication dynamics, emerged as formative sub-themes of (...) TC; self-efficacy and other’s-efficacy emerged as reflective sub-themes of CE. Our findings also suggest that TC is likely inter-related to CE in a systemic fashion. Practitioners should encourage the development of both shared and complementary models of thinking, while promoting verbal and non-verbal communication skills. Finally, increasing teammates’ confidence in themselves and in their teammates can help in the development of CE as well as the enhancement of TC. (shrink)

b>: A cooperative team of agents may perform many tasks better than isolated agents. The question is how coopera-.

The chapter reviews recent theoretical and empirical developments concerning the theory of team reasoning in game theoretic interactions.

Fraud in medical publications is an increasing concern. In particular, disciplines related to perioperative medicine—including anaesthesia and critical care—currently hold the highest rankings in terms of retracted papers for research misconduct. The dominance of this dubious achievement is attributable to a limited number of researchers who have repeatedly committed scientific fraud. In the last three decades, six researchers have authored 421 of the 475 papers retracted in perioperative medicine. This narrative review reports on six cases of fabricated publication (...) in perioperative medicine that resulted in the paper’s retraction. The process that led to the unveiling of the fraud, the impact on clinical practice, and changes in regulatory mechanisms of scientific companies and governmental agencies’ policies are also presented. Fraud in medical publications is a growing concern that affects perioperative medicine requiring a substantial number of papers to be retracted. The continuous control elicited by readers, by local institutional review boards, scientific journal reviewers, scientific societies and government agencies can play an important role in preserving the ‘pact of trust’ between authors, professionals and ultimately the relationship between doctors and patients. (shrink)

Background: Medical education literature suggests that ethics education should be learner-centered and problem-based rather than theory-based. Team-based learning is an appropriate method for this suggestion. However, its effectiveness was not investigated enough in medical ethics education. Research question: Is team-based learning effective in medical ethics education in terms of knowledge retention, in-class learner engagement, and learner reactions? Research design: This was a prospective controlled follow-up study. We changed lecture with team-based learning method to teach four topics in (...) a 2-week medical ethics clerkship, while the remaining topics were taught by lectures. For comparison, we formed team-based learning and lecture groups, in which the students and instructor are the same, but the topics and teaching methodologies are different. We determined in-class learner engagement by direct observation and student satisfaction by feedback forms. Student success for team-based learning and lecture topics in the end-of-clerkship exam and two retention tests performed 1 year and 2 years later were compared. Ethical considerations: Ethical approval for the study was granted by Akdeniz University Board of Ethics on Noninvasive Clinical Human Studies Ethics committee. Findings: Short-term knowledge retention did not differ; however, team-based learning was found superior to lecture at long-term retention tests. Student satisfaction was high with team-based learning and in-class engagement was better in team-based learning sessions. Discussion: Our results on learner engagement and satisfaction with team-based learning were similar to those of previous reports. However, knowledge retention results in our study were contrary to literature. The reason might be the fact that students prepared for the end-of-clerkship pass/fail exam (short term) regardless of the teaching method. But, at long-term retention tests, they did not prepare for the exam and answered the questions just using the knowledge retained in their memories. Conclusion: Our findings suggest that team-based learning is a better alternative to lecture to teach ethics in medical education. (shrink)

Decision theory explains weakness of will as the result of a conflict of incentives between different transient agents. In this framework, self-control can only be achieved by the I-now altering the incentives or choice-sets of future selves. There is no role for an extended agency over time. However, it is possible to extend game theory to allow multiple levels of agency. At the inter-personal level, theories of team reasoning allow teams to be agents, as well as individuals. I apply (...) team reasoning at the intra-personal level, taking the self as a team of transient agents over time. This allows agents to ask, not just “what should I-now do?’, but also ‘What should I, the person over time do?’, which may enable agents to achieve self-control. The resulting account is Aristotelian in flavour, as it involves reasoning schemata and perception, and it is compatible with some of the psychological findings about self-control. (shrink)

Identifying optimal ways of organizing exploration in particle physics mega-labs is a challenging task that requires a combination of case-based and formal epistemic approaches. Data-driven studies suggest that projects pursued by smaller master-teams are substantially more efficient than larger ones across sciences, including experimental particle physics. Smaller teams also seem to make better project choices than larger, centralized teams. Yet the epistemic requirement of small, decentralized, and diverse teams contradicts the often emphasized and allegedly inescapable logic of discovery that forces (...) physicists pursuing the fundamental levels of the physical world to perform centralized experiments in mega-labs at high energies. We explain, however, that this epistemic requirement could be met, since the nature of theoretical and physical constraints in high energy physics and the technological obstacles stemming from them turn out to be surprisingly open-ended. (shrink)

ABSTRACT:Despite extensive research on organizational virtue, our understanding about factors that promote virtue within organizations remains unclear. Drawing on upper echelon theory, we examine the relationship between five top management team characteristics and organizational virtue orientation —the integrated set of values and beliefs that support ethical traits and virtuous behaviors of an organization. Specifically, we utilize prospectuses of initial public offering firms and 10-K post-IPO filings to explore how TMT composition with respect to member age, tenure, education, functional background, (...) and gender influences OVO. Additionally, we examine the moderating effects of organizational size, and argue that the more expansive structures and processes associated with larger organizations diminish the main relationships. Our findings, using two sources of data, are consistent, but somewhat mixed in their support for our hypotheses. Overall, TMT characteristics do appear to influence OVO, but in more complex and counterintuitive ways than initially expected. (shrink)

Researchers are beginning to transition from studying human–automation interaction to human–autonomy teaming. This distinction has been highlighted in recent literature, and theoretical reasons why the psychological experience of humans interacting with autonomy may vary and affect subsequent collaboration outcomes are beginning to emerge (de Visser et al., 2018;Wynne and Lyons, 2018). In this review, we do a deep dive into human–autonomy teams (HATs) by explaining the differences between automation and autonomy and by reviewing the domain of human–human teaming to make (...) inferences for HATs. We examine the domain of human–human teaming to extrapolate a few core factors that could have relevance for HATs. Notably, these factors involve critical social elements within teams that are central (as argued in this review) for HATs. We conclude by highlighting some research gaps that researchers should strive toward answering, which will ultimately facilitate a more nuanced and complete understanding of HATs in a variety of real-world contexts. (shrink)

This paper examines the mechanisms that influence team-level performance, which is critical to organizational effectiveness. It investigates psychological safety, a shared belief that the team is safe for interpersonal risk-taking, and a causal model mediated by learning behavior and efficacy. This model hypothesizes that psychological safety and efficacy are related, which have been believed to be the same-dimension constructs. It also explains the process of how learning behavior affects the team’s efficacy. According to a study of 104 (...) field teams in a multinational enterprise in Korea, psychological safety did not affect team effectiveness. However, when mediated by learning behavior and efficacy, a full mediation effect was found. The result supports a well-known metaphor that psychological safety is the engine of performance, not the fuel. It also explains how individuals contribute to group performance under a psychologically safe climate, enhancing team processes. Based on the findings, this paper suggests theoretical and methodological implications for future research to maximize the effectiveness of teams. (shrink)