What do doctors mean when they talk about teamwork? Possible implications for interprofessional care

Abstract

The concept of teamwork has been associated with improved patient safety, more effective care and a better work environment. However, the academic literature on teamwork is pluralistic, and there are reports on discrepancies between theory and practice. Furthermore, healthcare professionals' direct conceptualizations of teamwork are sometimes missing in the research. In this study, we examine doctors' conceptualizations of teamwork. We also investigate what doctors think is important in order to achieve good teamwork, and how the empirical findings relate to theory. Finally, we discuss the methodological implications for future studies. The research design was explorative. The main data consisted of semi-structured interviews with twenty clinically active doctors, analyzed with conventional content analysis. Additional data sources included field observations and interviews with management staff. There was large variation in the doctors' conceptualizations of teamwork. The only characteristic they shared in common was that team members should have specific roles. This could have consequences for practice, because the rationale behind different behaviors depends on how teamwork is conceptualized. Several of the teamwork-enabling factors identified concerned non-technical skills. Future studies should put more emphasis on the practitioners' perspective in the research design, to create a more grounded foundation for both research and practice.

Medical professionalism research characteristics and hotspots: a 10-year bibliometric analysis of publications from 2010 to 2019

“…Having the lowest intra-cluster correlation and what is considered to be relatively peripheral development compared with clusters 1, 3, and 5, cluster 4 covers several subtopics related to healthcare professionals, such as knowledge, attitudes, and associated behaviors pertaining to health-related topics (Deniz et al, 2018 ; Sinclair et al, 2018 ), role in patient care teams, and interprofessional experiences in healthcare (Håkansson et al, 2019 ; Rydenfält et al, 2019 ). In this study, the target population on professionalism research mostly comprised physicians and medical students (Berger et al, 2020 ; Birden et al, 2013 ; Li et al, 2017 ).…”

Constructing shared understanding in interprofessional client sessions

“…Question-driven discussion can be driven in part by the hierarchical position of the doctor. Doctors are accustomed to having a leading role in interprofessional health care teams and their medical orientation can be dominant, thus naturally affecting the nature of interaction within the team (Dryden and Mytton 1999;Glaser and Suter 2015;Rydenfält, Borell, and Erlingsdottir 2018). From the dialogical point of view it was obvious that when symptom descriptions were reduced, there was more space for other questions related to the client's life.…”

“…The fourth form of interaction, cooperation, differs from the previous ones due to its inclusion of a shared focus and targets, which are achieved through mutual contracts between professionals and the client. This cannot yet be classed as collaboration because trust and common innovations are still lacking (Engeström 1992;Isaacs 1999;Tsoukas 2009;Yankelovich 2001;Rydenfält, Borell, and Erlingsdottir 2018). Collaboration is associated with confidence, which diminishes the need for control.…”

“…Insufficient understanding of the role of other professions can also negatively affect interprofessional collaboration. (Bayne-Smith et al 2014;Glaser and Suter 2015;Best and Williams 2018;Rydenfält, Borell, and Erlingsdottir 2018. ) The meaning of interaction and collaboration and how these are actually realized in interprofessional collaboration is, however, less clearly understood.…”

Non-technical Skills in Healthcare

“…Be it in a community health service or a large hospital, teams come in many forms: teams overlapping with other teams, teams nested within teams, teams dispersed in time and geographical space. It is therefore not surprising that there is a large variation among doctors in their conceptualisations of what and where teams are [100]. It may not be obvious to an individual practitioner where the team is, or even if one exists, for the task they are trying to perform.…”