An Integrated Literature Review of Time-on-Task Effects With a Pragmatic Framework for Understanding and Improving Decision-Making in Multidisciplinary Oncology Team Meetings

Relationships Between Communication, Time Pressure, Workload, Task Complexity, Logistical Issues and Group Composition in Transdisciplinary Teams: A Prospective Observational Study Across 822 Cancer Cases

“…Time-workload pressure and time spent making decisions were both associated with reduced frequency of task-oriented communication (i.e., asking questions and providing answers), and acts of solidarity, which is expected given that they are both barriers to team decision-making (Soukup et al, 2020a). However, despite no association with negative socio-emotional interactions (contrary to H1c), we found that the more cases the team reviews in a meeting, the higher the frequency of tension and disagreeing; a finding that is in line with the previous study showing an increase in negative and decrease in positive socioemotional interactions in the meeting (Soukup et al, 2020a), other work in the field focused on time-workload pressure (Kane and Luz, 2013), and the time-on-task effects previously recorded in MDT meetings including also other clinical settings (Soukup et al, 2019b).…”

“…Firstly, with minimal additional resource, a cancer team could reduce the size of meeting attendees and implement staff selection to ensure gender balance, while preserving the professional diversity necessary for clinical decision-making. A cancer team with particularly long meetings and high workload could introduce a short break with refreshments (Soukup et al, 2019b). Secondly, with some additional resource, a cancer team could appoint a trained, clinically non-contributing meeting chair to help effectively navigate interaction and communication process between disciplines, ensuring a uniformly better decisionmaking process for all patients reviewed by the MDT (Soukup et al, 2018).…”

Gaps and Overlaps in Cancer Multidisciplinary Team Communication: Analysis of Speech

“…Such interactive setting can contribute to systematic reduction in turn-taking opportunities and present with difficulties in securing one's turn to speak (Goodwin & Heritage, 1990). Hence, the observed inequality of participation that has been observed from a macroperspective in previous studies (see Soukup et al 2019b). This speaking challenge may intensify or lessen depending on the team members' seniority (see Cosby & Croskerry, 2004;Kohn et al, 2000;Vincent, 2010), which could drive the ability to secure one's turn to speak successfully, and effectively contribute to a case discussion.…”

“…Accordingly, there remains much to be explored at a micro-level; in particular how individual professionals, or professional groups, communicate and interact, as well as the development of feasible methodologies to capture such interactions. Teams in general are considered complex adaptive systems (Ramos-Villagrasa, et al, 2018) with professional meetings, such are cancer MDMs, a particularly intricate setting for studying groups (Halvorsen & Sarangi, 2015;Soukup et al, 2019b). The lack of qualitative and hybrid methods (Dinh et al, 2020) may be partly driven by the immense time and resource investment required by existing GAPS AND OVERLAPS IN TEAM COMMUNICATION 5 5 tools and approaches for detailed micro-level observations and coding of team interactions (Jefferson, 2004;Kettner-Polley, 2016;Soukup et al, 2017).…”

“…For instance, the preliminary evidence from studies of cancer MDMs suggests that the prolonged reviewing of sequential cases has a negative impact on the quality of treatment recommendations for patients (see Lamb et al, 2013;Soukup et al, 2091aSoukup et al, , 2019b. Better quality decisions were associated with discussing patients at the beginning of the MDM.…”