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Item Baseline Quality Improvement Capacity of 33 Endocrinology Centers Participating in the T1D Exchange Quality Improvement Collaborative(American Diabetes Association, 2022) Marks, Brynn E.; Mungmode, Ann; Neyman, Anna; Levin, Laura; Rioles, Nicole; Eng, Donna; Lee, Joyce M.; Basina, Marina; Hawah-Jones, Nana; Mann, Elizabeth; O’Malley, Grenye; Wilkes, Meredith; Steenkamp, Devin; Aleppo, Grazia; Accacha, Siham; Ebekozien, Osagie; Pediatrics, School of MedicineThis article describes the evolution of the Type 1 Diabetes Exchange Quality Improvement Collaborative (T1DX-QI) and provides insight into the development and growth of a successful type 1 diabetes quality improvement (QI) program. Since its inception 8 years ago, the collaborative has expanded to include centers across the United States with varying levels of QI experience, while simultaneously achieving many tangible improvements in type 1 diabetes care. These successes underscore the importance of learning health systems, data-sharing, benchmarking, and peer collaboration as drivers for continuous QI. Future efforts will include recruiting additional small- to medium-sized centers focused on adult care and underserved communities to further the goal of improving care and outcomes for all people living with type 1 diabetes.Item Peer Collaborative Clinical Decision-Making in Virtual Reality Nursing Simulation(2023-05) Ngo, Thye Peng; Reising, Deanna L.; Draucker, Claire Burke; Barnes, Roxie; Kwon, KyungbinIn nursing education, it is common for students to collaborate and make decisions as a group in simulations. One of the vital nursing competencies is students’ ability to make sound clinical judgments and decision-making in simulation. Teamwork among students in simulation significantly affects their critical thinking and clinical reasoning. However, how students collaborate and make decisions in simulation is a complex phenomenon and not well studied and understood. In addition, most existing decision-making frameworks, such as Tanner’s Clinical Judgment Model and the National Council of State Boards of Nursing’s Clinical Judgment Measurement Model, focus solely on individual decision-making. Alternatively, teamwork and collaboration frameworks, such as TeamSTEPPS®, emphasize interprofessional collaboration rather than intraprofessional or peer-to-peer collaboration. Furthermore, peer collaboration and decision-making cannot be accurately measured without a theoretical framework. Because clinical decision-making in nursing practice is a complex process that involves peer collaboration, more research is needed to explore how nursing students collaborate and make decisions in simulation. This qualitative study comprises of a hybrid concept analysis and Charmaz’s constructivist grounded theory to explore prelicensure nursing student’s peer collaborative clinical decision-making (PCCDM). The concept analysis develops a comprehensive definition of PCCDM based on theoretical and empirical data. The grounded theory develops the theoretical framework that captures the process of PCCDM, which consists of the three major domains of group cognition, behavior, and emotion. These domains undergo the peer regulatory process of awareness, communication, and regulation within the individual and collaborative space at various simulation phases. Additionally, a thematic analysis further explores group emotion in PCCDM as the domain is the least studied in nursing simulation. This study provides the framework to support healthcare and nursing simulation involving peer collaboration and decision-making.