A scoping review of approaches for measuring ‘interdependent’ collaborative performances

Abstract

Introduction: Individual assessment disregards the team aspect of clinical work. Team assessment collapses the individual into the group. Neither is sufficient for medical education, where measures need to attend to the individual while also accounting for interactions with others. Valid and reliable measures of interdependence are critical within medical education given the collaborative manner in which patient care is provided. Medical education currently lacks a consistent approach to measuring the performance between individuals working together as part of larger healthcare team. This review's objective was to identify existing approaches to measuring this interdependence.Methods: Following Arksey & O'Malley's methodology, we conducted a scoping review in 2018 and updated it to 2020. A search strategy involving five databases located >12 000 citations. At least two reviewers independently screened titles and abstracts, screened full texts (n = 161) and performed data extraction on twentyseven included articles. Interviews were also conducted with key informants to check if any literature was missing and assess that our interpretations made sense.Results: Eighteen of the twenty-seven articles were empirical; nine conceptual with an empirical illustration. Eighteen were quantitative; nine used mixed methods. The articles spanned five disciplines and various application contexts, from online learning to sports performance. Only two of the included articles were from the field of Medical Education. The articles conceptualised interdependence of a group, using theoretical constructs such as collaboration synergy; of a network, using constructs such as degree centrality; and of a dyad, using constructs such as synchrony. Both descriptive (eg social network analysis) and inferential (eg multi-level modelling) approaches were described. Conclusion:Efforts to measure interdependence are scarce and scattered across disciplines. Multiple theoretical concepts and inconsistent terminology may be limiting programmatic work. This review motivates the need for further study of measurement techniques, particularly those combining multiple approaches, to capture interdependence in medical education.

Interdependence is one of many factors that influences collaborative health care practice

“…Balmer, Rosenblatt and Boyer call for those training medical educators to 'recast belonging to multiple communities of practice as knowledgeability, not as tension or identity crisis'. 1 Reinterpreting the experience of multi-membership as a strength is welcome. In this commentary, I suggest that graduate programmes may go further and aim to equip students to capitalize on this knowledgeability by calving out legitimate zones in the peripheries, by becoming brokers at boundaries, and by handling the conflicts that often emerge from claims to multiple competencies.…”

“…This relationship has been termed interdependence and is defined as 'patterns of interaction between individuals, working collaboratively, that can afford or constrain one's performance and potentially shape the practice of a broader healthcare team' (page 2). 1 In their review paper, Sebok-Syer et al sought assessment approaches that included interdependent measures (ie those that consider both the individual and the team, with effort to capture both team and individual contributions). The concepts identified were diverse and only loosely related to health care assessment as it is typically operationalised: dyadic measurement (relevant to separating trainee from supervisor input), social network mapping (linking staff to certain clinical activities) and data mining and machine learning (eg linking Electronic Health Records to staff clicks).…”

“…Sebok‐Syer et al 1 describe that while clinical care is delivered collaboratively in a team, assessment of performance in that team is individual. This creates a conceptual paradox as we tend to think of competencies as residing in individuals yet the performance of a student or trainee is influenced by the team in which they work and by the clinical supervision they receive.…”

“…This creates a conceptual paradox as we tend to think of competencies as residing in individuals yet the performance of a student or trainee is influenced by the team in which they work and by the clinical supervision they receive. This relationship has been termed interdependence and is defined as ‘patterns of interaction between individuals, working collaboratively, that can afford or constrain one's performance and potentially shape the practice of a broader healthcare team’ (page 2) 1 …”

Optimising expert dyad performance in acute care settings: a scoping review protocol

“…It is based on input, process and reflection. 3 Sebok-Seyer et al 4 published a scoping review on the approaches for measuring 'interdependent' collaborative performances and found a strong level of interdependence between dyads of trainees and their supervisors. The learning practices of novices and experts and the interdependence between them is very different.…”