OBJECTIVE: Surgical pathology reports play an integral role in postoperative management of head and neck cancer patients. Pathology reports of complex head and neck resections must convey critical information to all involved clinicians. Previously, we demonstrated the utility of 3D specimen and defect scanning for communicating margin status and documenting the location of supplemental margins. We introduce a newly designed permanent pathology report which improves documentation of intraoperative margin mapping and extent of corresponding supplemental margins harvested.
METHODS: We test the hypothesis that gaps in understanding exist for head and neck resection pathology reports across providers. A cross-sectional exploratory study using human-centered design was implemented to evaluate the existing permanent pathology report with respect to understanding margin status. Pathologists, surgeons, radiation oncologists, and medical oncologists from United States-based medical institutions were surveyed. The results supported a redesign of our surgical pathology template, incorporating 3D specimen / defect scans and annotated radiographic images indicating the location of inadequate margins requiring supplemental margins, or indicating frankly positive margins discovered on permanent section.
RESULTS: Forty-seven physicians completed our survey. Analyzing surgical pathology reports, 28/47 (60%) respondents reported confusion whether re-excised supplemental margins reflected clear margins, 20/47 (43%) reported uncertainty regarding final margin status, and 20/47 (43%) reported the need for clarity regarding the extent of supplemental margins harvested intraoperatively. From this feedback, we designed a new pathology report template; 61 permanent pathology reports were compiled with this new template over a 12-month period.
CONCLUSIONS: Feedback from survey respondents led to a redesigned permanent pathology report that offers detailed visual anatomic information regarding intraoperative margin findings and exact location/size of harvested supplemental margins. This newly designed report reconciles frozen and permanent section results and includes annotated radiographic images such that clinicians can discern precise actions taken by surgeons to address inadequate margins, as well as to understand the location of areas of concern that may influence adjuvant radiation planning.

BACKGROUND: Coronary computed tomography angiography (CCTA) has become a central tool for the primary diagnosis of stable coronary artery disease (CAD). Its integration into the service catalog of the German statutory health insurance will not only transform the way patients are examined and treated but also enhance the collaboration between nonradiologists and radiologists.
OBJECTIVE: This article explores the requirements nonradiologists have for CCTA and identifies ways to promote successful interdisciplinary communication.
METHODS: The study addresses criteria for proper patient selection and preparation for CCTA. It considers the perspectives and needs of patients and various medical specialties, highlighting essential aspects of interdisciplinary communication.
RESULTS: CCTA enables precise clarification of CAD and should be used for patients with a pretest probability of chronic CAD between 15 and 50%. Clear action plans in the diagnostic report are crucial to assist general practitioners and cardiologists in treatment planning. Patients expect clear information about the procedure, possible risks, and results.
CONCLUSIONS: Close collaboration between various medical disciplines is essential for the successful implementation of CCTA. Clear, structured diagnostic reports with annotated images, along with regular case discussions and feedback loops, can improve report interpretation and interdisciplinary communication. Patient-friendly reports can make diagnostic results more understandable and enhance patient adherence.
UNASSIGNED: HINTERGRUND: Die Computertomographie-Koronarangiographie (CCTA) ist eine wichtige Methode in der Primärdiagnostik der stabilen koronaren Herzkrankheit (KHK). Ihre Integration in den Leistungskatalog der gesetzlichen Krankenversicherung verändert künftig nicht nur die Art und Weise, wie Patienten untersucht und behandelt werden, sondern erfordert auch eine enge Zusammenarbeit zwischen Nicht-Radiologen und Radiologen.
UNASSIGNED: Welche Anforderungen Nicht-Radiologen an die CCTA stellen und welche Wege es gibt, um eine erfolgreiche interdisziplinäre Kommunikation zu fördern, wird im folgenden Artikel detailliert erörtert.
METHODS: Die Arbeit thematisiert Kriterien der Patientenselektion und Patientenvorbereitung für eine CCTA. Sie berücksichtigt Perspektiven und Bedürfnisse des Patienten sowie verschiedener medizinischer Fachrichtungen und beleuchtet wesentliche Aspekte der interdisziplinären Kommunikation.
UNASSIGNED: Die CCTA ermöglicht eine präzise KHK-Abklärung und sollte bei einer Vortestwahrscheinlichkeit für eine chronische KHK zwischen 15 und 50 % eingesetzt werden. Klare Handlungsanweisungen im Befundbericht sind entscheidend, um Hausärzte und Kardiologen bei der Therapieplanung zu unterstützen. Patienten erwarten verständliche Informationen zum Untersuchungsablauf, möglichen Risiken und Ergebnissen.
CONCLUSIONS: Die enge Zusammenarbeit zwischen verschiedenen medizinischen Disziplinen ist für die künftig erfolgreiche Implementation der CCTA entscheidend. Durch klar strukturierte Befundberichte mit annotierten Bilddaten sowie regelmäßige Fallbesprechungen und Feedbackschleifen kann die Befundinterpretation verbessert und die interdisziplinäre Kommunikation gefördert werden. Durch patientengerechte Befundzusammenfassungen können Befunde verständlicher gemacht und die Patientenadhärenz verbessert werden.

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UNASSIGNED: Effective communication within a medical team is crucial not only because it results in higher job satisfaction and better joint decision-making among team members, but also because, ultimately, it makes for high-quality, patient-centered care. Since the transition to the clinical phase of study poses a challenge for many medical students, the University of Lübeck introduced \"Ich im Team\" (me as team member), a German-language communication workshop for third-year medical students, in the 2020/21 winter semester.
UNASSIGNED: The workshop forms a basis for future collaboration and is meant to strengthen the interpersonal skills needed for working in teams, communicating with patients, and supporting a no-blame culture.
UNASSIGNED: This workshop, which incorporates elements of improvisational theater and coaching, was offered for the first time in 2020/21. Due to the positive evaluations, it has been a required component of the curriculum since the 2021/22 winter semester.
UNASSIGNED: The students have accepted the workshop very well, which is reflected in the excellent evaluations of it. Furthermore, a research study carried out during the first two times the workshop was conducted showed, among other things, directly positive effects on the ability to work in interprofessional teams and handle mistakes.
UNASSIGNED: The workshop offers students a solid point of entry into the clinical setting and an awareness of their own role on a given team. Covering the content in more depth and the possible inclusion of other study programs are being discussed.
UNASSIGNED: Eine effektive Kommunikation in Behandler-Teams ist von entscheidender Bedeutung, da sie nicht nur zu einer höheren Arbeitszufriedenheit der Teammitglieder und einer besseren gemeinsamen Entscheidungsfindung, sondern letztendlich zu einer qualitativ hochwertigen und patientenzentrierten Versorgung führt. Da der Übergang in den klinischen Studienabschnitt für viele Medizinstudierende eine Herausforderung darstellt, führte die Universität zu Lübeck im Wintersemester 2020/2021 einen Kommunikationsworkshop „Ich im Team“ für die Medizinstudierenden im 3. Studienjahr ein.
UNASSIGNED: Der Workshop schafft durch die Auseinandersetzung mit der eigenen Rolle im Team eine Basis für die spätere Zusammenarbeit und soll zwischenmenschliche Kompetenzen wie Teamfähigkeit, Patientenkommunikation und Fehlermanagement stärken.
UNASSIGNED: Der Workshop mit Elementen des Improvisationstheaters und Coachings wurde 2020/21 erstmalig angeboten. Aufgrund der positiven Evaluationsergebnisse ist er seit dem Wintersemester 2021/2022 verpflichtender Bestandteil des Curriculums.
UNASSIGNED: Die Studierenden haben den Workshop sehr gut angenommen, was sich in den exzellenten Evaluationsergebnissen widerspiegelt. Eine wissenschaftliche Begleitstudie während der ersten beiden Durchgänge zeigte zudem unmittelbare positive Effekte u.a. auf die interprofessionellen Teamfähigkeiten und den Umgang mit Fehlern.
UNASSIGNED: Die Workshops bieten für die Studierenden einen guten Einstieg in die Klinik und eine Sensibilisierung für ihre eigene Rolle in Teams. Eine inhaltliche Vertiefung und die Möglichkeit weitere Studiengänge zu beteiligen, werden diskutiert.

OBJECTIVE: Multi-disciplinary Team (MDT) meetings are widely regarded as the \'gold standard\' of lung cancer care. MDTs improve adherence to clinical guidelines for lung cancer patients. In this study, we describe and compare lung cancer MDTs in Denmark and Norway by combining national surveys and the MDT-Metric for the Observation of Decision-making (MDT-MODe) instrument.
METHODS: Identical surveys were sent out to all lung cancer MDT centers in Denmark and Norway by the Danish Lung Cancer Group and the Norwegian Lung Cancer Group. Six MDT centers, three in Denmark and three in Norway, were observed using the MDT-MODe instrument.
CONCLUSIONS: We found similar organization of MDT meetings in both countries, with the main difference being more local MDT meetings in Norway. All lung cancer MDTs were chaired by respiratory physicians and attended by a radiologist. Other members included oncologists, pathologists, thoracic surgeons, specialist nurses, nuclear medicine specialists and junior doctors. Overall, members reported that they had sufficient time for preparation and attending MDT meetings. With the MDT-MODe instrument it was found that the MDT chairs, surgeons, oncologists, radiologists all contributed positively to case discussion. Comorbidities were included in the discussion of most patients while the patient\'s view and psychosocial issues were less often discussed. A treatment decision was reached in 79.7% of cases discussed. In conclusion, we found similar settings and overall good quality concerning lung cancer MDT meetings in Denmark and Norway.

Trauma surgical care in Germany faces major challenges. The increasing number of cases due to demographic change, combined with reduced bed capacity, requires a rethink in many areas. In order to continue to ensure basic and standard care at a high level and across the board in the future, economic incentives must be created to maintain sufficient locations for trauma care. At the same time, there is a shortage of skilled workers that will worsen in the coming years if appropriate measures are not taken to counteract it. Structural changes will also be needed to improve cross-sector networking between outpatient and inpatient care. With the increase in outpatient care, future shortages of both bed capacity and staff shortages may be buffered.
Die unfallchirurgische Versorgung in Deutschland steht vor großen Herausforderungen. Die zunehmenden Fallzahlen aufgrund des demografischen Wandels bei gleichzeitig reduzierter Bettenkapazität bedingen ein Umdenken in vielen Bereichen. Um die Grund- und Regelversorgung zukünftig weiter auf hohem Niveau und flächendeckend zu gewährleisten, müssen ökonomische Anreize geschaffen werden, um ausreichend Standorte der Traumaversorgung zu erhalten. Gleichzeitig gibt es einen Fachkräftemangel, der sich in den kommenden Jahren noch verschärfen wird, wenn nicht mit geeigneten Maßnahmen gegengesteuert wird. Auch strukturell wird es Änderungen brauchen, um eine sektorübergreifende Vernetzung zwischen der ambulanten und stationären Versorgung zu verbessern. Mit der zunehmenden Ambulantisierung können möglicherweise zukünftige Engpässe sowohl an Bettenkapazitäten als auch an Personalmangel abgepuffert werden.

BACKGROUND: Digital technologies, such as wearable devices and smartphone applications (apps), can enable the decentralisation of clinical trials by measuring endpoints in people\'s chosen locations rather than in traditional clinical settings. Digital endpoints can allow high-frequency and sensitive measurements of health outcomes compared to visit-based endpoints which provide an episodic snapshot of a person\'s health. However, there are underexplored challenges in this emerging space that require interdisciplinary and cross-sector collaboration. A multi-stakeholder Knowledge Exchange event was organised to facilitate conversations across silos within this research ecosystem.
METHODS: A survey was sent to an initial list of stakeholders to identify potential discussion topics. Additional stakeholders were identified through iterative discussions on perspectives that needed representation. Co-design meetings with attendees were held to discuss the scope, format and ethos of the event. The event itself featured a cross-disciplinary selection of talks, a panel discussion, small-group discussions facilitated via a rolling seating plan and audience participation via Slido. A transcript was generated from the day, which, together with the output from Slido, provided a record of the day\'s discussions. Finally, meetings were held following the event to identify the key challenges for digital endpoints which emerged and reflections and recommendations for dissemination.
RESULTS: Several challenges for digital endpoints were identified in the following areas: patient adherence and acceptability; algorithms and software for devices; design, analysis and conduct of clinical trials with digital endpoints; the environmental impact of digital endpoints; and the need for ongoing ethical support. Learnings taken for next generation events include the need to include additional stakeholder perspectives, such as those of funders and regulators, and the need for additional resources and facilitation to allow patient and public contributors to engage meaningfully during the event.
CONCLUSIONS: The event emphasised the importance of consortium building and highlighted the critical role that collaborative, multi-disciplinary, and cross-sector efforts play in driving innovation in research design and strategic partnership building moving forward. This necessitates enhanced recognition by funders to support multi-stakeholder projects with patient involvement, standardised terminology, and the utilisation of open-source software.

UNASSIGNED: Health policymakers have tried to improve the care pathway for cancer patients by improving collaboration between participating healthcare professionals by involving the general practitioner (GP).
UNASSIGNED: To explore how patients, GPs, oncologists and nurses interacted and how they perceived, in their practice, professional roles, collaboration, and cancer care pathways.
UNASSIGNED: Between January 2018 and December 2021, we conducted a qualitative study that combined phenomenology and a general inductive analysis, based on semi-structured interviews with cancer patients and their GPs, oncologists, and nurses in France.
UNASSIGNED: Our analysis of 59 interviews showed that the stakeholders had different perceptions of the cancer care pathway. Task division was implicit and depended on what each health professional thought he/she should be doing; this led to the blurring of certain tasks (announcement of the diagnosis, coordination, and follow-up). The healthcare professionals were stuck in frameworks centred on their own needs and expectations and were unaware of the other health professionals\' needs and expectations. Outside the hospital, GPs and nurses worked in isolation; they were not aware of the other stakeholders and did not communicate with them. GPs and nurses justified this attitude by the lack of a perceived need. Interprofessional communication varied as a function of the needs, involvement and knowledge of the other health professionals and was often mediated by the patient.
UNASSIGNED: In the cancer management in France, to improve cancer care pathway, there is a need to train healthcare professionals in interprofessional collaboration delivering care tailored to patient needs and preferences.
In the management of patients with cancer, the division of tasks between health professionals was not clear and was not discussed by the group.Communication within the health professionals was mediated often by the patient.Interprofessional collaboration is strongly encouraged by France’s public health policies but was not mentioned or put into practice by the health professionals.

Outpatient letters are an essential communication tool in healthcare. Yet doctors receive little training on letter writing and what details recipients consider important. We surveyed 106 hospital doctors and 63 general practitioners (GPs), identifying differences in each group\'s preferences; GPs preferred more structured, detailed letters. Opportunities for feedback, formal templates and advanced software systems can improve communication in outpatient clinics.

Simulation-enhanced interprofessional education (SIM-IPE) offers an avenue to teach and facilitate communication, collaboration, and teamwork while gaining an appreciation for the unique roles different healthcare professionals from a variety of settings bring to such learning experiences. This article provides an initial overview of the current trajectory of interprofessional simulation-based education in healthcare practice. An introduction to the Interprofessional Education Collaborative Core Competencies and the Healthcare Simulation Standards of Best Practice will have a TM after Practice in superscript. Practical applications of integrating Sim-IPE into the varied workplaces where nurses are leaders within interdisciplinary teams are provided.