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140917L - BEING AN EFFECTIVE TEAM PLAYER

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Lecture for 3rd Year Medical Students Faculty of Medicine King Fahad Medical City Riyadh on September 17, 2014 by Professor Omar Hasan Kasule Sr.


LEARNING OBJECTIVES

  • To understand the importance of teamwork in health-care;
  • To know how to be an effective team player;
  • To recognize you will be a member of a number of health-care teams as a medical students
  • To identify the attributes of a successful team
  • To facilitate the operation of small-group learning
  • To maximize the power of teams to improve learning
Keywords:  Team-player, Small-group learning, Team, values, assumptions, roles and responsibilities, learning styles, listening skills, conflict resolution, leadership, effective communication.





LEARNING OUTCOMES: knowledge and performance
  • The different types of teams in health care;
  • The characteristics of effective teams;
  • The role of the patient in the team.
DEFINITION OF A TEAM
Salas defines teams as a “distinguishable set of two or more people who interact dynamically, interdependently, and adaptively towards a common and valued goal/objective/mission, who have been each assigned specific roles or functions to perform, and who have a limited lifespan of membership”

TYPES OF TEAMS
  • Teams that draw from a single
  • Professional group;
  • Multi-professional teams
  • Teams that work closely together in one place;
  • Teams that are geographically distributed;
  • Teams with constant membership;
  • Teams with constantly changing membership.
  • One task temporary teams
CHARACTERISTICS OF TEAMS
  • Team members have specific roles and interact together to achieve a common goal
  • teams make decisions;
  • teams possess specialized knowledge and skills and often function under conditions of
  • High workloads
  • teams differ from small groups in as much as they embody a collective action arising out of task interdependency
TEAMS THAT SUPPORT HEALTH CARE
  • Core teams: direct care
  • Coordinating teams: operational management
  • Contingency teams: for emergent or specific events
  • Ancillary services: eg cleaners
  • Support services: indirect tasks
  • Administration
HOW DO TEAMS FORM AND DEVELOP?  1
  • Forming: initiation
  • Storming: conflict and adjustment
  • Norming: getting to know one another
  • Performing: perfection
BENEFITS OF TEAM WORK
  • Reduced hospitalization time and costs
  • Improved coordination of care
  • Enhanced job satisfaction
  • Reduced unanticipated admissions
  • Efficient use of health-care services
  • Acceptance of treatment Greater role clarity Better accessibility for patients
  • Enhanced communication and professional diversity
  • Improved health outcomes and quality of care
  • Reduced medical errors
  • Enhanced well-being
MEASURES OF EFFECTIVE TEAMWORK
  • Open communication between team members is established
  • Generally accepted procedures and communication patterns are established.
  • The team focuses all of its attention on achieving the goals.
  • The team is close and supportive, open and trusting, resourceful and effective
THE CHARACTERISTICS OF SUCCESSFUL TEAMS
  • Common purpose
  • Measurable goals
  • Effective leadership
  • Effective communication
  • Good cohesion
  • Mutual respect
LEADERSHIP IN A TEAM
  • Effective leadership is a key characteristic of an effective team.
  • Effective team leaders facilitate and coordinate the activities of
  • other team members
Communication techniques for health-care teams
  • Situation
  • Background
  • Assessment
  • Recommendation
  • Call-out: communicate important or
  • critical information that:
  • Check-back
  • Handover or handoff
RESOLVING DISAGREEMENT AND CONFLICT
  • Key to successful teamwork is the ability to resolve conflict or disagreement in the team; this can be especially challenging for junior members of the team, such as medical students, or in teams that are highly hierarchical in nature.
  • It is important for all members of the team to feel they can comment when they see something that they feel will impact on the safety of a patient.
TWO-CHALLENGE RULE
  • The two-challenge rule is designed to empower all team members to “stop” an activity if they sense or discover an essential safety breach.
  • There may be times when an approach is made to a team member but is ignored or dismissed without consideration. 
  • This will require a person to voice his or her concerns by restating their concerns at least twice, if the initial assertion is ignored (thus the name “two-challenge rule”). These two attempts may come from the same person or two different team members:
CUS: three-step process in assisting people in stopping the activity.
  • I am Concerned
  • I am Uncomfortable
  • This is a Safety issue
DESC Script: constructive process for resolving conflicts.
  • Describe the specific situation or behavior and provide concrete evidence or data.
  • Express how the situation makes you feel and what your concerns are.
  • Suggest other alternatives and seek agreement.
  • Consequences should be stated in terms of impact on established team goals or patient
  • safety. The goal is to reach consensus.
BARRIERS TO EFFECTIVE TEAMWORK
  • Changing roles
  • Changing settings
  • Medical hierarchies
  • Individualistic nature of medicine
  • Instability of teams
WHAT STUDENTS NEED TO DO: (PERFORMANCE REQUIREMENTS)
  • Be mindful of how one’s values and assumptions affect interactions with other team members
  • Be mindful of the role of team members and how psychosocial factors affect team interactions, recognize the impact of change on team members
  • Include the patient as a member of the team.
  • Using mutual support techniques and resolving conflicts, using communication
  • techniques and changing and observing behaviours
SUMMARY HOW MEDICAL STUDENTS CAN LEARN TEAM WORK
  • Team training for medical students can be effective using a variety of techniques, many of which can be delivered in the classroom or low-fidelity simulated environment.
  • Ideally medical students should take part in real teams and learn through experience and guided reflection.
  • As far as possible, team training should focus on as many principles of effective teamwork as possible.
TOOLS AND RESOURCES