Objectives The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. Methods The authors recruited 203 senior nursing students and 235 fourth-year medical students (total N¼438) from two major universities for a 1-day interdisciplinary teamwork training course. All participants received a didactic lecture and then were randomly assigned to one of four educational methods: didactic (control), audience response didactic, role play and human patient simulation. Student performance was assessed for teamwork attitudes, knowledge and skills using: (a) a 36-item teamwork attitudes instrument (CHIRP), (b) a 12-item teamwork knowledge test, (c) a 10-item standardised patient (SP) evaluation of student teamwork skills performance and (d) a 20-item modification of items from the Mayo High Performance Teamwork Scale (MHPTS The TeamSTEPPS programme is designed to improve care and patient safety through improved teamwork training to enhance provider communication skills. While the 7 h multidisciplinary Team-STEPPS programme has proven very effective, questions remain regarding the most effective and cost-efficient approach to providing this content to learners at all stages of the health-education continuum.Various educational approaches have been used to address training in team coordination skills in healthcare. Methods such as crisis resource management training using high fidelity human patient simulation provide realism and interactivity.1e3 However, this training modality is both costly and time-consuming, with one instructor per five trainees costing as much as $5000 per day. 12Because of this, medical and nursing schools are implementing more traditional didactic approaches to teaching team coordination skills as well as computer-based instruction, small-group sessions, analysis of videotaped team coordination scenarios and workplace practice experiences.10 11 13 Questions remain about the effectiveness of any of these methods to achieve the necessary changes in student attitudes, knowledge and skills, and there is little evidence for selecting particular methods. Therefore, this study was designed and implemented to adapt the TeamSTEPPS content to pre-licensure nursing and medical students, and measure the effectiveness of four educational interventions at teaching this material. METHODS ProtocolWe conducted a full-day teamwork training and assessment exercise for 438 students composed of fourth-year medical students (N¼235) and finalsemester nursing students (N¼203) from four health-professional schools at two major universities: all students convened on the one campus where they were randomised to one of four educational intervention groups. Students were offered the option of not participating in the research project but could not decline the educational experience. Institutional review boards of both universities approved the proj...

Through acknowledging gender barriers and taking intentional steps to address them with prenursing and nursing students, schools of nursing may create a more inclusive environment and enhance the profession's diversity. [J Nurs Educ. 2017;56(5):295-299.].

Nurse managers in focus groups reported that new graduates of all types of prelicensure programs were not prepared clinically for beginning practice. Graduates of accelerated programs had similar knowledge and skills as other new nurses but also brought work experience and maturity to the clinical setting, which fostered their transition to the nursing role. Nurse managers reported generational differences among graduates beyond their educational preparation and explained how those differences affected their learning of new technologies. Educational implications are discussed.

Variability in streamflows can lead to reduced generation from hydropower producers and result in reductions in revenues that can be financially disruptive. This link between hydrologic and financial uncertainty, and the possibility of increased hydrologic variability in the future, suggests that hydropower producers need to begin to consider new strategies and tools for managing these financial risks. This study uses an integrated hydro-economic model of the Roanoke River Basin to characterize the financial risk faced by hydropower generators as a result of hydrologic variability, and develops several index-based financial hedging contracts intended to mitigate this risk. Several di↵erent indices are evaluated in terms of their ability to serve as the basis for e↵ective financial contracts. Contract structures are then developed and evaluated using a 100-year simulation that describes hydropower operations in the Roanoke basin. Basis risk, contract pricing, and risk mitigation are investigated for three styles of contracts: insurance, binary, and collar. In all three cases, the contracts are shown to be capable of substantially reducing the risks of very low revenue years for costs that are a small fraction of total annual revenues (1-3%).

Prolonged periods of low reservoir inflows (droughts) significantly reduce a hydropower producer's ability to generate both electricity and revenues. Given the capital intensive nature of the electric power industry, this can impact hydropower producers' ability to pay down outstanding debt, leading to credit rating downgrades, higher interests rates on new debt, and ultimately, greater infrastructure costs. One potential tool for reducing the financial exposure of hydropower producers to drought is hydrologic index insurance, in particular, contracts structured to payout when streamflows drop below a specified level. An ongoing challenge in developing this type of insurance, however, is minimizing contracts' ''basis risk,'' that is, the degree to which contract payouts deviate in timing and/or amount from actual damages experienced by policyholders. In this paper, we show that consideration of year-to-year changes in the value of hydropower (i.e., the cost of replacing it with an alternative energy source during droughts) is critical to reducing contract basis risk. In particular, we find that volatility in the price of natural gas, a key driver of peak electricity prices, can significantly degrade the performance of index insurance unless contracts are designed to explicitly consider natural gas prices when determining payouts. Results show that a combined index whose value is derived from both seasonal streamflows and the spot price of natural gas yields contracts that exhibit both lower basis risk and greater effectiveness in terms of reducing financial exposure.