This article considers tools to support remote gesture in video systems being used to complete collaborative physical tasks-tasks in which two or more individuals work together manipulating three-dimensional objects in the real world. We first discuss the process of conversational grounding during collaborative physical tasks, particularly the role of two types of gestures in the grounding process: pointing gestures, which are used to refer to task objects and locations, and rep- HUMAN-COMPUTER INTERACTION, 2004, Volume 19, pp. 273-309 Copyright © 2004 resentational gestures, which are used to represent the form of task objects and the nature of actions to be used with those objects. We then consider ways in which both pointing and representational gestures can be instantiated in systems for remote collaboration on physical tasks. We present the results of two studies that use a "surrogate" approach to remote gesture, in which images are intended to express the meaning of gestures through visible embodiments, rather than direct views of the hands. In Study 1, we compare performance with a cursor-based 274 FUSSELL ET AL.

Introduction:Although many organizations have reported successful outcomes as a result of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), implementation can be challenging, with its share of administrative obstacles and lack of research that shows observable change in practice.Methods:This quantitative, pretest/posttest design pilot research used a combination of classroom simulation-based instruction and in situ simulation in a Pediatrics department in an urban academic center. All personnel with direct patient care responsibilities (n = 547) were trained in TeamSTEPPS in an 8-week period. TeamSTEPPS course knowledge scores were compared pretraining to posttraining using the Wilcoxon rank-sum test. The performance of two-day and overnight shift teams, pre- and postintervention was assessed using the TeamSTEPPS Team Performance Observation Tool.Results:TeamSTEPPS course knowledge improved from the beginning of the course to completion with median scores of 16 and 19, respectively (P < 0.001). Both day and evening postintervention groups demonstrated greater team performance scores than their control counterparts. Specifically, postintervention day shift team showed the greatest improvement and demonstrated more TeamSTEPPS behaviors.Conclusion:This pilot study involving 1 department in an urban hospital showed that TeamSTEPPS knowledge and performance could be improved to increase patient safety and reduce medical errors. However, teams need to be trained within a shorter period so they can apply a shared-model of teamwork and communication. Leaders and educators throughout the department must also reinforce the behaviors and include them in every education intervention.

Background and Objectives. The code team course is a 3-hour, interactive course that follows a 4-phase brain-based lesson plan for simulation. Interprofessional teams receive instruction and practice in evidence-based teamwork, communication, and individual skills. Methods. This quantitative research included a pre-test and post-test design in an urban Department of Medicine. Sixteen groups (n=109) participated in the course over a period of eight weeks. Classroom metrics included pre- and post-course High-Quality cardiopulmonary resuscitation (CPR) and code team didactic knowledge assessed by Wilcoxon rank-sum tests. In addition, four in-situ mock code simulations were conducted to provide the researchers with baseline and post-intervention data. Code team performance assessment scores were tallied and compared between baseline and post-intervention by Fisher’s Exact Test. Results. The classroom metrics produced significant results. High-Quality CPR scores were higher post-training than pre-training (median score 4 vs. 3, respectively; p=0.006). Didactic knowledge test scores were also significantly higher (median score 90 vs. 70, respectively; p <0.001). In-situ team performance improved in several areas. There was a significant improvement in the area of cardiac code management in the day shift group. The percent “done well” improved from 25% (5/20) to 100% (20/20) (p= <0.001). Conclusion. The results of this pilot study suggest that code team training using the 4-phase BBL plan for simulation is associated with improvements in interprofessional team knowledge and performance during cardiac emergencies. It is equally important that the training is conducted over a short period in order to ensure that all team members are properly prepared.

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