Communication and Interprofessional Collaboration in Primary Care: From Ideal to Reality in Practice

To improve patient-centered care, many health care systems are mandating interprofessional collaboration (IPC). However, in many primary care contexts, IPC is still nascent and fraught with tension. Communication is thought to be a key determinant of IPC, but few studies empirically examine IP communication practices. Therefore, we report here on the qualitative portion of a mixed methods pilot study investigating observed IPC and communication in primary care clinics in Quebec, Canada. Studying actual communication practices to understand collaborative activities, we seek to investigate how the ideals of patient centeredness and clinical democracy put forward in the IP literature stack up against actual IPC practice in primary care. Qualitative data was gathered by shadowing health professionals in two primary care clinics, and analyzed through thematic coding. A typology of observed IP practices was created and compared to the continuum of interprofessional collaborative practice. Further analysis focused on how participants made sense of their collaboration, especially why, how and with whom they collaborated. Findings were grouped into three categories of communicative actions: coordinating sequential efforts; assisting others' sensemaking; and working to understand together. Implications for practice and future research are discussed.

Variables associated with interprofessional collaboration: a comparison between primary healthcare and specialized mental health teams

BACKGROUND

This study has two aims: first, to identify variables associated with interprofessional collaboration (IPC) among a total of 315 Quebec mental health (MH) professionals working in MH primary care teams (PCTs, N = 101) or in specialized service teams (SSTs, N = 214); and second, to compare IPC associated variables in MH-PCTs vs MH-SSTs.

METHODS

A large number of variables acknowledged as strongly related to IPC in the literature were tested. Multivariate regression models were performed on MH-PCTs and MH-SSTs respectively.

RESULTS

Results showed that knowledge integration, team climate and multifocal identification were independently and positively associated with IPC in both MH-PCTs and MH-SSTs. By contrast, knowledge sharing was positively associated with IPC in MH-PCTs only, and organizational support positively associated with IPC in MH-SSTs. Finally, one variable (age) was significantly and negatively associated with IPC in SSTs.

CONCLUSIONS

Improving IPC and making MH teams more successful require the development and implementation of differentiated professional skills in MH-PCTs and MH-SSTs by care managers depending upon the level of care required (primary or specialized). Training is also needed for the promotion of interdisciplinary values and improvement of interprofessional knowledge regarding IPC.

[Organizational learning and health promotion: a Quebec project]

OBJECTIVE

This article focuses on health promotion laboratories, a Quebec professional development program offered by the Public Health Department of the Montréal Region to teams of professionals and managers working in health promotion within local public health organizations. The objective is to examine the process of translating the knowledge gained by participants as a result of the program over the longer term within the organization.

METHOD

This was a qualitative descriptive study. The work was guided by Nonaka’s Organizational Knowledge Creation Model. Data were collected from participants at several types of discussion and development events held in the three months following the end of the pilot project. A thematic content analysis was performed using a grid derived from Nonaka’s model.

RESULTS

The analysis revealed the presence of both externalization and internalization in two of the sites, as well as a considerable volume of combinations in the four sites studied. In the latter case, the learnings reused over the longer term were similar to those that had been transferred in the short term (e.g. ideas and methods relating to partnership, planning, etc.).

CONCLUSION

These results are important, in that they confirm the laboratories’ potential to propagate the learnings throughout the organization, beyond the short-term gains made by participants during the laboratories. These learnings could potentially pave the way for new practices.

Harnessing instability as an opportunity for health system strengthening: A review of health system resilience

In recent years, resilience has emerged as a prominent topic in global health systems discourse as a result of the increasing variety and volume of sources of instability inflicting strain on systems. In line with this study's intent to bring together existing literature on health system resilience as a means to understand the process through which systems achieve resilience, a review of academic literature related to health system resilience was conducted. Emerging from this review is an operational model of resilience that builds on existing health systems frameworks. The model highlights health system resilience as a process through which leaders in all sectors need to be mobilized in order to harness instability as an opportunity for health system strengthening rather than a threat to the system's sustainability and integrity.

Profiling mental health professionals in relation to perceived interprofessional collaboration on teams

OBJECTIVES

This study aims at identifying profiles of mental health professionals based on individual, interactional, structural and professional role characteristics related to interprofessional collaboration.

METHODS

Mental health professionals (N = 315) working in primary health care and specialized mental health teams in four Quebec local service networks completed a self-administered questionnaire eliciting information on individual, interactional, structural and professional role characteristics.

RESULTS

Cluster analysis identified four profiles of mental health professionals. Those with the highest interprofessional collaboration scores comprised two profiles labeled "highly collaborative female professionals with fewer conflicts and more knowledge sharing and integration" and "highly collaborative male professionals with fewer conflicts, more participation in decision-making and mutual trust." By contrast, the profile labeled "slightly collaborative professionals with high seniority, many conflicts and less knowledge integration and mutual trust" had the lowest interprofessional collaboration score. Another profile positioned between these groups was identified as "moderately collaborative female psychosocial professionals with less participation in decision-making."

DISCUSSION AND CONCLUSION

Organizational support, participation in decision-making, knowledge sharing, knowledge integration, mutual trust, affective commitment toward the team, professional diversity and belief in the benefits of interdisciplinary collaboration were features associated with profiles where perceived interprofessional collaboration was higher. These team qualities should be strongly encouraged by mental health managers for improving interprofessional collaboration. Training is also needed to promote improvement in interprofessional collaboration competencies.

Examining perceptions from in situ simulation-based training on interprofessional collaboration during crisis event management in post-anesthesia care

Due to the potentially life-threatening conditions and risk of severe complications, post-anesthesia care units (PACU) require prompt team interventions. Miscommunication among professionals during crisis event management may directly affect patient safety. Therefore, developing strategies to enhance interprofessional collaboration (IPC) among critical care teams should be prioritized. In situ simulation (ISS) can be valuable in improving patient safety because it allows the practice of care team dynamics within a real clinical environment. However, its impact on IPC has yet to be demonstrated. The aim of this study was to evaluate the effect of in situ simulation-based training on interprofessional collaboration and satisfaction toward co-workers during crisis event management in post-anesthesia care. A quasi-experimental study, pretest and post-test design with a paired control group was performed. A convenience sample (N = 69) was recruited from the healthcare professionals of the regular PACU team. The intervention group (N = 33) underwent a 6-hour ISS-based interprofessional training session. Three scenarios of deteriorating cases encountered in critical care settings were used, each followed by a debriefing period. The measured outcomes were evaluated by the Collaborative Work Questionnaire and the Satisfaction Towards Coworkers Questionnaire. Questionnaires were answered by the two groups before the intervention (T1), immediately after (T2) and six to eight weeks later (T3). We found that the change from baseline (T1) was different between the groups for global IPC (F = 3.88; p = 0.025) and for communication (F = 4.09; p = 0.021). Regarding global IPC, we observed a significant group effect from T1 to T2 (F = 5.65; p = 0.021) and from T1 to T3 (F = 5.34; p = 0.024). Furthermore, we observed a significant time effect for the experimental group (F = 4.06; p = 0.027). Regarding communication, we observed a significant group effect from T1 to T2 (F = 7.5; p = 0.001). In conclusion, ISS-based training had a slight impact on self-assessed IPC and communication during crisis event management in the PACU. The use of ISS should be promoted among critical care teams to enhance IPC and contribute to patient safety.

Variables associated with interprofessional collaboration: The case of professionals working in Quebec local mental health service networks

This study identified variables associated with interprofessional collaboration (IPC) among 315 mental health (MH) professionals working in primary health care (PHC) and specialized teams, within four Quebec (Canada) local service networks (LSNs). IPC was measured with a validated scale, and independent variables were organized according to a four-block conceptual framework that included Individual, Interactional, Organizational and Professional Role Characteristics. Bivariate and multiple linear regression analyses were performed. Five variables were associated with Interactional Characteristics (knowledge sharing, knowledge integration, affective commitment toward the team, team climate, team autonomy), and one variable with Professional Role (multifocal identification) and Individual Characteristics (age), respectively. Findings suggest the importance of positive team climate, knowledge sharing and knowledge integration, professional and team identification (multifocal identification), team commitment and autonomy for strengthening IPC in MH teams. These results suggest that team managers should remain alert to behavioral changes and tensions in their teams that could signal possible deterioration in IPC, while promoting IPC competencies, and interdisciplinary values and skills, in team activities and training programs. As well, the encouragement of team commitment on the part of senior professionals, and support toward their younger counterparts, may enhance IPC in teams.

Évaluation du Plan d’action en santé mentale (2005-2015) : intégration et performance des réseaux de services

Cet article présente les résultats d’un programme de recherche visant à : 1) évaluer l’implantation de la réforme en santé mentale (SM) et ses facteurs favorisant ou entravant dans 11 réseaux locaux de services et la performance d’équipe en SM ; 2) cerner dans quatre réseaux les processus influençant la qualité des services d’équipe ; 3) analyser dans ces mêmes réseaux les effets des structures et des processus d’équipe sur les usagers. Les objectifs de la réforme en SM n’ont été que partiellement atteints dans les réseaux. Les résultats montrent qu’une plus grande utilisation d’outils et d’approches cliniques et des interactions fréquentes entre les équipes et les organisations améliorent la performance. De même, divers processus d’équipe comme l’autonomie, la participation aux processus décisionnels et le partage des connaissances incitent à la performance des professionnels et à la qualité des services. L’intensité des besoins des usagers réduit la capacité des services à répondre aux besoins. Enfin, le rétablissement et la qualité de vie sont fortement corrélés à la continuité et à la diversité des services offerts. Différentes recommandations sont formulées afin d’améliorer les services dont la promotion de cultures organisationnelles plus orientées sur les résultats et la collaboration, le soutien et la formation des professionnels sur l’intégration de pratiques basées sur les données probantes, l’augmentation de l’autonomie des professionnels et leur implication dans les décisions, ainsi que la formalisation de stratégies d’intégration. Enfin, un soutien biopsychosocial diversifié et continu d’intensité variable est recommandé pour améliorer le rétablissement et la qualité de vie des usagers.

Author Correction: Associated and Mediating Variables Related to Job Satisfaction among Professionals from Mental Health Teams

The original version of this article unfortunately contained a mistake in the author group section. The family name of Dr. François should be "Chiocchio" not "Chiochio."

Associated and Mediating Variables Related to Job Satisfaction among Professionals from Mental Health Teams

Using a structural analysis, this study examines the relationship between job satisfaction among 315 mental health professionals from the province of Quebec (Canada) and a wide range of variables related to provider characteristics, team characteristics, processes, and emergent states, and organizational culture. We used the Job Satisfaction Survey to assess job satisfaction. Our conceptual framework integrated numerous independent variables adapted from the input-mediator-output-input (IMOI) model and the Integrated Team Effectiveness Model (ITEM). The structural equation model predicted 47% of the variance of job satisfaction. Job satisfaction was associated with eight variables: strong team support, participation in the decision-making process, closer collaboration, fewer conflicts among team members, modest knowledge production (team processes), firm affective commitment, multifocal identification (emergent states) and belonging to the nursing profession (provider characteristics). Team climate had an impact on six job satisfaction variables (team support, knowledge production, conflicts, affective commitment, collaboration, and multifocal identification). Results show that team processes and emergent states were mediators between job satisfaction and team climate. To increase job satisfaction among professionals, health managers need to pursue strategies that foster a positive climate within mental health teams.

Une politique concernant les données issues d’un programme de recherches interventionnelles en santé mondiale

La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L’un d’eux est la conservation, l’accès, l’utilisation et la publication des données. Malgré l’existence de multiples politiques et documents phares sur l’éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d’un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d’une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l’article présente le processus de formulation et d’adoption de cette politique par les chercheurs d’une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l’accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au coeur de tout partenariat scientifique en recherche interventionnelle.

[Evaluation of the Mental Health Action Plan (2005-2015): Integration and Performance of Service Networks]

Objectives This study aimed to: 1) assess implementation of the 2005-2015 Quebec mental health (MH) reform, and its enabling and hindering factors as well as MH team performance, in 11 local health service networks; then, for a subset of 4 networks: 2) identify processes influencing service quality in MH teams, and 3) analyze effects of team structures and processes on outcomes for service users.Methods The networks were selected in consultation with 20 MH decision makers. Data sources included: 1) documentation on population, organization and service characteristics, integration strategies, and network challenges; 2) individual and group interviews with 102 regional managers, MH professionals and managers from primary care or specialized MH teams, community organization directors, respondent psychiatrists and general practitioners (GPs); and 3) questionnaires completed by 16 respondent psychiatrists, 90 managers, 315 MH professionals from primary care or specialized teams, and 327 service users.Results Objectives of the MH reform were only partially achieved across the 11 health service networks, given the limited availability of practice guidelines related to implementing new structures and services, and reluctance among MH professionals (mainly GPs) to adopt them. As well, most primary care teams lacked GPs or psychiatrists. Implementation was more successful in large networks with specialized services located in general hospitals. The use of clinical tools and approaches, and frequent interactions with other teams or organizations enhanced team performance. Several team process variables including autonomy, involvement in decision-making, and knowledge sharing were strongly associated with the performance of MH professionals and higher quality services. While geographic variables (e.g. frequency of interactions with GPs) had more influence on performance in specialized services, individual variables (e.g. lower seniority in the team) and organizational variables (e.g. lower proportion of service users with personality disorders) influenced performance in primary care teams. Work satisfaction was more strongly associated with team process variables (e.g. fewer conflicts, higher team support, greater collaboration) and recovery-oriented services with organizational variables (e.g. primary care team). Some types of organizational culture were strongly associated with team performance (clan and hierarchical cultures), and work satisfaction (market culture). Concerning effects of team structure and processes on service user outcomes, higher quality of life and recovery scores were strongly associated with continuity and diversity of services. Finally, high seriousness of needs among service users represented a major obstacle for MH services attempting to address their quality of life issues and recovery.Conclusion This study suggests various measures that may improve MH service quality: promotion of more results-oriented organizational cultures, and greater collaboration, professional training on evidence-based practices, greater support for professionals, increasing their autonomy and involvement in decision-making, and more formalized integration strategies. Diversified and continuous biopsychosocial support was also recommended for improving quality of life and recovery among service users.

Professional development programs in health promotion: tools and processes to favor new practices

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants.

Variables Associated With Perceived Work Role Performance Among Professionals in Multidisciplinary Mental Health Teams Overall and in Primary Care and Specialized Service Teams, Respectively

This study had a dual purpose (1) to identify variables associated with perceived work role performance (WRP) among 315 mental health professionals (MHPs) in Quebec and (2) to compare variables related to WRP in MH primary care teams (PCTs) and specialized service teams (SSTs), respectively. WRP was measured using an adapted version of the work role questionnaire. Variables were organized within five areas: individual characteristics, perceived team attributes, perceived team processes, perceived team emergent states, and geographical and organizational context. Half of the WRP variables were linked to team processes. Knowledge sharing correlated with WRP in both MH PCTs and SSTs. Team attributes had more impact on MH PCTs, while team processes and team emergent states played a larger role among SSTs. The association between WRP and knowledge sharing confirms the need for a systematic training program to promote interdisciplinary collaboration. Integration strategies (e.g., service agreements) could improve collaboration between MH PCTs and SSTs and help MHPs perform more effectively within PCTs.

Variables associated with work performance in multidisciplinary mental health teams

OBJECTIVES

This study investigates work performance among 79 mental health teams in Quebec (Canada). We hypothesized that work performance was positively associated with the use of standardized clinical tools and clinical approaches, integration strategies, "clan culture," and mental health funding per capita.

METHODS

Work performance was measured using an adapted version of the Work Role Questionnaire. Variables were organized into four key areas: (1) team attributes, (2) organizational culture, (3) inter-organizational interactions, and (4) external environment.

RESULTS

Work performance was associated with two types of organizational culture (clan and hierarchy) and with two team attributes (use of standardized clinical tools and approaches).

DISCUSSION AND CONCLUSION

This study was innovative in identifying associations between work performance and best practices, justifying their implementation. Recommendations are provided to develop organizational cultures promoting a greater focus on the external environment and integration strategies that strengthen external focus, service effectiveness, and innovation.

Informational role self-efficacy: a validation in interprofessional collaboration contexts involving healthcare service and project teams

Background

Healthcare professionals perform knowledge-intensive work in very specialized disciplines. Across the professional divide, collaboration becomes increasingly difficult. For effective teamwork and collaboration to occur, it is considered necessary for individuals to believe in their ability to draw on their expertise and provide what others need to perform their job well. To date, however, no instruments exist to measure such a construct.

Methods

A two-study design is used to test the psychometric properties, factor structure and incremental validity of a five-item questionnaire measuring informational role self-efficacy.

Results

Based on parallel analysis and exploratory factor analysis, Study 1 shows a robust and reliable one-dimensional construct. Study 2 cross-validates this factor structure using confirmatory factor analysis. Study 2 also shows that informational role self-efficacy predicts proactive teamwork behaviors over and above goal similarity, interdependence, coordination and intra-team trust.

Conclusions

The instrument can be used in research to assess an individual’s capability beliefs in communicating his/her informational characteristics that are pertinent to the task performance of others. The construct is also shown to have value in team-building exercises.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1382-x) contains supplementary material, which is available to authorized users.

Multi-Level Efficacy Evidence of a Combined Interprofessional Collaboration and Project Management Training Program for Healthcare Project Teams

Project work is essential for the improvement of healthcare organizations; yet, project management and collaboration in the project context are not taught to healthcare professionals. Three half-day training workshops integrating project management and collaboration were designed and delivered to 14 interprofessional healthcare project teams. Multivariate measures were taken over the course of 36 weeks. Individual, team, and project-level results showed high satisfaction and perceptions of utility; improved self-efficacy for project-specific task work and teamwork; increased goal clarity and coordination; and a significant impact on the functional performance of projects. This study provides initial benchmark measures regarding the pertinence of project management and interprofessional collaboration training for healthcare project teams.

An analysis of the adaptability of a professional development program in public health: results from the ALPS Study

Background

Professional development is a key component of effective public health infrastructures. To be successful, professional development programs in public health and health promotion must adapt to practitioners’ complex real-world practice settings while preserving the core components of those programs’ models and theoretical bases. An appropriate balance must be struck between implementation fidelity, defined as respecting the core nature of the program that underlies its effects, and adaptability to context to maximize benefit in specific situations. This article presents a professional development pilot program, the Health Promotion Laboratory (HPL), and analyzes how it was adapted to three different settings while preserving its core components. An exploratory analysis was also conducted to identify team and contextual factors that might have been at play in the emergence of implementation profiles in each site.

Methods

This paper describes the program, its core components and adaptive features, along with three implementation experiences in local public health teams in Quebec, Canada. For each setting, documentary sources were analyzed to trace the implementation of activities, including temporal patterns throughout the project for each program component. Information about teams and their contexts/settings was obtained through documentary analysis and semi-structured interviews with HPL participants, colleagues and managers from each organization.

Results

While each team developed a unique pattern of implementing the activities, all the program’s core components were implemented. Differences of implementation were observed in terms of numbers and percentages of activities related to different components of the program as well as in the patterns of activities across time. It is plausible that organizational characteristics influencing, for example, work schedule flexibility or learning culture might have played a role in the HPL implementation process.

Conclusions

This paper shows how a professional development program model can be adapted to different contexts while preserving its core components. Capturing the heterogeneity of the intervention’s exposure, as was done here, will make possible in-depth impact analyses involving, for example, the testing of program–context interactions to identify program outcomes predictors. Such work is essential to advance knowledge on the action mechanisms of professional development programs.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-015-0903-3) contains supplementary material, which is available to authorized users.

The Difficult but Necessary Task of Developing a Specific Project Team Research Agenda

Project teams are central to organizations everywhere; however, there is a knowledge gap between project management scholars on the one hand and organizational behavior and industrial–organizational (OB/IO) scholars on the other. This gap seriously impedes the advancement of knowledge, because scholars from both fields have not leveraged each other's considerable knowledge and might be relying on outdated models and evidence to study project team phenomena, manage project teams, or develop university curricula. A call is made for interdisciplinary research projects devoted specifically to developing a research agenda on project teams.

Communities of practice as a professional and organizational development strategy in local public health organizations in Quebec, Canada: an evaluation model

Communities of practice (CoPs) are among the professional development strategies most widely used in such fields as management and education. Though the approach has elicited keen interest, knowledge pertaining to its conceptual underpinnings is still limited, thus hindering proper assessment of CoPs' effects and the processes generating the latter. To address this shortcoming, this paper presents a conceptual model that was developed to evaluate an initiative based on a CoP strategy: Health Promotion Laboratories are a professional development intervention that was implemented in local public health organizations in Montreal (Quebec, Canada). The model is based on latest theories on work-group effectiveness and organizational learning and can be usefully adopted by evaluators who are increasingly called upon to illuminate decision-making about CoPs. Ultimately, validation of this conceptual model will help advance knowledge and practice pertaining to CoPs as well as professional and organizational development strategies in public health.

Teamwork in Integrated Design Projects: Understanding the Effects of Trust, Conflict, and Collaboration on Performance

Teamwork during integrated design projects is complex. We address this by investigating how trust, collaboration, and conflict evolve over time to affect performance. Our results stem from data gathered using validated self-report questionnaires with 38 participants in 5 multidisciplinary teams at three points in time during a 6-week integrated design competition. Results show that without collaboration, trust and conflict have no bearing on performance. In addition to an unambiguous practical outcome—fostering collaboration helps build trust and manage conflict—our study points to theoretical developments: as trust- and conflict-performance relations grow over time, so does collaboration's mediating effect.

Cohesion and Performance

The management of project teams is evolving from managing technical processes to focusing on psychosocial determinants of performance. This trend puts a strain on project management theory and practice. Past meta-analyses on the cohesion—performance relationship show a positive correlation. However, they integrate effect sizes across different types of teams and settings. To clarify this issue for project teams, this meta-analysis differentiates 33 cohesion—performance correlations depending on whether teams are project, production, or service teams in organizational or academic settings. Results show that types of teams and settings are moderators. Project teams in organizational and academic settings show large effect sizes and differ from other teams. Theoretical considerations point to five interrelated modifiers: task uncertainty, task versus outcome performance, student samples' mental representation of the project outcome, and group heterogeneity.

Project Team Performance: A Study of Electronic Task and Coordination Communication

Communication is a key factor in team performance, successful project completion, and effective project management. Collective asynchronous electronic messages on task and coordination sent among members of 34 teams were analyzed using time-series analysis. Results suggest that compared to low-performing teams, high-performing teams exchanged more messages, modified their exchanges around milestones, and were more prone to self-organize prior to project completion. Also, high-performing teams started to coordinate themselves later but maintained higher levels of coordination afterward. Project managers could benefit from monitoring the amount and the way their team members discuss task and coordination in order to ensure high team and project performance.

The impact of a treatment process for substance users as a function of their degree of exposure to treatment

The objective of this research is to evaluate the outcomes of a treatment for addicts. 248 subjects were tested before and 5 months after treatment with the Addiction Severity Index (ASI). Exposure to treatment was based on the number of clients' contact hours with a therapist. The sample was divided into three groups according to number of hours spent in treatment. The data were analyzed using MANOVA on the seven scales of the ASI for the three groups and the two time periods. Results showed that the severity of addiction problems decreased after treatment, and decreased more for subjects who underwent treatment for a longer period of time.