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Assessment of Teams/Teamwork: A Critical Synthesis

Assessment of Teams/Teamwork: A Critical Synthesis. Hollis Day, MD, MS Susan Meyer, PhD. Background. Four domains for effective practice outlined in the Interprofessional Education Collaborative’s “Core Competencies for Interprofessional Collaborative Practice:” values/ethics

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Assessment of Teams/Teamwork: A Critical Synthesis

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  1. Assessment of Teams/Teamwork: A Critical Synthesis Hollis Day, MD, MS Susan Meyer, PhD

  2. Background • Four domains for effective practice outlined in the Interprofessional Education Collaborative’s“Core Competencies for Interprofessional Collaborative Practice:” • values/ethics • roles/responsibilities • communication • teams/teamwork

  3. Background • Most health professions have interprofessional education as expectations in their accreditation standards • There is a need to evaluate a learner’s ability to work and communicate effectively in teams • To date, few validated tools for assessment of interprofessional competency attainment have been identified

  4. Objectives • Identify tools used in healthcare settings to assess the performance of teams • Propose how these tools might be translated into the medical education environment • Authors chose the one domain of “Teams/Teamwork” to determine if there was a tool or tools that evaluated each of the 11 individual competencies

  5. Teams/Teamwork Competencies

  6. Methods • Teamwork, teamwork assessment and valid • Databases included: PubMed, HaPI, ERIC, PsychInfo, Cochrane Library • Bibliographies of articles were hand searched as well • Tools assessed measured performance of teams of two or more healthcare providers, including a physician and at least one other health professional

  7. Methods: Inclusion criteria of articles • Included articles reported measures of reliability and validity • Only articles published in English were reviewed

  8. Methods: Exclusion criteria • Conference abstracts and articles that focused on patient care outcomes • Attitudinal questionnaires as we were seeking instruments that assessed specific behaviors

  9. Methods • Authors independently reviewed each of the tools and mapped individual elements of the tools to one of the Teams/Teamwork competencies • Discrepancies were discussed and mutually resolved

  10. Methods • TT3 and 4 (Engaging other healthcare professionals and integrating the knowledge and experience of other health professionals in shared decision making) were collapsed into one item for the purposes of tool development as it was difficult to identify differences between the two competencies when looking at existing tools

  11. Results • 2281 references were identified • From these references, 68 unique tools with reported validity and reliability or use in multiple settings were chosen • No one tool evaluated all of the Team/Teamwork competencies • There were no tools that assessed TT2 and few tools outlined behaviors for TT1 or TT11

  12. Sample Mapping Strategy

  13. Sample Mapping Strategy

  14. Mapping to Our Tool

  15. Mapping to Our Tool

  16. Final Tool Items • The team establishes a leader.  • The team assigns roles and responsibilities. • The team engages all relevant team members in decision making, integrating individual assessments of patient needs. • The team leader varies depending upon the situation. • The team leader showed an appropriate balance between authority and openness to suggestions. • The team leader recognizes contributions of team members. • The team agrees upon and uses a process to resolve conflicts to determine not who is right but what is right for the situation. • Team members mutually agree upon goals.

  17. Final Tool Items Con’t • Team members seek assistance when needed. • Team members provide assistance when needed. • Team members respectfully correct each other's mistakes to ensure that procedures are followed properly. • Team members openly talk about what is and isn't working. • The team gets, gives, and uses feedback about its effectiveness and productivity. • Team members refer to established protocols/checklists for the procedure/intervention. • Team member skills overlap sufficiently for work to be shared when necessary. • When appropriate, roles are shifted to address changing situations.

  18. Translating to Educational Setting

  19. Limitations • Articles only in English • We did not explicate TT2 on our tool • All tools created for physician engagement • Tools are often context specific so taking them out of context may change their designated purpose

  20. Conclusions • While there are multiple tools addressing teamwork in healthcare, no one tool addresses all of the competencies in the teamwork domain • It is possible through an iterative process to develop a tool that can be applied to the educational setting

  21. Future Directions • Further refine and validate the tool • Informed item development for TT2 • Identify ways in which this tool may assist residency and health science schools in meeting accreditation standards

  22. Future Directions: Immediate • Presented at All Together Better Health • Interest in participating in validation

  23. Thanks • SDRME for funding this project • Maria Magone for outstanding research assistance

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