Teams That Work: The Seven Drivers of Team EffectivenessThe Seven Drivers of Team Effectiveness
Abstract
Why do some teams thrive, while others struggle? If you are a team leader, team member, senior leader, or consultant, you need to know what really drives team effectiveness. Many books and consultants offer advice about teamwork based on opinion or conjecture. Some of that advice is useful, but much of it is overly simplistic or even misleading. Fortunately, a growing body of research is now available with which to separate the myths from the facts. For example, is it possible to “team away” talent deficiencies? Will more frequent communications improve performance? Is a team likely to perform better when members know each other? What do great team members know, do, and think? When and how can conflict be constructive? In Teams That Work , Scott Tannenbaum and Eduardo Salas answer these and other questions about team effectiveness. While reading the book you’ll learn: Eleven desirable team member competencies and three traits you’ll want to avoid; Four cooperative beliefs that consistently impact team effectiveness; Four coordination behaviors that you’ll want your teams to demonstrate; Eight types of shared cognitions team members need to possess; A dozen conditions that enable collaboration; and seven essential team leadership functions. The book culminates with specific, evidence-based tips along with tangible tools for putting the science of teamwork into practice.
... Tannenbaum and Salas [4] define a team as "two or more people, who interact with one another, in situations where at least some members need to rely on other team members at least some of the time, sharing a common sense of purpose or goals and they are viewed as a unit by others and themselves". Also, they say that "A team is highly effective when it consistently performs well, remains resilient in the face of challenges, and stays energetic over time.". ...
... Also, they say that "A team is highly effective when it consistently performs well, remains resilient in the face of challenges, and stays energetic over time.". For teams to be effective, we must constantly monitor and improve team members' skills and be alert for red flags relating to the teams' attitudes, behaviors, and cognitions [4]. For example, if team members focus on completing their tasks and are unwilling to help others, we should react and eradicate this behavior from the team. ...
... We chose these components because they are well-founded in literature [2] [4] [20]. The initial set of behavioral markers proposed in the Big Five model was also expanded for each teamwork component [4] [5] [21]. ...
Teamwork is crucial in software engineering. However, recent literature concludes that software engineering graduates have underdeveloped teamwork skills. Instructors wishing to develop teamwork skills are faced with many teamwork models and a lack of empirical studies that examine their utility in higher education. We conducted an exploratory study to examine teamwork components of attitudinal, behavioral, and cognitive psychological facets (collectively called ABCs) in eight undergraduate software engineering teams composed of 14 to 17 members. We answered two research questions: Which teamwork components were the least developed at the beginning of the project, and Which teamwork components remained underdeveloped by the end of the project. For each team, we conducted two focus group discussions, and analyzed four sprint retrospective reports during the semester. We synthesize the gathered data to define each team by the presence of teamwork components, development of teamwork components, experienced challenges, average course grades, and project results. Teamwork components that were initially underdeveloped were Mutual performance monitoring, Shared cognitions, Leadership, Communication, Psychological safety and Trust. Two teamwork components that remained underdeveloped were Shared cognitions and Mutual performance monitoring. The answer to our first question highlights teamwork components that instructors should pay attention to in their teamwork-oriented courses. For the second question, we explain the mechanisms that we applied to develop teamwork components and highlight which components were the most challenging to develop, as well as in which period instructors should provide the most support to students. Engineering education researchers might benefit from our methodological design, measurement instruments, and raw data to conduct studies in their contexts.
... Open-door policies, where managers make themselves available for employee queries and concerns, are another means of effective communication that helps in the workplace (Tannenbaum & Salas, 2020). In the case of UBA, such policies could close hierarchical gaps and build a sense of inclusion by allowing employees to have a say in what affects them. ...
... In this way, employees are more supported and heard at UBA, while their satisfaction and engagement in their job roles are correspondingly very well improved, hence reducing the tendency for burnout and eventual turnover (Bakker & Demerouti, 2017). This is very important, considering the banking industry, which often faces a high rate of turnover and usually presents very costly actions to any organization concerned (Tannenbaum & Salas, 2020) . If UBA could establish a free and responsive environment for communication, then as Men (2014) and Tannenbaum & Salas (2020) noted, the company would be able to enhance employee morale, increase retention rates, and ultimately improve their job performance. ...
... This is very important, considering the banking industry, which often faces a high rate of turnover and usually presents very costly actions to any organization concerned (Tannenbaum & Salas, 2020) . If UBA could establish a free and responsive environment for communication, then as Men (2014) and Tannenbaum & Salas (2020) noted, the company would be able to enhance employee morale, increase retention rates, and ultimately improve their job performance. ...
... The aviation industry leverages the collective intelligence and collaborative efforts of team members to achieve outcomes that may not be possible through individual efforts alone. Some of the major dynamics that make up successful teams include effective collaboration, communication, and coordination (Tannenbaum & Salas, 2020). In recent years, many industries have seen the advent of AI in human teams (Jarrahi, 2018). ...
... Collaboration is an essential component of successful teamwork (Tannenbaum & Salas, 2020). In aviation, collaboration involves the cooperative efforts of team members working towards a shared objective, such as flying the aircraft. ...
... Effective collaboration relies on a shared purpose between team members, seamless communication, coordinated efforts, and defined roles, all of which result in improved safety standards and task success. A shared purpose among team members increases motivation towards common goals, maximizing a team's collective potential and driving them towards effective outcomes (Tannenbaum & Salas, 2020). Communication plays a crucial role in coordinating crew members' efforts by facilitating the timely and accurate exchange of information, instructions, and feedback. ...
... As members from five generations from different eras in time intersect, potentially clashing perspectives on work, life, and values interact in one location. As a result, research has begun to center on the emerging multigenerational phenomenon, the various work processes used, and the impact of this diversity on key work outcomes (Al-Asfour & Lettau, 2014;Tannenbaum & Salas, 2020). ...
... In this new dispensation, Tannenbaum and Salas (2020) explained that "team leadership is about (a) ensuring that your team has all the capabilities, cooperation, coordination, cognition, coaching, and conditions it needs and (b) enabling them to learn and adapt as needed" (p. 187). ...
... This leadership is positively related to team effectiveness and directly to empowering leadership . Together with transformational leadership, servant leadership, and civil leadership, it stands as one of the four leadership approaches that resonate with teams (Tannenbaum & Salas, 2020). ...
This research intends to examine the relationship between key variables of the multigenerational workforce: generational intelligence, team cohesion, and the perception of team performance. It aims to situate the current state of the JAMU as a multigenerational workforce and elicit recommendations on how it can be optimized as a multigenerational workplace going forward. The central question is how JAMU can optimize its standing as a multigenerational workforce through effective team outcomes.
... Teams in [healthcare organizations] seldom spend 2 hours per year practicing, when their ability to function as a team counts 40 hours per week -Wise. (1974) Teamwork is the defining characteristic of modern work: 90% of employees believe that teamwork is indispensable in order for their organization's success (Tannenbaum & Salas, 2021). However, only 25% rate their own teams as effective (Tannenbaum & Salas, 2021). ...
... (1974) Teamwork is the defining characteristic of modern work: 90% of employees believe that teamwork is indispensable in order for their organization's success (Tannenbaum & Salas, 2021). However, only 25% rate their own teams as effective (Tannenbaum & Salas, 2021). Teamwork has proliferated over the last couple of decades, and whilst this has led to positive organizational outcomes, many organizations have failed to realize that teamwork is not a default, it is not a given skill, and this lack of consideration has led to problems. ...
... In order for a team to be effective, it must be able to sustain performance over time, be resilient, and exhibit vitality (Tannenbaum & Salas, 2021). In healthcare, a profession replete with burnout, which is associated with negative job performance outcomes (Salyers et al., 2017) -solutions that target a team's effort reserves are desperately needed. ...
The healthcare industry is inadvertently a teamwork industry – and yet – little time is devoted to improving teamwork on the field. As a response to this issue, team development intervention (TDI) tools have flourished. Findings suggest the capability for TDIs to better team competencies, and potentially mitigate prominent healthcare problems. However, team coaching has been excluded as a potential TDI for healthcare. For this reason, we seek to 1) discuss existing team coaching models, integrating findings across the literature, 2) highlight the advantages of Hackman and Wageman (2005)’s model over others, 3) display its empirically-corroborated propositions, and finally, 4) provide general guidance on how to move forward. We move beyond extant literature by providing an outline on what outcomes team coaching can and cannot yield, accumulating evidence from fields outside of healthcare and incorporating team coaching into the TDI literature. By doing so, we hope empirical research on team coaching is incentivized, resulting in an efficient and accessible TDI for healthcare professionals and the field of interprofessional care. Access can be found here: https://www.tandfonline.com/eprint/UCHJDP8XYSYPNT6PFMUE/full?target=10.1080/13561820.2023.2285030
... The study [14] shows that workplace culture has a significant impact on performance, innovation, creativity and engagement, or is most strongly associated with them. Many scholars and research studies [15], [16], [17], [18], [19] focus on the key characteristics and dynamics of team processes that determine/influence effective team performance and job satisfaction, which are important for achieving competitive advantage. ...
... The effectiveness of teams is not a given, but depends on how the team learns and develops over time [19]. ...
Organisations face the challenge of adapting to rapid change in a world of volatility, uncertainty, complexity, and ambiguity (VUCA). They need to seize opportunities faster than their competitors and are therefore increasingly relying on teams to tackle complex tasks and solve challenging problems. The aim of this paper is to identify team members' perceptions on the scales of Context, Morale and Norms of the Team Assessment Survey II (TAS-II) in 85 Slovak work teams-important for effective collaboration. Examination of responses to the individual items using "Heartbeat analysis" revealed relatively fewer favourable votes for all but 2 of 9 items on the Norms scale, for Conflicts and Celebration (Morale scale) and Assumptions (Context scale), in contrast to the Safeguard and Accountability (Norms scale) and Understanding (Context scale) items Proud, Cooperation and Trust from the Morale scale. We discuss the possible causes. The results provide new insights and help to understand how important organisational context, team morale and norms are for the effectiveness of teamwork, as they can promote resilience, sustainable development and competitiveness.
... Muitas vezes, os grupos estão na origem de comportamentos oportunistas (Ingham et al., 1974;Latané et al., 1979), de relacionamentos excessivamente competitivos, geradores de preconceitos e de conflitos (Dovidio, Glick, & Rudman, 2008), de ineficiências na produção de resultados e de erros graves ou até de fenómenos colectivos de alienação (Janis, 1971;Janis & Mann, 1977). O que significa que o simples facto das pessoas se juntarem para realizar uma qualquer tarefa, com a expectativa de que o resultado seja inovador, por si só é uma pura fantasia e uma fonte recorrente de desilusões, que importa desfazer (Hackman, 2014;Tannenbaum & Salas, 2020). Um grupo é mais do que um conjunto de pessoas a fazer uma mesma tarefa num mesmo local. ...
As perspectivas da sociedade da aprendizagem e a da educação ao longo da vida abriram novos horizontes aos projectos educativos, criando necessidades que vão além das respostas dos sistemas educativos formais. Neste sentido, a animação socioeducativa é um campo privilegiado para projectos de aprendizagem em contextos não formais com um potencial relevante, quando articulados com os projectos educativos das escolas. Neste capítulo apresenta-se um relato de um projecto de animação socioeducativa, no qual se ensaiou uma articulação entre a Fundação Bissaya Barreto, consultora de educação do “Portugal dos Pequenitos”, a licenciatura de Animação Socioeducativa da Escola Superior de Educação de Coimbra e uma rede de escolas do 1º ciclo do ensino básico do concelho de Coimbra, pelo qual cerca de 150 crianças acederam a experiências de aprendizagem cooperativa em contextos não formais.
... Unlike individual taskwork dimensions, in which teammate characteristics may be measured at the level of an individual teammate, these interaction dimensions rely on more than one teammate to be measured. The team competencies described in this section may be considered to be generalizable team skills, such as communication, coordination [65,66,67], or trust [68]. ...
Animal-Human-Machine (AHM) teams are a type of hybrid intelligence system wherein interactions between a human, AI-enabled machine, and animal members can result in unique capabilities greater than the sum of their parts. This paper calls for a systematic approach to studying the design of AHM team structures to optimize performance and overcome limitations in various applied settings. We consider the challenges and opportunities in investigating the synergistic potential of AHM team members by introducing a set of dimensions of AHM team functioning to effectively utilize each member's strengths while compensating for individual weaknesses. Using three representative examples of such teams -- security screening, search-and-rescue, and guide dogs -- the paper illustrates how AHM teams can tackle complex tasks. We conclude with open research directions that this multidimensional approach presents for studying hybrid human-AI systems beyond AHM teams.
... Engaging the team in regular debriefs provided valuable insights into the project's dynamics and uncovered hidden issues. 35 Moreover, debriefs enhance team resilience and ability to adapt to disruptive changes. 36 ...
Background/Objective
The Clinical and Translational Science Awards (CTSA) Program supports a national network of medical research institutions working to expedite the development of treatments and interventions. High-performing translational teams (TTs) involving inter-institutional collaborations are critical for advancing these evidence-based approaches. However, management of these complex teams can be difficult, and tailored project management may help TTs overcome the unique challenges they face.
Methods
We conducted qualitative interviews with 14 dedicated project managers (PMs) from six CTSAs to learn more about their experiences with TTs. Information derived from the thematic analysis of the data was used to identify barriers and facilitators for effective project management.
Results
Barriers included a lack of institutional support, communication issues, pushback, role confusion, and a need for agility. Facilitators included transparent communication, supportive team environments, shared leadership with autonomy, and opportunities for professional development. The PMs interviewed for this study provided descriptions of their work that depicted a more expansive view of project management than the more traditional approach focused on meeting deadlines and managing deliverables.
Conclusion
Our findings have been used to inform development, training, and guidance for an innovative project management resource, the Project Management Innovation Center of Excellence (PROMICE) recently launched at the UW-Madison Institute for Clinical and Translational Research (ICTR). Through the development of a dedicated career path, PROMICE recognizes the value that PMs bring to translational science and provides the support that they need to be innovative, leading their teams to success.
... In financial services, this real-time feedback is invaluable for projects that involve multiple stakeholders or regulatory oversight. The ability to quickly adapt to changes or challenges ensures that the project stays on track, even in highly regulated environments (Tannenbaum & Salas, 2020). Agile's focus on customer feedback also helps financial institutions align their projects more closely with market needs. ...
This paper explores using Agile story points to enhance team productivity and efficiency in financial services, highlighting their benefits, challenges, and future implications. Story points are essential for estimating task complexity, risk, and effort, offering a flexible approach to sprint planning and resource allocation. The paper discusses the role of story points in improving communication among teams, increasing predictability, and ensuring timely customer delivery. Additionally, it examines the challenges associated with subjectivity in estimations, the influence of team dynamics, and the difficulties of scaling Agile practices in large financial institutions. Recommendations are provided for optimizing story point usage, scaling Agile across teams, and ensuring the necessary technological and organizational support for maximizing productivity. The findings emphasize that, with the right framework and leadership buy-in, Agile story points can drive significant improvements in efficiency within the highly regulated financial services sector. Keywords: Agile Story Points, Team Productivity, Financial Services, Resource Allocation, Sprint Planning, Scaling Agile
... The analysis will be conceptually informed by the PROC (Reeves et al., 2010) and 7Cs (Tannenbaum & Salas, 2010) frameworks. The PROC is healthcare-specific and adopts a sociological lens to point to four interconnecting social factors influencing teamwork: processual, relational, organizational, and contextual. ...
In intensive care units (ICUs), various healthcare professions work together in interprofessional teams to deliver high-quality, effective care. These teams and their teamwork practices have implications for staff retention, burnout, and wellbeing, as well as patient safety and care outcomes. However, the United Kingdom's (UK) annual National Health Service (NHS) Staff Survey indicates that reported rates of high-quality teamwork are waning. Interventions to enhance teamwork are therefore crucial, yet in the NHS there is still no consistent approach to training teams. This protocol reports on the qualitative methodology we will employ to understand the factors that influence interprofessional teamwork practices in UK ICUs with a view to developing an evidence-based intervention. Methods consist of a rapid ethnography carried out across a minimum of five different hospitals with ICUs in England, coupled with interviews of health professionals. This in-depth approach will provide the opportunity to observe how different professionals interact with one another, their perceptions of these interactions, and the factors that influence collaborative work. In doing so, we aim to gain a comprehensive and contemporary understanding of ICU team working dynamics in the post-pandemic space. With this knowledge, we will collaborate with healthcare professionals to co-develop an interprofessional toolkit to improve teamwork to ultimately enhance staff wellbeing and improve patient outcomes.
... 18 23 Team leadership is widely acknowledged as crucial, with multiple meta-analyses showing that it significantly impacts team success. 24 25 Understanding the dynamics of leadership, communication and collaboration is foundational for ensuring effective teamwork in co-located teams, and there is no evidence that distributed teams differ in this respect. 19 24 26 Focusing on these aspects aligns with their established importance in traditional co-located team settings. ...
Introduction
Increased globalisation and technological advancements have led to the emergence of distributed teams in various sectors, including healthcare. However, our understanding of how leadership, communication and collaboration influence distributed healthcare teams remains limited.
Objectives
This study aimed to map knowledge on leadership, communication and collaboration in short-term distributed teams across various fields to gain insights that could benefit healthcare.
Design
Scoping review.
Data source
A database search of PubMed, CINAHL, Scopus and PsycINFO was conducted in May 2021 and updated in February 2023 and May 2024.
Eligibility criteria
Articles were eligible if they involved leadership, communication or collaboration in distributed short-term teams supported by synchronised audio-visual communication technology. Two researchers independently screened titles, abstracts and full texts for inclusion.
Data extraction and synthesis
Extracted data on leadership, communication and collaboration were synthesised narratively and reported in terms of patterns, advances, gaps, evidence for practice and research recommendations.
Results
Among 6591 articles, 55 met the eligibility criteria, spanning military, engineering, business, industrial and healthcare contexts. The research focus has shifted over time from adverse effects to solutions for overcoming challenges in distributed teams. Inclusive leadership is vital for engaging all team members. ‘Team opacity’, the absence of non-verbal cues and reduced awareness of team members’ actions, can occur in distributed teams relying on technology. Clear communication is crucial for avoiding misunderstandings and fostering collaboration and adaptability. Developing shared mental models and trust is more challenging, leading to uncertainty and reduced information sharing. There is a lack of studies examining how to apply this knowledge to health professionals’ education.
Conclusion
Our findings highlight the importance of implementing strategies in healthcare to enhance inclusive leadership and improve communication in distributed healthcare settings. More empirical research is needed to understand the intricacy of distributed healthcare settings and identify effective ways to train distributed healthcare teams.
... Οι Tannenbaum & Salas (2020) ορίζουν 7 παραμέτρους που χαρακτηρίζουν τις αποτελεσματικές ομάδες και αυτές είναι η ικανότητα των στελεχών των ομάδων, η συνεργασία, ο συντονισμός, η επικοινωνία, η επίγνωση, η ηγεσία και οι συνθήκες εργασίας. Στην περίπτωση που κάποιο από τα χαρακτηριστικά δεν λειτουργεί, τότε η αποτελεσματικότητα της ομάδας φθίνει. ...
Η διεπιστημονικότητα αποτελεί βασικό άξονα προσέγγισης των διαφόρων εκπαιδευτικών ζητημάτων. Το άρθρο παρουσιάζει τα αποτελέσματα μιας έρευνας, η οποία πραγματοποιήθηκε μεταξύ μελών των διεπιστημονικών ομάδων των Κέντρων Διεπιστημονικής Αξιολόγησης και Συμβουλευτικής Υποστήριξης (ΚΕ.Δ.Α.Σ.Υ.) με τη χρήση του ερωτηματολογίου “Team Effectiveness Diagnostic” της London Leadership Academy. Σκοπός της έρευνας ήταν η διαπίστωση των αντιλήψεων του επιστημονικού προσωπικού των ΚΕ.Δ.Α.Σ.Υ. σχετικά με τον βαθμό αποτελεσματικότητας των διεπιστημονικών ομάδων και τους παράγοντες που την επηρεάζουν. Η ανάλυση των ευρημάτων της έρευνας κατέδειξε ότι οι συμμετέχοντες αισθάνονται πιο αποτελεσματικοί κατά την εργασία τους στις διεπιστημονικές ομάδες, ιδιαίτερα σε ό,τι αφορά την επίτευξη των σκοπών και των στόχων που τίθενται. Αντίθετα, θεωρούν τον εαυτό τους λιγότερο αποτελεσματικό στις διεργασίες που αφορούν την άμεση και αποτελεσματική επίλυση προβλημάτων, την ευελιξία, τις συνεχείς μεταβολές ρόλων και τη συνεργασία με άλλες ομάδες. Από την ανάλυση διακύμανσης διαπιστώθηκε ότι η εμπειρία, η εκπαίδευση και η εξειδίκευση διαδραματίζουν σημαντικό ρόλο στην επίτευξη μεγαλύτερης αποτελεσματικότητας.
... The ten-minute video developed by Dr. Carlos Corleto, a member of our team, was then shown. Dr. Corleto shared that the number one reason teams fail is poor communication [15], and he provided Nokia [16] and the Costa Concordia cruise ship disaster [17] as case studies of how communication issues can lead to failure. While referencing Dr. Daisy Lovelace's Communication within Teams LinkedIn course [18], our video emphasized three key elements important to our students: trust, cross-cultural communication, and conflict management. ...
... Updates to theories, models, and framework should consider integrating teams and team-level constructs [20]. In addition, there are well-established theories of team effectiveness that could inform hypotheses about how specific team constructs affect implementation [104][105][106][107]. Table 6 Limitations of current research on teams & implementation science and recommendations for future research ...
Background
Implementation of new practices in team-based settings requires teams to work together to respond to new demands and changing expectations. However, team constructs and team-based implementation approaches have received little attention in the implementation science literature. This systematic review summarizes empirical research examining associations between teamwork and implementation outcomes when evidence-based practices and other innovations are implemented in healthcare and human service settings.
Methods
We searched MEDLINE, CINAHL, APA PsycINFO and ERIC for peer-reviewed empirical articles published from January 2000 to March 2022. Additional articles were identified by searches of reference lists and a cited reference search for included articles (completed in February 2023). We selected studies using quantitative, qualitative, or mixed methods to examine associations between team constructs and implementation outcomes in healthcare and human service settings. We used the Mixed Methods Appraisal Tool to assess methodological quality/risk of bias and conducted a narrative synthesis of included studies. GRADE and GRADE-CERQual were used to assess the strength of the body of evidence.
Results
Searches identified 10,489 results. After review, 58 articles representing 55 studies were included. Relevant studies increased over time; 71% of articles were published after 2016. We were unable to generate estimates of effects for any quantitative associations because of very limited overlap in the reported associations between team variables and implementation outcomes. Qualitative findings with high confidence were: 1) Staffing shortages and turnover hinder implementation; 2) Adaptive team functioning (i.e., positive affective states, effective behavior processes, shared cognitive states) facilitates implementation and is associated with better implementation outcomes; Problems in team functioning (i.e., negative affective states, problematic behavioral processes, lack of shared cognitive states) act as barriers to implementation and are associated with poor implementation outcomes; and 3) Open, ongoing, and effective communication within teams facilitates implementation of new practices; poor communication is a barrier.
Conclusions
Teamwork matters for implementation. However, both team constructs and implementation outcomes were often poorly specified, and there was little overlap of team constructs and implementation outcomes studied in quantitative studies. Greater specificity and rigor are needed to understand how teamwork influences implementation processes and outcomes. We provide recommendations for improving the conceptualization, description, assessment, analysis, and interpretation of research on teams implementing innovations.
Trial registration
This systematic review was registered in PROSPERO, the international prospective register of systematic reviews. Registration number: CRD42020220168.
... A team is a group of two or more people who interact with each other, rely on each other, share a common purpose, and view themselves as a unit [25]. A key part of distinguishing a leader who has employees working for them vs. a leader who is leading a team is an underlying common purpose-a shared goal. ...
Team coaching has been found to increase group effort, improve interpersonal processes, and increase team knowledge and learning. However, the team coaching literature is renowned for its inability to define team coaching itself—making it difficult to solidify its place in the world of team science. So far, there is no consensus on what specific training would serve internal leaders best, and how they would connect to the team coaching literature. We know leadership and team training are effective in improving organizational outcomes, but the gap in the literature lies in identifying what specific competencies internal team coaches need, and what training could fulfill these. In this piece, we seek to (1) identify what competencies internal team leaders need based on the outcomes we know team coaching yields, (2) identify specific behaviors that can fulfill these competencies, and (3) integrate the literature to form an evidence-based guide on what training to provide to internal team coaches. By doing so, we hope to provide a definitive understanding of what internal team coaches need to be successful.
... People come to the team with different experiences, perspectives, working styles, and communication styles. The second lecture module emphasizes the importance of effective communication to maximize team performance since poor communication is one of the top reasons for team failures [11,12]. Prior to any lecturing, the instructor would ask students to experience the "Lost at Sea" activity [13]. ...
... Salas et al., 1993) (8) Team purpose and objective(s): a shared purpose, outcome and accepted common goals (e.g. Gremyr et al., 2020;Hackman, 2002;O'Leary et al., 2011;Salas et al., 2015;Tannenbaum and Salas, 2020;Woods and West, 2010) (9) Team reflexivity and continuous improvement: collective reflection on performance and goal achievement and how to improve working methods (e.g. Richardson, 2011) (10) Team roles and responsibilities: specified roles and shared responsibilities (e.g. ...
Purpose
The purpose of this paper is to describe the perception of real teamwork and sustainable quality culture as well as success factors for achieving a sustainable quality culture within an organisation, focusing on top management teams (TMTs). An additional purpose is to explore the relationship between real teamwork and sustainable quality culture.
Design/methodology/approach
A mixed-methods design focusing on TMTs was used. Four TMTs were open-sampled and located in different parts of Sweden. The data were collected through questionnaires and focus group discussions between April 2022 and December 2022. Follow-up meetings were thereafter held with the participants. A meta-analysis was conducted of the data from the four TMTs.
Findings
Two overarching conclusions of this study were: to follow the developed methodology can be one way to increase TMTs' abilities for real teamwork alongside a sustainable quality culture, and the results also showed the importance of a systems view, emotional commitment and continuous improvement for improving real teamwork and creating a sustainable quality culture.
Practical implications
Practical implications were suggestions on how to increase the TMTs' abilities for real teamwork alongside a sustainable quality culture. A deepened understanding of real teamwork and a sustainable quality culture was also achieved by the participants.
Originality/value
The novelty of this paper is the use of a new methodology for assessing teamwork and sustainable quality culture. To the authors' knowledge, no similar research has previously been performed to investigate teamwork alongside a sustainable quality culture, focusing on TMTs.
... The authors express their gratitude for the pioneering contributions of Heifetz et al. (2009) who originally introduced the concept of adaptive leadership in the literature. Here, we take the adaptive leadership behaviors proposed by Heifetz et al. (2009) and combined them with the factors influencing team effectiveness, as outlined by T. Tannenbaum and Salas (2020). We then applied this combined knowledge to our own set of health care leadership insights, using the backdrop of the COVID-19 pandemic. ...
Leadership plays a crucial role in health care organizations, particularly in fostering effective teamwork amidst challenging circumstances. Here, we aim to provide a practical introduction for health care leaders seeking to cultivate effective teams in a post-COVID-19 era. We emphasize key factors such as psychological safety, team cohesion, effective communication channels, leveraging transitive memory systems, and embracing shared leadership principles. By integrating these insights into their practices, health care leaders can promote teamwork, enhance patient outcomes, and create a positive work environment. Here, we highlight the criticality of leadership in health care and offer actionable strategies for leaders to navigate complex situations and foster effective teamwork in their organizations.
... This expansion and dynamic nature of the diagnostic team can have a significant impact on patient safety, as cognitive contributions to the DxP are distributed across the various care team members (including patients/families) and effective collaboration among members requires them to have a shared mental model about the process and shared accountability toward a diagnostic outcome [28]. Patient comments of "what's going well" as they relate to the whole care team, including observations on collaboration across specialties, may reflect instances of effective "teaming" where members of the team collectively promote the patient's perception of feeling heard and constructive collaboration [29]. ...
Objectives
Accurate and timely diagnosis relies on close collaboration between patients/families and clinicians. Just as patients have unique insights into diagnostic breakdowns, positive patient feedback may also generate broader perspectives on what constitutes a “good” diagnostic process (DxP).
Methods
We evaluated patient/family feedback on “what’s going well” as part of an online pre-visit survey designed to engage patients/families in the DxP. Patients/families living with chronic conditions with visits in three urban pediatric subspecialty clinics (site 1) and one rural adult primary care clinic (site 2) were invited to complete the survey between December 2020 and March 2022. We adapted the Healthcare Complaints Analysis Tool (HCAT) to conduct a qualitative analysis on a subset of patient/family responses with ≥20 words.
Results
In total, 7,075 surveys were completed before 18,129 visits (39 %) at site 1, and 460 surveys were completed prior to 706 (65 %) visits at site 2. Of all participants, 1,578 volunteered positive feedback, ranging from 1–79 words. Qualitative analysis of 272 comments with ≥20 words described: Relationships (60 %), Clinical Care (36 %), and Environment (4 %). Compared to primary care, subspecialty comments showed the same overall rankings. Within Relationships, patients/families most commonly noted: thorough and competent attention (46 %), clear communication and listening (41 %) and emotional support and human connection (39 %). Within Clinical Care, patients highlighted: timeliness (31 %), effective clinical management (30 %), and coordination of care (25 %).
Conclusions
Patients/families valued relationships with clinicians above all else in the DxP, emphasizing the importance of supporting clinicians to nurture effective relationships and relationship-centered care in the DxP.
... Wawancara memberikan pemahaman yang mendalam tentang bagaimana seorang profesional berinteraksi dengan rekan kerja, atasan, dan bawahan. Dalam riset yang dilakukan oleh (Tannenbaum and Salas 2020), dan (Morgan et al. 2020), pengukuran keterampilan interpersonal diidentifikasi sebagai elemen kunci dalam pengembangan sumber daya manusia, dan wawancara diakui sebagai metode yang efektif untuk memahami dimensi ini. ...
Evaluasi kinerja profesional merupakan suatu aspek yang krusial dalam mengukur kontribusi individu terhadap tujuan organisasi. Dalam mendekati evaluasi tersebut, metode penilaian yang tepat menjadi elemen sentral untuk memastikan ketepatan dan keadilan dalam pengambilan keputusan manajerial. Salah satu metode penilaian yang telah dikenal luas dan terbukti efektif dalam mengeksplorasi potensi serta kinerja seorang profesional adalah melalui proses wawancara. Wawancara tidak hanya menjadi sebuah aktivitas rutin, namun sebuah prosedur yang mendalam untuk memahami dimensi kualitatif dari kontribusi seorang individu terhadap organisasi (Aguinis and Burgi-Tian 2021). Dalam konteks ini, penting untuk menyoroti bahwa evaluasi kinerja tidak semata-mata tentang mengukur kuantitas hasil kerja, tetapi juga memahami kualitas dari upaya yang telah dilakukan. Wawancara sebagai alat penilaian kinerja memberikan dimensi ekstra yang memungkinkan evaluator untuk mendapatkan wawasan langsung mengenai kekuatan, kelemahan, dan potensi pengembangan karyawan. Seiring dengan peningkatan kompleksitas tuntutan pekerjaan, evaluasi kinerja harus mampu melampaui batas-batas pengukuran kuantitatif dan memasuki ranah analisis kualitatif untuk memastikan keadilan dan keberlanjutan dalam pengembangan profesional (Wildan 2022). Dalam penelitian oleh (Dauda and Luki 2021), konsep pentingnya wawancara dalam evaluasi kinerja diperkuat dengan fokus pada "penilaian perilaku" yang dapat diungkapkan melalui interaksi langsung dengan individu. Mereka menegaskan bahwa wawancara memberikan kesempatan untuk mengeksplorasi lebih lanjut aspek-aspek intangible, seperti inisiatif, kerja sama tim, dan kemampuan beradaptasi terhadap perubahan, yang tidak selalu terpenuhi oleh metode pengukuran kuantitatif. Oleh karena itu, penelitian ini bertujuan untuk menggali lebih dalam mengenai bagaimana wawancara mampu mengoptimalkan potensi kinerja profesional melalui analisis mendalam terhadap aspek kualitatif dalam kontribusi individu.
... Measurement of team constructs should be informed by existing theory and research. While the IMOI framework is a helpful starting point, other models of team effectiveness provide more specific theories about drivers of team effectiveness (e.g., Hackman, 2012;Tannenbaum & Salas, 2020), developmental processes in teams (e.g., Tuckman, 1965), and team interventions (Hackman & Wageman, 2005;Tannenbaum & Cerasoli, 2013); these models may be useful in developing and testing specific research questions. An array of well-validated measures of team constructs are available, including measures that are aligned with theories of team effectiveness (e.g., Mathieu et al., 2020;see Marlow, Bisbey et al., 2018;Valentine et al., 2014). ...
Background
Effective teams are essential to high-quality healthcare. However, teams, team-level constructs, and team effectiveness strategies are poorly delineated in implementation science theories, models, and frameworks (TMFs), hindering our understanding of how teams may influence implementation. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework is a flexible and accommodating framework that can facilitate the application of team effectiveness approaches in implementation science.
Main Text
We define teams and provide an overview of key constructs in team effectiveness research. We describe ways to conceptualize different types of teams and team constructs relevant to implementation within the EPIS framework. Three case examples illustrate the application of EPIS to implementation studies involving teams. Within each study, we describe the structure of the team and how team constructs influenced implementation processes and outcomes.
Conclusions
Integrating teams and team constructs into the EPIS framework demonstrates how TMFs can be applied to advance our understanding of teams and implementation. Implementation strategies that target team effectiveness may improve implementation outcomes in team-based settings. Incorporation of teams into implementation TMFs is necessary to facilitate application of team effectiveness research in implementation science.
... To summarise, a team can be defined as a bounded set of individuals (two or more) who perceive themselves and are perceived by others as a clearly defined social unit with a clear and accepted common purpose and objective(s) (e.g. Tannenbaum and Salas, 2020;Hackman, 2002;O'Leary et al., 2011). A team consists of members with different roles and responsibilities who operate interdependently to fulfil a common purpose and objective(s) (e.g. ...
Purpose
The purpose was to present a developed, tested and evaluated methodology for assessing teamwork and sustainable quality culture, focusing on top management teams (TMTs).
Design/methodology/approach
The developed methodology was based on a convergent mixed-method design, including two data collection methods: questionnaire and focus group discussion. Two pilot tests were performed with two TMTs. This design involved analysing, merging and interpreting data, first separately by data collection method and theme and then in a meta-interpretation. Lastly, there was a follow-up meeting for evaluating results.
Findings
Findings from the study were that the methodology can be used to assess teamwork and sustainable quality culture, and the results also showed the strength of using two data collection methods to provide a broader picture of teamwork and sustainable quality culture. A follow-up meeting validated the results and provided additional value to the two TMTs in the form of suggestions on how to improve their teamwork and sustainable quality culture.
Practical implications
Applying this methodology can guide TMTs in how to improve their teamwork and sustainable quality culture within their organisations.
Originality/value
This is a new methodology, containing a developed questionnaire and an interview guide, aiming to assess and evaluate teamwork within TMTs and sustainable quality culture. The practice of the methodology adds value to both TMTs and their organisations, as well as provides a theoretical and methodological contribution to research on teamwork and sustainable quality culture.
... Recent trends suggest that top management teams continue leveraging collaboration and teamwork as a strategic organizational advantage (e.g., O'Neill & Salas, 2018). Fortunately, a great deal of literature has examined factors leading to high performance in work teams, and a critical mass of evidence exists (see Mathieu, Wolfson, & Park, 2018;Salas, Diaz Granados, et al., 2008;Tannenbaum & Salas, 2021). Most notably, these factors become highly complex when one examines computer-mediated teaming, which can often enhance or detract from common teaming factors through technology integration (Gilson et al., 2023 in press-a). ...
... Future research could propose a model that considers the sequentially of tasks, the organization of these tasks in work subteams, and the inclusion of the underlying systems of the cultural agency theory: the cultural system and the personality system [10]. In the cultural system, variables could be included at the organizational level (practices, corporate policies, and managerial leadership), and in the personality system, variables at the team level would be included (skills, coordination, cooperation, communication, cognition, leadership, and internal conditions) [36]. ...
Agile project management (APM) can be defined as an iterative approach that promotes satisfying customer requirements, adjusts to change, and develops a working product in rapidly changing environments. Managers usually apply agile management as the project management approach in projects requiring extraordinary speed and flexibility in their processes. Earned value management (EVM) is a fundamental part of project management to establish practical measures. Often, managers use a task board to visually represent the work on a project and the path to completion. Still, managing an agile project can be a challenging endeavor. In this paper, we propose an agent-based model describing the management of tasks within a project using earned value assessment and a task board. Our model illustrates how EVM yields an efficient method to measure a project’s performance by comparing actual progress against planned activities, thus facilitating the formulation of more accurate predicted estimations. As proof of concept, we leverage our implementation to calculate EVM performance indexes according to a performance measurement baseline (PMB) in a task board fashion.
This essay introduces the special issue of Small Group Research that features essays from 10 winners of the Joseph E. McGrath Award for Lifetime Achievement in the Study of Groups. In our introductory essay, we briefly summarize the history of research on groups and teams, and we situate each of the essayists within that history. We describe the key themes across the essays, including the authors’ autobiographical journeys, new contributions made in some of the essays, and future challenges and recommendations for group researchers that were offered by the essayists. These essays provide fascinating summaries and insights into the professional and personal journeys of the authors. As a group, they highlight the progression of the science of groups and teams over the last 50 years.
This chapter explores the intersection of real-time de-identification, trust, creativity, and innovation in virtual groups. It provides an in-depth analysis of good practices, methods, and tools for using real-time de-identification to increase creativity and innovation in organizations. The chapter highlights the importance of de-identification in protecting individual privacy, examines the role of psychological safety in fostering trust, and explores the unique dynamics of virtual teams. The findings are based on a comprehensive review of research.
This study examines the integration of Artificial Social Intelligence (ASI) into human teams, focusing on how ASI can enhance teamwork processes in complex tasks. Teams of three participants collaborated with ASI advisors designed to exhibit Artificial Theory of Mind (AToM) while engaged in an interdependent task. A profiling model was used to categorize teams based on their taskwork and teamwork potential and study how these influenced perceptions of team processes and ASI advisors. Results indicated that teams with higher taskwork or teamwork potential had more positive perceptions of their team processes, with those high in both dimensions showing the most favorable views. However, team performance significantly mediated these perceptions, suggesting that objective outcomes strongly influence subjective impressions of teammates. Notably, perceptions of the ASI advisors were not significantly affected by team performance but were positively correlated with higher taskwork and teamwork potential. The study highlights the need for ASI systems to be adaptable and responsive to the specific traits of human teams to be perceived as effective teammates.
This study aims to explore the frequency of workers’ participation in modern team types, compare them to each other, and report how participation in the various team types fulfills basic needs satisfaction. An exploratory, cross-sectional study was conducted among employees from the USA. (N = 459) and the UK. (N = 612). Participation in unconventional team types (i.e. temporary, self-managing, and temporary self-managing teams) serves as an independent variable to explore employees’ experiences. Next, we correlate team-type experiences and Basic Need Satisfaction (W-BNS). Evidence suggests that temporary forms of teamwork underperform teams of open-ended duration in meeting basic needs satisfaction. The study reveals that a novel team form, a temporary self-managing team, is understudied yet relatively common in workplaces. Unconventional teams are increasingly common, especially in dynamic industries. However, these teams often under satisfy members compared to permanent, managed teams in meeting psychological needs like autonomy, competence, and relatedness. Organizations must balance innovative team configurations with individual needs. National sampling suggests that unidentified cultural differences are not yet understood, and further investigation is required to explain national/cultural (USA/UK) differences.
Dynamic teaming is required whenever people must coordinate with one another in a fluid context, particularly when the fundamental structures of a team, such as membership, priorities, tasks, modes of communication, and location are in near-constant flux. This is certainly the case in the contemporary ambulatory care diagnostic process, where circumstances and conditions require a shifting cast of individuals to coordinate dynamically to ensure patient safety. This article offers an updated perspective on dynamic teaming commonly required during the ambulatory diagnostic process. Drawing upon team science, it clarifies the characteristics of dynamic diagnostic teams, identifies common risk points in the teaming process and the practical implications of these risks, considers the role of providers and patients in averting adverse outcomes, and provides a case example of the challenges of dynamic teaming during the diagnostic process. Based on this, future research needs are offered as well as clinical practice recommendations related to team characteristics and breakdowns, team member knowledge/cognitions, teaming dynamics, and the patient as a team member.
Objectives
To identify the leadership styles, strengths, strategies, and key factors of PA leaders in healthcare executive, clinical, and academic settings.
Methods
An exploratory, qualitative study was completed through the American Academy of Physician Associates 2023 Practice Survey to answer seven qualitative questions. Of the 1,423 PAs who responded to the survey invitation, 348 PA leaders in formal and informal roles chose to answer, for a 24.4% response rate.
Results
For PA leaders' styles and strengths, collaborative and emotional intelligence emerged as themes. For key factors of PA leadership, balancing expectations and giving and receiving critical feedback emerged as themes. For skills or qualities PA leaders wish they had before starting to lead, project management skills and increased confidence emerged as themes.
Conclusions
Leadership development training needs to be in the didactic and clinical curriculum of PA programs for the future of PA leadership. Leadership pathways for PA leaders in healthcare executive, clinical, and academic settings need to be created and established more widely.
ARTICLE HISTORY KEYWORDS Group Work Forming Storming Norming Performing This study explores the perspectives of foundation studies students in Malaysia regarding the four stages of the Tuckman Model (forming, storming, norming, performing) in the context of group work. Additionally, it examines the correlation between these phases and conflicts within a group. The study, which involved 178 individuals, reveals significant links between different stages of group growth that influence both group dynamics and learning outcomes. The findings highlight the significance of competent leadership in handling the storming phase and emphasise the critical roles of communication and trust in the shaping and norming stages. Furthermore, the results emphasise the importance of connectedness in improving group productivity throughout the performing phase. Proficiently managing disagreements has been demonstrated to improve group dynamics and promote development. This study offers crucial insights into the ways in which organised group interactions might enhance educational settings by analysing both the difficulties and favourable aspects of each phase. Suggestions encompass techniques for enhancing communication and collaboration abilities, along with guidance for maximising teaching approaches by gaining a more profound comprehension of group dynamics.
Forty years ago, Dyer summarized team science research, finding that in many areas, we lacked theoretical backing and empirical evidence—sometimes to the point of meagerness. This commentary summarizes the last four decades of team research with Dyer’s seven leading questions—finding our progress far from scant. We have uncovered groundbreaking theories, moved past understanding teamwork as only the task, researched hundreds of team emergent states, and conducted vast meta-analytic research while continuing to uncover how to make teamwork more effective and what conditions foster greatness. We also find we continue to require work in other areas, from developing better methodological practices to considering teamwork’s dynamic nature. This commentary seeks to revisit team science’s most significant breakthroughs, such as the vast improvement of team training research, and weak spots, such as our continued lack of longitudinal research. By doing so, we highlight how much progress we can make together.
A common source of failure in a human‑dependent barrier or safety critical task is a designed‑in mismatch error. The mismatch is a cognitive demand that exceeds the human capability to reliably and promptly respond to that demand given the plausible situations at that moment. Demand situations often include incomplete information, increased time pressures, and challenging environments.
This book presents innovative solutions to reveal, prevent, and mitigate these and many other cognitive‑type errors in barriers and safety critical tasks. The comprehensive model and methodologies also provide insight into where and to what extent these barriers and task types are significantly underspecified given current standards and practice and the potential consequences.
This title presents a new and comprehensive prototype design and lifecycle model specific to human‑dependent barriers and safety critical tasks. Designed to supplement current practice, the model is fully underpinned by cognitive ergonomics and cognitive science. The book also presents a compelling case for why a new global consensus standard specific to human‑dependent barriers is needed. Taking a novel approach, it presents its suggested basis, framing, and content. Both solutions seek to redress deficiencies in global regulations, standards, and practice. The model is guided by industry recommendations and best practice guidance and solutions from globally recognized experts. Its processes are fully explained and supported by examples, analysis, and well‑researched background materials. Real‑life case studies from offshore oil and gas, chemical manufacturing, transmission pipelines, and product storage provide further insight into how overt and latent design errors contributed to barrier degradation and failure and the consequence of those errors.
An essential and fascinating read for professionals, Human Barrier Design and Lifecycle: A Cognitive Ergonomics Approach and Path Forward will appeal to those in the fields of human factors, process and technical safety, functional safety, display and safety system design, risk management, facility engineering, and facility operations and maintenance.
This article is open access. There is no abstract, it can be viewed at: https://www.frontiersin.org/articles/10.3389/fmed.2024.1282173/full
This paper presents a rationale for establishing collaboration between corporate IT projects and those conducting empirical research on teamwork. A review of teamwork research reveals gaps in many teamwork models: the influence of context of performance, the mechanisms of team development over time, and data generated by practitioners in naturalistic settings. The paper describes the Scrum framework for executing projects in IT departments in terms of input artifacts, output artifacts, team processes, and the role of organizational context. Given the lack of quantitative project outputs, the method describes how Thematic Analysis and qualitative research are needed to convert project outputs to insights on team processes. This method of conducting research on team performance aligns closely with the macroergonomics framework for research and its attention to team, task, context, and study with practitioners in naturalistic settings.
How can teams make sense of a complex organizational transformation and be ready to change? These questions must be addressed as organizations turn towards team-based structures to become more reactive. During organizational transformations, we argue team reflexivity enables team members to share interpretations of changes, leading to the development of team change vision—the overarching sense of direction for simultaneous change initiatives. We further argue that team reflexivity is more effective for teams with greater team tenure dispersion and additive team tenure. We tested and found support for our theory using time-lagged, survey-based data from 70 teams at a Canadian governmental organization. Overall, our study contributes to team readiness to change literature by identifying team reflexivity as a central information-processing activity enabling teams to develop a team change vision during an organizational transformation and by clarifying the effect of team tenure on such activity.
This paper presents a rationale for establishing collaboration between corporate IT projects and those conducting empirical research on teamwork. A review of teamwork research reveals gaps in many teamwork models: the influence of context of performance, the mechanisms of team development over time, and data generated by practitioners in naturalistic settings. The paper describes the Scrum framework for executing projects in IT departments in terms of input artifacts, output artifacts, team processes, and the role of organizational context. Given the lack of quantitative project outputs, the method describes how Thematic Analysis and qualitative research are needed to convert project outputs to insights on team processes. This method of conducting research on team performance aligns closely with the Macroergonomics framework for research and its attention to team, task, context, and study with practitioners in naturalistic settings.
Infants born with congenital diaphragmatic hernia have high mortality and morbidity and require coordinated multidisciplinary care for optimal outcomes. Over the past several decades numerous articles have been published on the technical aspects of the care of these patients demonstrating both the variation in management across institutions as well as the desirability and need for standardization of care. Unfortunately, none have focused on the organization of care for CDH patients encompassing the range from early prenatal diagnosis to long-term postnatal care. However, to achieve optimal care and optimal outcomes, it is important to not only have excellent technical surgical and medical care but also to have an organized, systematic, and purposefully designed program for the delivery of healthcare to infants with this condition. In this article, based on our experience and drawing on general principles of building clinical programs, we describe the important elements of an ideal CDH program.
The purpose of this paper is to examine how organizational development and change (ODC) consultants engage in complex processses of facilitating and implementing team interventions in organizational contexts. The notion of high -performing teams in organizational contexts needs to be re-examined and reinterpreted beyond team building, developmental and training strategies. Complexity issues such as organizational cultural and political realities impact teams and teamwork effectiveness or lack of it. The qualitative methodology integrates ODC methodologies in examining the challenges and opportunities experienced in facilitating change related to tasks and roles required in the diagnosis and implementation of team intervention. The case study of team intervention in a business school depicted capacity improvements in team building and training outcomes which demonstrated its success. However, the organizational cultural and political factors remained the team's challenge. Since these complexities were not solved the team eventually collapsed.
Keywords
Complexity Perspective Model, Multiple Levels Analysis, Team Interventions in Organizations, Team Intervention Strategies, Organizational Development and Change.
The stories unpacked in this chapter illustrate the challenges faced by intensivists as they attempt to forge unified care teams. This can be especially challenging to those trained using the more individualistic models prevalent in the past. Moreover, team member turnover can reduce the stability and longevity of a team once it forms. When team cohesion does occur, however, it can result in both enhanced provider support and improved clinical outcomes.KeywordsTeamworkStabilityTeam cohesionTeam narrativeTeam support
Background
Accurate and timely diagnosis relies on sharing perspectives among team members and avoiding information asymmetries. Patients/Families hold unique diagnostic process (DxP) information, including knowledge of diagnostic safety blindspots—information that patients/families know, but may be invisible to clinicians. To improve information sharing, we co-developed with patients/families an online tool called ‘Our Diagnosis (OurDX)’. We aimed to characterise patient/family contributions in OurDX and how they differed between individuals with and without diagnostic concerns.
Method
We implemented OurDX in two academic organisations serving patients/families living with chronic conditions in three subspecialty clinics and one primary care clinic. Prior to each visit, patients/families were invited to contribute visit priorities, recent histories and potential diagnostic concerns. Responses were available in the electronic health record and could be incorporated by clinicians into visit notes. We randomly sampled OurDX reports with and without diagnostic concerns for chart review and used inductive and deductive qualitative analysis to assess patient/family contributions.
Results
7075 (39%) OurDX reports were submitted at 18 129 paediatric subspecialty clinic visits and 460 (65%) reports were submitted among 706 eligible adult primary care visits. Qualitative analysis of OurDX reports in the chart review sample (n=450) revealed that participants contributed DxP information across 10 categories, most commonly: clinical symptoms/medical history (82%), tests/referrals (54%) and diagnosis/next steps (51%). Participants with diagnostic concerns were more likely to contribute information on DxP risks including access barriers, recent visits for the same problem, problems with tests/referrals or care coordination and communication breakdowns, some of which may represent diagnostic blindspots.
Conclusion
Partnering with patients and families living with chronic conditions through OurDX may help clinicians gain a broader perspective of the DxP, including unique information to coproduce diagnostic safety.
Objectives:
Emergency department (ED) teams frequently perform under conditions of high stress. Stress exposure simulation (SES) is specifically designed to train recognition and management of stress responses under these conditions. Current approaches to design and delivery of SES in emergency medicine are based on principles derived from other contexts and from anecdotal experience. However, the optimal design and delivery of SES in emergency medicine are not known. We aimed to explore participant experience to inform our approach.
Methods:
We performed an exploratory study in our Australian ED with doctors and nurses participating in SES sessions. We used a three-part framework-sources of stress, the impacts of that stress, and the strategies to mitigate-to inform our SES design and delivery and to guide our exploration of participant experience. Data were collected through a narrative survey and participant interviews and analyzed thematically.
Results:
There were 23 total participants (doctors n = 12, nurses n = 11) across the three sessions. Sixteen survey responses and eight interview transcripts were analyzed, each with equal numbers of doctors and nurses. Five themes were identified in data analysis: (1) experience of stress, (2) managing stress, (3) design and delivery of SES, (4) learning conversations, and (5) transfer to practice.
Conclusions:
We suggest that design and delivery of SES should follow health care simulation best practice, with stress adequately induced by authentic clinical scenarios and to avoid trickery or adding extraneous cognitive load. Facilitators leading learning conversations in SES sessions should develop a deep understanding of stress and emotional activation and focus on team-based strategies to mitigate harmful impacts of stress on performance.
Work teams are intrinsic to how 21 st century organizations operate. For several decades, business research has therefore focused on work team performance. De Bono thinking tools have also been used extensively by work teams, for several decades. However, there is a paucity of research on the correct use of de Bono thinking tools in business organizations. The getting on-the-same-page classic grounded theory is therefore a new theory explaining what happens when work teams utilize these tools. The research problem was the main concern of people using de Bono thinking tools in this substantive area. The study revealed their concern is resolved with a three-stage process of change in personal cognitive capability. This process is fragile and can cease at any time. When it continues however, there are three stages of emergent change: tooling-up, tensing and enabling. Discovery of this process contributes to work team theory and praxis, particularly in the area of work team processes and effectiveness.
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