Public-Private Partnership Transportation Projects: An Exploratory Study

When public transportation projects were delivered through design-bid-build and later design-build, governments found a serious issue: inadequate funding. With population growth, governments began to develop new arrangements in which the private sectors were involved to cut the financial burden. This arrangement, Public-Private Partnership (PPP), has its own risks; however, performance outputs can motivate or discourage its use. On top of such output are time and budget, which can be affected by the type of project delivery methods. Project completion within or ahead of schedule as well as within or under budget is among any owner’s objectives. With a higher application of PPP in the highway industry in the US and insufficient research, the current study addresses the schedule and cost performance of PPP highway projects and determines which one outperforms the other. To meet this objective, after collecting performance data of all PPP projects, schedule growth and cost growth are calculated, and finally, statistical analysis is conducted to evaluate the PPP performance. The results show that PPP highway projects on average have saved time and cost; however, the main benefit is a faster delivery rather than an under-budget completion. This study can provide better insights to understand PPP highways’ performance and assist practitioners in applying PPP for transportation projects with the opportunity to save time and cost.

Governance, Risk Management, and Compliance Factors Influencing the Adoption of Cloud Computing in Australia

A business decision to move to the cloud brings fundamental changes in how an organization develops and delivers its Information Technology solutions. The accelerated pace of digital transformation across businesses and government agencies increases the reliance on cloud-based services. Collecting, managing, and retaining large amounts of data in cloud environments make information security and data privacy protection essential. It becomes even more important to understand what key factors drive successful cloud adoption following the commencement of the Privacy Amendment Notifiable Data Breaches (NDB) Act 2017 in Australia as the regulatory changes impact many organizations and industries. This quantitative correlational research investigated the governance, risk management, and compliance factors contributing to cloud security success. The factors influence the adoption of cloud computing within an organizational context after the commencement of the NDB scheme. The results and findings demonstrated that corporate information security policies, data storage location, management understanding of data governance responsibilities, and regular compliance assessments are the factors influencing cloud computing adoption. The research has implications for organizations, future researchers, practitioners, policymakers, and cloud computing providers to meet the rapidly changing regulatory and compliance requirements.

Exploring the Challenges to Usage of Building and Construction Cost Indices in Ghana

Price fluctuation contract is imperative and of paramount essence in the construction industry as it provides adequate relief and cushioning for changes in the prices of input resources during construction. As a result, several methods have been devised to better help in arriving at fair recompense in the event of price changes. However, stakeholders often appear not to be satisfied with the existing methods of fluctuation evaluation, ostensibly because of the challenges associated with them. The aim of this study was to identify the challenges to usage of building construction cost indices in Ghana. Data were gathered from contractors and quantity surveying firms. The study utilized survey questionnaire approach to elicit responses from the contractors and the consultants. Data gathered were analyzed scientifically, using the Relative Importance Index (RII) to rank the problems associated with the existing methods. The findings revealed the following among others: late release of data; inadequate recovery of costs; and work items of interest not included in the published indices as the main challenges of the existing methods. Findings provided useful lessons for policy makers and practitioners in decision making towards the usage and improvement of available indices.

Design Systems and the Need for a Usability Method: Assessing the Fitness of Components and Interaction Patterns in Design Systems Using Atmosphere Methodology

The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Sonic Therapeutic Intervention for Preventing Financial Fraud: A Phenomenological Study

The specific problem is that private and public organizational leaders often do not understand the importance of sonic therapeutic intervention in preventing financial fraud. The study aimed to explore sonic therapeutic intervention practitioners' lived experiences regarding the value of sonic therapeutic intervention in preventing financial fraud. The data collection methods were semi-structured interviews of purposeful samples and documentary reviews, which were analyzed thematically. Four themes emerged from the analysis of interview transcription data: Sonic therapeutic intervention enabled self-control, pro-spiritual values, consequentiality mindset, and post-conventional consciousness. The itemized four themes helped non-engagement in financial fraud. Implications for positive social change include enhanced financial fraud management, more significant financial leadership, and result-oriented decision-taking in the financial market. Also, the study results can improve the increased de-escalation of anxiety/stress associated with defrauding.

Research Design for Developing and Validating Ice-Hockey Team Diagnostics Scale

In the modern world, ice-hockey (and in a broader sense, team sports) is becoming an increasingly popular field of entertainment. Although the main element is most likely perceived as the show itself, winning is an inevitable part of the successful operation of any sports team. In this paper, the author creates a research design allowing to develop and validate an ice-hockey team-focused diagnostics scale, which enables researchers and practitioners to identify the problems associated with underperforming teams. The construction of the scale starts with personal interviews with experts of the field, carefully chosen from Hungarian ice-hockey sector. Based on the interviews, the author is shown to be in the position to create the categories and the relevant items for the scale. When constructed, the next step is the validation process on a Hungarian sample. Data for validation are acquired through reaching the licensed database of the Hungarian Ice-Hockey Federation involving Hungarian ice-hockey coaches and players. The Ice-Hockey Team Diagnostics Scale is to be created to orientate practitioners in understanding both effective and underperforming team work.

A Review and Comparative Analysis on Cluster Ensemble Methods

Clustering is an unsupervised learning technique for aggregating data objects into meaningful classes so that intra cluster similarity is maximized and inter cluster similarity is minimized in data mining. However, no single clustering algorithm proves to be the most effective in producing the best result. As a result, a new challenging technique known as the cluster ensemble approach has blossomed in order to determine the solution to this problem. For the cluster analysis issue, this new technique is a successful approach. The cluster ensemble's main goal is to combine similar clustering solutions in a way that achieves the precision while also improving the quality of individual data clustering. Because of the massive and rapid creation of new approaches in the field of data mining, the ongoing interest in inventing novel algorithms necessitates a thorough examination of current techniques and future innovation. This paper presents a comparative analysis of various cluster ensemble approaches, including their methodologies, formal working process, and standard accuracy and error rates. As a result, the society of clustering practitioners will benefit from this exploratory and clear research, which will aid in determining the most appropriate solution to the problem at hand.

Exploring the Perspective of Service Quality in mHealth Services during the COVID-19 Pandemic

The impact of COVID-19 has a significant effect on all sectors of society globally. Health information technology (HIT) has become an effective health strategy in this age of distancing. In this regard, Mobile Health (mHealth) plays a critical role in managing patient and provider workflows during the COVID-19 pandemic. Therefore, the users' perception of service quality about mHealth services plays a significant role in shaping confidence and subsequent behaviors regarding the mHealth users' intention of use. This study's objective was to explore levels of user attributes analyzed by a qualitative method of how health practitioners and patients are satisfied or dissatisfied with using mHealth services; and analyzed the users' intention in the context of Taiwan during the COVID-19 pandemic. This research explores the experienced usability of a mHealth services during the Covid-19 pandemic. This study uses qualitative methods that include in-depth and semi-structured interviews that investigate participants' perceptions and experiences and the meanings they attribute to them. The five cases consisted of health practitioners, clinic staff, and patients' experiences using mHealth services. This study encourages participants to discuss issues related to the research question by asking open-ended questions, usually in one-to-one interviews. The findings show the positive and negative attributes of mHealth service quality. Hence, the significant importance of patients' and health practitioners' issues on several dimensions of perceived service quality is system quality, information quality, and interaction quality. A concept map for perceptions regards to emergency uses' intention of mHealth services process is depicted. The findings revealed that users pay more attention to "Medical care", "ease of use" and "utilitarian benefits" and have less importance for "Admissions and Convenience" and "Social influence". To improve mHealth services, the mHealth providers and health practitioners should better manage users' experiences to enhance mHealth services. This research contributes to the understanding of service quality issues in mHealth services during the COVID-19 pandemic.

A Mixed-Methods Approach to Developing and Evaluating an SME Business Support Model for Innovation in Rural England

Cumbria is a geo-political county in Northwest England within which the Lake District National Park, a UNESCO World Heritage site is located. Whilst the area has a formidable reputation for natural beauty and historic assets, the innovation ecosystem is described as ‘patchy’ for a number of reasons. The county is one of the largest in England by area and is sparsely populated. This paper describes the needs, development and delivery of an SME business-support programme funded by the European Regional Development Fund, Lancaster University and the University of Cumbria. The Cumbria Innovations Platform (CUSP) Project has been designed to respond to the nuanced needs of SMEs in this locale, whilst promoting the adoption of research and innovation. CUSP utilizes a funnel method to support rural businesses with access to university innovation intervention. CUSP has been built on a three-tier model: Communicate, Collaborate and Create. The paper describes this project in detail and presents results in terms of output indicators achieved, a beneficiary telephone survey and wider economic forecasts. From a pragmatic point-of-view, the paper provides experiences and reflections of those people who are delivering and evaluating knowledge exchange. The authors discuss some of the benefits, challenges and implications for both policy makers and practitioners. Finally, the paper aims to serve as an invitation to others who may consider adopting a similar method of university-industry collaboration in their own region.

The Underestimation of Cultural Risk in the Execution of Megaprojects

There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Protection of Cultural Heritage against the Effects of Climate Change Using Autonomous Aerial Systems Combined with Automated Decision Support

The article presents an ongoing work in research projects such as SCAN4RECO or ARCH, both funded by the European Commission under Horizon 2020 program. The former one concerns multimodal and multispectral scanning of Cultural Heritage assets for their digitization and conservation via spatiotemporal reconstruction and 3D printing, while the latter one aims to better preserve areas of cultural heritage from hazards and risks. It co-creates tools that would help pilot cities to save cultural heritage from the effects of climate change. It develops a disaster risk management framework for assessing and improving the resilience of historic areas to climate change and natural hazards. Tools and methodologies are designed for local authorities and practitioners, urban population, as well as national and international expert communities, aiding authorities in knowledge-aware decision making. In this article we focus on 3D modelling of object geometry using primarily photogrammetric methods to achieve very high model accuracy using consumer types of devices, attractive both to professions and hobbyists alike.

The Relations among Business Model, Higher Education, University and Entrepreneurship Education: An Analysis of Academic Literature of 2009-2019 Period

Business model (BM) is a term that has been receiving the attention of scholars and practitioners and has been consolidating itself as a field of study and research. Although there is no agreement in the academic literature on the definition of BM, at least there is an explicit agreement: BM defines a logical structure of how an organization creates value, capture value and delivers value for the customers and stakeholders. The lack of understanding about connections and elements among BM and higher education, university, and entrepreneurship education opens a gap in the academic literature. Thus, it is interesting to analyze how BM has been approached by the literature and applied in higher education, university, and entrepreneurship education aimed to know the main streams of research. This is because higher education institutions are characterized by innovation, leading to a greater acceptance of new and modern concepts such as BM. Our research has the main motivation to fill the gap in the academic literature, making it possible to increase the power of understanding about connections and aspects among BM and higher education, university, and entrepreneurship education. The objective of the research is to analyze the main aspects among BM and higher education, university, and entrepreneurship education in academic literature. The research followed the systematic literature review (SLR). The SLR is based on three main factors: clarity, validity, and auditability. 82 academic papers were found in the past 10 years, from 2009-2019. The search was carried out in Science Direct and Periodicos Capes databases. The main findings indicate that there are links between BM and higher education, BM and university, BM, and entrepreneurship education. The main findings are inserted within seven aspects. The findings are innovative and contribute to increase the power of understanding about the connection among BM and higher education, university, and entrepreneurship education in academic literature. The research findings addressed to the gap exposed in academic literature. The research findings have several practical implications, and we highlight only two main ones. First, researchers will be able to use the research findings to mitigate a BM research agenda involving connections between BM and higher education, BM and university, and BM and entrepreneurship education. Second, directors, deans, and university leaders will be able to carry out BM awareness programs, BM professors training programs, and makers planning for the inclusion of BM, as one of the components of the curricula of the undergraduate and graduate courses.

Government of Ghana’s Budget: An Assessment of Its Compliance with Fundamental Budgeting Principles

Public sector budgeting, all over the world, is underpinned by some universally accepted principles of sound budget management such as budget unity, universality, annuality, and a balanced budget. These traditional principles, though fundamental, had, in recent years, been augmented by the more modern principles of budgeting within fiscal objective, alignment with medium-term strategic plans as well as the observance of such related concepts as transparency, openness and accessibility. In this paper, we have endeavored to shed light, from literature and practice, on the meaning and purposes of such fundamental budgeting principles. We have also assessed the extent to which the Government of Ghana’s budget complies with the four traditional principles of budget unity, universality, annuality, and a balanced budget and the three out of the ten modern principles of budgetary governance of Organisation for Economic Co-operation and Development (OECD). We did so by using a qualitative method of review and analysis of existing documents and the performance assessment reports on Ghana’s Public Financial Management (PFM) measured using such frameworks as the Public Expenditure and Financial Accountability (PEFA), the Open Budget Survey (OBS) and its Index (OBI), the reports and action plans of Open Government Partnership (OGP) and the Global Initiative for Fiscal Transparency (GIFT). Other performance assessment reports that were relied on included, but not limited to, the Joint Evaluation Report of PFM in Ghana, 2001-2010, and the Joint Evaluation of Budget Support to Ghana, 2005-2015. We have, through this paper, brought to the fore the lessons that could be learned on how those budgetary principles undergird the Government of Ghana’s budget formulation, execution, accounting, control, and oversight. These lessons include, but are not limited to, the need for both scholars and practitioners in the PFM space to be aware of the impact of those principles on public sector budgeting.

Robotic Assistance in Nursing Care: Survey on Challenges and Scenarios

Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Physiological Effects during Aerobatic Flights on Science Astronaut Candidates

Spaceflight is considered the last frontier in terms of science, technology, and engineering. But it is also the next frontier in terms of human physiology and performance. After more than 200,000 years humans have evolved under earth’s gravity and atmospheric conditions, spaceflight poses environmental stresses for which human physiology is not adapted. Hypoxia, accelerations, and radiation are among such stressors, our research involves suborbital flights aiming to develop effective countermeasures in order to assure sustainable human space presence. The physiologic baseline of spaceflight participants is subject to great variability driven by age, gender, fitness, and metabolic reserve. The objective of the present study is to characterize different physiologic variables in a population of STEM practitioners during an aerobatic flight. Cardiovascular and pulmonary responses were determined in Science Astronaut Candidates (SACs) during unusual attitude aerobatic flight indoctrination. Physiologic data recordings from 20 subjects participating in high-G flight training were analyzed. These recordings were registered by wearable sensor-vest that monitored electrocardiographic tracings (ECGs), signs of dysrhythmias or other electric disturbances during all the flight. The same cardiovascular parameters were also collected approximately 10 min pre-flight, during each high-G/unusual attitude maneuver and 10 min after the flights. The ratio (pre-flight/in-flight/post-flight) of the cardiovascular responses was calculated for comparison of inter-individual differences. The resulting tracings depicting the cardiovascular responses of the subjects were compared against the G-loads (Gs) during the aerobatic flights to analyze cardiovascular variability aspects and fluid/pressure shifts due to the high Gs. In-flight ECG revealed cardiac variability patterns associated with rapid Gs onset in terms of reduced heart rate (HR) and some scattered dysrhythmic patterns (15% premature ventricular contractions-type) that were considered as triggered physiological responses to high-G/unusual attitude training and some were considered as instrument artifact. Variation events were observed in subjects during the +Gz and –Gz maneuvers and these may be due to preload and afterload, sudden shift. Our data reveal that aerobatic flight influenced the breathing rate of the subject, due in part by the various levels of energy expenditure due to the increased use of muscle work during these aerobatic maneuvers. Noteworthy was the high heterogeneity in the different physiological responses among a relatively small group of SACs exposed to similar aerobatic flights with similar Gs exposures. The cardiovascular responses clearly demonstrated that SACs were subjected to significant flight stress. Routine ECG monitoring during high-G/unusual attitude flight training is recommended to capture pathology underlying dangerous dysrhythmias in suborbital flight safety. More research is currently being conducted to further facilitate the development of robust medical screening, medical risk assessment approaches, and suborbital flight training in the context of the evolving commercial human suborbital spaceflight industry. A more mature and integrative medical assessment method is required to understand the physiology state and response variability among highly diverse populations of prospective suborbital flight participants.

Insiders’ Perspectives of Countering Public Sector Corruption in Nigeria: Identifying and Targeting Its Nature, Characteristics and Fundamental Causes

This paper explores the extent, nature, and characteristics of public sector corruption in Nigeria and the enhancement of the major anti-corruption initiatives (reforms), thereby providing insight into the types, forms and causes of corruption in Nigeria. This paper argues that attempts to devise and suggest effective anti-corruption reforms to control systemic corruption in Nigeria require identifying the most prevalent types of corruption targeted and tackling the fundamental country specific causes. It analyses two types of public sector corruption as it relates to Nigeria and the workings of its inefficient governance system. This paper concludes with the imperative of a collective action against corruption supported by considerable amount of domestic political will existing in a favourable policy context. In undertaking this, the paper draws upon publicly available documents, case laws review and semi-structured interviews conducted with various personnel working in the field of corruption in the dedicated anticorruption agencies, academics, and practitioners from other relevant institutions of accountability.

Dialogue Meetings as an Arena for Collaboration and Reflection among Researchers and Practitioners

The research question of the article is to explore whether the dialogue meetings method could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in municipalities, or not. A testbed was planned to be implemented in a retirement home in a Swedish municipality, and the practitioners worked with a pre-study of that testbed. In the article, the dialogue between the researchers and the practitioners in the dialogue meetings is described and analyzed. The potential of dialogue meetings as an arena for learning and reflection among researchers and practitioners is discussed. The research methodology approach is participatory action research with mixed methods (dialogue meetings, focus groups, participant observations). The main findings from the dialogue meetings were that the researchers learned more about the use of traditional research methods, and the practitioners learned more about how they could improve their use of the methods to facilitate change processes in their organization. These findings have the potential both for the researchers and the practitioners to result in more relevant use of research methods in change processes in organizations. It is concluded that dialogue meetings could be relevant for reflective learning among researchers and practitioners when welfare technology should be implemented in a health care organization.

Methodology of the Turkey’s National Geographic Information System Integration Project

With its spatial data reliability, interpretation and questioning capabilities, Geographical Information Systems make significant contributions to scientists, planners and practitioners. Geographic information systems have received great attention in today's digital world, growing rapidly, and increasing the efficiency of use. Access to and use of current and accurate geographical data, which are the most important components of the Geographical Information System, has become a necessity rather than a need for sustainable and economic development. This project aims to enable sharing of data collected by public institutions and organizations on a web-based platform. Within the scope of the project, INSPIRE (Infrastructure for Spatial Information in the European Community) data specifications are considered as a road-map. In this context, Turkey's National Geographic Information System (TUCBS) Integration Project supports sharing spatial data within 61 pilot public institutions as complied with defined national standards. In this paper, which is prepared by the project team members in the TUCBS Integration Project, the technical process with a detailed methodology is explained. In this context, the main technical processes of the Project consist of Geographic Data Analysis, Geographic Data Harmonization (Standardization), Web Service Creation (WMS, WFS) and Metadata Creation-Publication. In this paper, the integration process carried out to provide the data produced by 61 institutions to be shared from the National Geographic Data Portal (GEOPORTAL), have been trying to be conveyed with a detailed methodology.

Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

A Study to Evaluate the Effectiveness of Simulation on Anaesthetic Non-Technical Skills in the Management of Major Trauma Patients

Background: Dynamic, challenging instances during the management of major trauma patients requires optimal team intervention to ensure patient safety and effective crisis management. These factors highlight the importance of increased awareness in both technical and non-technical skills (NTS) training. Simulation based training (SBT) is an effective tool that replicates and teaches the required clinical skills, resulting in teamwork improvement, better patient safety, and care. Aims: This study investigates change in NTS, during the management of major trauma patients, using SBT. We also investigated the relationship between NTS performance and participation in previous NTS workshop (NTSW), years of experience, previous simulation (PS), previous exposure to major trauma patient management (MTPM) and group size. Methods: NTS behaviours were assessed by a single rater using previously validated framework for observing and rating Anaesthetists’ Non-Technical Skills (ANTS) for anaesthetists and Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) for anaesthetic nurses during SBT. Two anaesthetists (one senior, one junior) together with one to four registered anaesthetic nurses formed 17 teams. The SBT consisted of 3 major trauma scenarios: 1) Major haemorrhage following multiple stab wounds to the torso, 2) Traumatic brain injury complicated by unanticipated difficult intubation, and 3) Penetrating neck injury with major haemorrhage, complicated by a failed intubation. The scores of each NTS category for each scenario are evaluated for significance in change and used to correlate whether NTS during the simulation were affected by previous NTSW, PS, previous exposure to MTPM and group size. Results: The resulting anaesthetists and anesthetic nurses’ p-values were < 0.05 indicating a significant improvement in all NTS resulting from score differences between scenarios 1 & 2 and 1 & 3. Anaesthetists’ NTS categories were not influenced by PS, previous NTSW, and exposure to MTPM. However, anaesthetic nurses NTS categories were influenced by PS, exposure to MTPM but not by NTSW. Conclusions: SBT has shown to be effective in improving the NTS for both anaesthetists and anaesthetic nurses. This enhances safety and team performance for MTPM. The impact of SBT in the clinical environment for patient management and safety warrants further research.