The authors describe the development and psychometric testing across three study phases of an Attitudes Toward Health Care Teams Scale. The measure contains two subscales: Quality of Care/Process (14 items) and Physician Centrality (6 items). The Quality of Care/Process subscale measures team members' perceptions of the quality of care delivered by health care teams and the quality of teamwork to accomplish this. The Physician Centrality subscale measures team members' attitudes toward physicians' authority in teams and their control over information about patients. Tests of reliability and validity demonstrate that each subscale is a strong measure of its respective underlying concept. The measure has potential for use as a research tool and as a pre- and posttest tool for educational interventions with teams and for evaluating clinically based team training programs for medical and health professions students and residents.
After presenting a theory of team development, we propose that the informal role structure of a team is dependent upon the degree of anomie in the team culture, and we provide measures of anomie and informal roles that can be used in field settings. Then we test hypotheses on a national sample of 111 interdisciplinary health care teams in geriatrics in US Veterans Affairs medical centers. We find evidence that as teams develop from early to later stages, the interpersonal behavior of members becomes less differentiated on three dimensions: prominence, sociability, and task-orientation. In addition, we find that images of each member come into clearer focus, as evidenced by reduced variation in how each member is seen by other team members. Finally, we find that regardless of stage of team development, the more education the team members have, the more prominent and task-oriented they are. In general, physicians score highest in prominence and task-orientation, but relatively low in sociability.
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