Interprofessional healthcare team function is critical to the effective delivery of patient care. Team members must possess teamwork competencies, as team function impacts patient, staff, team, and healthcare organizational outcomes. There is evidence that team training is beneficial; however, consensus on the optimal training content, methods, and evaluation is lacking. This manuscript will focus on training content. Team science and training research indicates that an effective team training program must be founded upon teamwork competencies. The Team FIRST framework asserts there are 10 teamwork competencies essential for healthcare providers: recognizing criticality of teamwork, creating a psychologically safe environment, structured communication, closed-loop communication, asking clarifying questions, sharing unique information, optimizing team mental models, mutual trust, mutual performance monitoring, and reflection/debriefing. The Team FIRST framework was conceptualized to instill these evidence-based teamwork competencies in healthcare professionals to improve interprofessional collaboration. This framework is founded in validated team science research and serves future efforts to develop and pilot educational strategies that educate healthcare workers on these competencies.

Background: Transitions of care are a patient-safety priority. Constructs such as SBAR (situation, background, assessment, recommendation) and I-PASS (illness severity, patient summary, action list, situation awareness, synthesis by receiver) have been used to teach the benefit of structured handovers and have demonstrated an impact in simulated and clinical environments. Despite this, there is still a lack of literature describing handover training for medical students that allows early and sustained knowledge and skill acquisition. Methods: We designed a curriculum to teach handovers to medical students that spanned 28 months of a 4-year medical education curriculum at a large medical school. The curriculum included two separate workshops that book-ended medical student core clerkships. The curriculum was evaluated via knowledge-based surveys and open-ended feedback from students. Results: Two-hundred and forty students participated in the first 'Transition to clerkship' (T2C) workshop. There was improvement in the mean scores on a knowledgebased survey after the workshop (p < 0.001). The overall improvement in performance remained significant 1 year later (p < 0.001). Following Handovers have been a patientsafety priority in the USA since publication of the Institute of Medicine report Building a Safer Health System

Background: More than 80% of those newly diagnosed with breast cancer are now surviving 5 years or more, which creates a target group that is in need of activity programs to prevent treatment side effects and complications. Purpose: The purpose of our systematic review was to identify patient perceptions, preferences, and barriers as well as the strategies to improve adherence to a physical exercise program. Data Sources: PubMed, Academic Search Complete, MEDLINE, SPORTDiscus, EMBASE, Web of Science, PsycINFO, and CINAHL were searched, yielding 2511 studies. Study Selection: In total, 16 qualitative studies were retained and published from 2013 to 2018 in English. Data Extraction: Three reviewers independently extracted data from the studies, evaluated the evidence, and organized the data into tables for ease of reference and analysis. Data Synthesis: Of the 16 retained studies, 7 used interviews, 6 used surveys/questionnaires, and 3 used a mix of interviews and questionnaires. The CASP (Critical Appraisal Skills Programme) instrument was used to appraise quality. Discussion and Limitations: Patient education, group-based programming, electronic tracking devices, enhancing confidence and self-efficacy, and providing alternatives for exercising at home were identified as strategies that could be used to improve adherence. Publication bias and 100% female participation within the retained studies could have affected the results of this review. Conclusions: The barriers, perceptions, preferences, motivators, and recommendations that have been identified will enable physical therapists to optimize, design, and implement a well-rounded program for the initiation and maintenance of physical activity for women with breast cancer.

Background As part of the worldwide call to enhance the safety of patient handovers of care, the Association of American Medical Colleges (AAMC) requires that all graduating students “give or receive a patient handover to transition care responsibly” as one of its Core Entrustable Professional Activities (EPAs) for Entering Residency. Students therefore require educational activities that build the necessary teamwork skills to perform structured handovers. To date, a reliable instrument designed to assess teamwork competencies, like structured communication, throughout their preclinical and clinical years does not exist. Method Our team developed an assessment instrument that evaluates both the use of structured communication and two additional teamwork competencies necessary to perform safe patient handovers. This instrument was utilized to assess 192 handovers that were recorded from a sample of 229 preclinical medical students and 25 health professions students who participated in a virtual course on safe patient handovers. Five raters were trained on utilization of the assessment instrument, and consensus was established. Each handover was reviewed independently by two separate raters. Results The raters achieved 72.22 % agreement across items in the reviewed handovers. Krippendorff’s alpha coefficient to assess inter-rater reliability was 0.6245, indicating substantial agreement among the raters. A confirmatory factor analysis (CFA) demonstrated the orthogonal characteristics of items in this instrument with rotated item loadings onto three distinct factors providing preliminary evidence of construct validity. Conclusions We present an assessment instrument with substantial reliability and preliminary evidence of construct validity designed to evaluate both use of structured handover format as well as two team competencies necessary for safe patient handovers. Our assessment instrument can be used by educators to evaluate learners’ handoff performance as early as their preclinical years and is broadly applicable in the clinical context in which it is utilized. In the journey to optimize safe patient care through improved teamwork during handovers, our instrument achieves a critical step in the process of developing a validated assessment instrument to evaluate learners as they seek to accomplish this goal.