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

Abstract

Guided by the principles of conversation analysis, we examined the communication practices used to negotiate levels of participation in cancer multidisciplinary team meetings and their implications for patient safety. Three cancer teams participated. Thirty-six weekly meetings were video recorded, encompassing 822 case reviews. A cross-section was transcribed using Jefferson notation. We found a low frequency of gaps between speakers (3%), high frequency of overlaps (24%), and no-gaps-no-overlaps (73%), suggesting fast turn transitions. Securing a turn to speak is challenging due to a systematic reduction in turn-taking opportunities. We contribute to group research with the development of a microlevel methodology for studying multidisciplinary teams.

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

“…There were no overlaps between teams i.e., members were not participants of more than one team. Detailed breakdown of team composition has been reported elsewhere (Soukup et al, 2020b). The data on team interaction and the analyses reported here are novel and have not been published previously.…”

“…Partial correlation analysis controlling for team/tumor type (i.e., breast, colorectal, and gynecological MDTs) and case complexity (using MeDiC) was used to explore the relationship between internal and external factors and team interactions. For the categorical variables, such as disciplinary Soukup et al (2020b). CC BY-NC-ND.…”

“…From the perspective of patient safety (Leonard et al, 2004;Vincent, 2010;Francis, 2015;Gluyas, 2015), optimal healthcare teams (Weller et al, 2014;Soukup et al, 2020b), and team decision-making (Orlitzky and Hirokawa, 2001;Hollingshead et al, 2005;Kugler et al, 2012;Forsyth, 2014;Kettner-Polley, 2016), effective interaction and communication are at the center of effective teamwork. The most influential theory of group decision-making, namely the functional perspective (Figure 1), and the associated research evidence, suggest that variability in team performance is attributable to human factors.…”

Development and Validation of a Short Version of the Metric for the Observation of Decision-Making in Multidisciplinary Tumor Boards: MODe-Lite

“…A detailed team composition breakdown has been published previously. 12,22,23 Ethical approvals were given by the North West London Research Ethics Committee and locally by the participating hospitals as part of the original research. 23 Oral and written consents were given by the team members.…”

Is patient participation in multidisciplinary tumour conferences associated with their information needs? A multicentre prospective observational study

“…15 On the other hand, MTCs are often very fast-paced technical meetings in which information that is potentially life changing for individual patients is encoded in specialised medical terms and abbreviations. 18 Rather than satisfying patients' information needs, such a setting can run the risk of overburdening patients both cognitively and emotionally. This may result in the opposite of the intended effect, namely confusion, and even an increase in anxiety.…”