Are we at risk of groupthink in our approach to teamwork interventions in health care?

Abstract:

CONTEXT:The incidence of medical error, adverse clinical events and poor quality health care is unacceptably high and there are data to suggest that poor coordination of care, or teamwork, contributes to adverse outcomes. So, can we assume that increased collaboration in multidisciplinary teams improves performance and health care outcomes for patients? METHODS:In this essay, the authors discuss some reasons why we should not presume that collective decision making leads to better decisions and collaborative care results in better health care outcomes. RESULTS:Despite an exponential increase in interventions designed to improve teamwork and interprofessional education (IPE), we are still lacking good quality data on whether these interventions improve important outcomes. There are reasons why some of the components of 'effective teamwork', such as shared mental models, team orientation and mutual trust, could impair delivery of health care. For example, prior studies have found that brainstorming results in fewer ideas rather than more, and hinders rather than helps productivity. There are several possible explanations for this effect, including 'social loafing' and cognitive overload. Similarly, attributes that improve cohesion within groups, such as team orientation and mutual trust, may increase the risk of 'groupthink' and group conformity bias, which may lead to poorer decisions. CONCLUSIONS:In reality, teamwork and IPE are not inherently good, bad or neutral; instead, as with any intervention, their effect is modified by the persons involved, the situation and the interaction between persons and situation. Thus, rather than assume better outcomes with teamwork and IPE interventions, as clinicians and educators we must demonstrate that our interventions improve the delivery of health care.

journal_name

Med Educ

journal_title

Medical education

authors

Kaba A,Wishart I,Fraser K,Coderre S,McLaughlin K

doi

10.1111/medu.12943

subject

Has Abstract

pub_date

2016-04-01 00:00:00

pages

400-8

issue

4

eissn

0308-0110

issn

1365-2923

journal_volume

50

pub_type

杂志文章
  • Computer-aided learning in the real world of medical education: does the quality of interaction with the computer affect student learning?

    abstract:BACKGROUND:Computerised learning clearly offers exciting potential for improving student learning, either as an aid to or as a replacement for traditional formats, or for the development of innovative approaches. However, rigorous evaluation of the utility of computer-aided learning (CAL) in enhancing student learning ...

    journal_title:Medical education

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1365-2929.2004.01892.x

    authors: Hudson JN

    更新日期:2004-08-01 00:00:00

  • Portfolio use in general practice vocational training: a survey of GP registrars.

    abstract:BACKGROUND:Portfolios are increasingly advocated in medical education. Qualitative studies have suggested their value in stimulating experiential learning, promoting deep learning and encouraging reflection. This study explored the use of educational portfolios in reflective learning by general practice (GP) registrars...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2004.01737.x

    authors: Pearson DJ,Heywood P

    更新日期:2004-01-01 00:00:00

  • Resident doctors' understanding of their roles as clinical teachers.

    abstract:INTRODUCTION:Limited data illuminate how resident doctors view their important roles as teachers, supervisors and role models. Analysing qualitative data about resident teachers' self-perceptions can offer helpful insights. METHODS:One year after a randomised trial of a residents-as-teachers curriculum at a university...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2929.2004.02063.x

    authors: Morrison EH,Shapiro JF,Harthill M

    更新日期:2005-02-01 00:00:00

  • Project work in the medical curriculum.

    abstract::This paper outlines one component, the project, which in 4 years became an integral part of the Human Ecology course at the Department of Community Medicine at the University of Glasgow. Although it is to be retained in some form, it would seem that the full potential of the device for medical undergraduates has not b...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1984.tb01012.x

    authors: Craddock MJ

    更新日期:1984-07-01 00:00:00

  • Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan.

    abstract:OBJECTIVES:This study analyses and discusses recent changes in young Japanese doctors' career paths, in terms of their distribution in different types of facilities and specialties, following changes to the postgraduate clinical training system in 2004. METHODS:Data from the National Survey of Physicians, Dentists and...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2009.03582.x

    authors: Koike S,Ide H,Yasunaga H,Kodama T,Matsumoto S,Imamura T

    更新日期:2010-03-01 00:00:00

  • Interactive video in medical education: a program on jugular venous pressure and the cardiac cycle.

    abstract::Interactive video is a new teaching medium that has much potential in medical education. Hitherto, the realization of this potential has been restrained by lack of awareness among medical teachers of the advantageous features provided and how to implement them, while computer specialists lack the required medical know...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1991.tb00044.x

    authors: Jamison JP,Brannigan P

    更新日期:1991-03-01 00:00:00

  • Development of a tool to support holistic generic assessment of clinical procedure skills.

    abstract:CONTEXT:The challenges of maintaining comprehensive banks of valid checklists make context-specific checklists for assessment of clinical procedural skills problematic. OBJECTIVES:This paper reports the development of a tool which supports generic holistic assessment of clinical procedural skills. METHODS:We carried ...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2923.2008.03023.x

    authors: McKinley RK,Strand J,Gray T,Schuwirth L,Alun-Jones T,Miller H

    更新日期:2008-06-01 00:00:00

  • Doctors' knowledge of the costs of medical care.

    abstract::In achieving a more effective use of resources in the National Health Service (NHS), the medical profession has a role to play by improving cost efficiency in clinical practice. This role implies that doctors should have some knowledge of medical costs. In order to determine the extent of this knowledge, sixty-seven h...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1985.tb01150.x

    authors: Fowkes FG

    更新日期:1985-03-01 00:00:00

  • British medical undergraduates in 1975: a student survey in 1975 compared with 1966.

    abstract::Undergraduate medical education in Britain has been in a state of change since before the introduction of the National Health Service. Since then the changes in the General Medical Councils's recommendations concerning the medical curriculum (1947, 1957, 1967) have accompanied attention to curricular content, and the ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1976.tb01484.x

    authors: Donnan SP

    更新日期:1976-09-01 00:00:00

  • Influence of new educational technology on problem-based learning at Harvard Medical School.

    abstract:PURPOSE:Computers with 50-inch, wall-mounted plasma screens and broadband Internet access were installed in all small group tutorial rooms at Harvard Medical School. This study examines how the introduction of this educational technology impacted on the problem-based learning tutorials. METHOD:A total of 37 tutorial g...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2929.2005.02105.x

    authors: Kerfoot BP,Masser BA,Hafler JP

    更新日期:2005-04-01 00:00:00

  • Medical students' attitudes to psychiatric illness in primary care.

    abstract:CONTEXT:Previous research has shown that general practitioners (GPs) hold negative attitudes towards patients with schizophrenia, which do not simply reflect the nature or chronic aspects of the illness. This study aimed to describe the attitudes and predicted behaviour of medical students towards patients with mental ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2008.03183.x

    authors: Dixon RP,Roberts LM,Lawrie S,Jones LA,Humphreys MS

    更新日期:2008-11-01 00:00:00

  • Activating prior knowledge using multiple-choice question distractors.

    abstract:CONTEXT:A student's academic success in graduate and professional school may depend on prior knowledge. However, these students may not see important and necessary material for extended periods of time between their pre-requisites and their new course work. As such, they are more prone to being unable to access availab...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.14162

    authors: Schimmelfing LC,Persky AM

    更新日期:2020-10-01 00:00:00

  • Evidence-based education: development of an instrument to critically appraise reports of educational interventions.

    abstract:OBJECTIVES:Educational interventions may ultimately impact on patient care as well as affecting individuals' learning. Critical evaluation of educational literature by those involved in designing and developing educational interventions is therefore important. A checklist instrument for critically appraising reports of...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1999.00479.x

    authors: Morrison JM,Sullivan F,Murray E,Jolly B

    更新日期:1999-12-01 00:00:00

  • Effects of morning report case presentation on length of stay and hospitalisation costs.

    abstract:CONTEXT:The primary goal of discussing patient cases during the morning report is to teach appropriate clinical decision making. In addition, the selection of the best diagnostic strategy and application of evidence-based patient care are important. Reducing hospital costs is fundamental to controlling inflation in hea...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.12152

    authors: Boushehri E,Khamseh ME,Farshchi A,Aghili R,Malek M,Ebrahim Valojerdi A

    更新日期:2013-07-01 00:00:00

  • 'Part of the team': professional identity and social exclusivity in medical students.

    abstract:OBJECTIVES:Medical students must develop not only their professional identity but also inclusive social attitudes for effective medical practice in the future. This study explores the elements that contribute to medical students' sense of professional identity and investigates the concept of social exclusivity and how ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2011.04046.x

    authors: Weaver R,Peters K,Koch J,Wilson I

    更新日期:2011-12-01 00:00:00

  • Script concordance testing: a review of published validity evidence.

    abstract:CONTEXT:Script concordance test (SCT) scores are intended to reflect respondents' competence in interpreting clinical data under conditions of uncertainty. The validity of inferences based on SCT scores has not been rigorously established. OBJECTIVES:This study was conducted in order to develop a structured validity a...

    journal_title:Medical education

    pub_type: 杂志文章,评审

    doi:10.1111/j.1365-2923.2010.03863.x

    authors: Lubarsky S,Charlin B,Cook DA,Chalk C,van der Vleuten CP

    更新日期:2011-04-01 00:00:00

  • Psychological size and distance: emphasising the interpersonal relationship as a pathway to optimal teaching and learning conditions.

    abstract:BACKGROUND:Positive interpersonal relationships between teachers and learners increase the quality of learning. The purpose of this study was to investigate psychological size (perceived status) and psychological distance (perceived emotional connectedness) in medical teaching interactions and their impact on the teach...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2929.2004.01952.x

    authors: Vaughn LM,Baker RC

    更新日期:2004-10-01 00:00:00

  • Student assessment in community settings: a comprehensive approach.

    abstract::Student assessment in community settings presents problems for medical teachers, e.g., difficulties in assessing the contribution of individual members to group work, and lack of test standardization due to varying field conditions. The Faculty of Medicine, University of Gezira, Sudan is a community-oriented, communit...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.1998.00151.x

    authors: Magzoub ME,Schmidt HG,Abdel-Hameed AA,Dolmans D,Mustafa SE

    更新日期:1998-01-01 00:00:00

  • Standard setting in an objective structured clinical examination: use of global ratings of borderline performance to determine the passing score.

    abstract:BACKGROUND:Objective structured clinical examination (OSCE) standard-setting procedures are not well developed and are often time-consuming and complex. We report an evaluation of a simple 'contrasting groups' method, applied to an OSCE conducted simultaneously in three separate schools. SUBJECTS:Medical students unde...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.2001.01041.x

    authors: Wilkinson TJ,Newble DI,Frampton CM

    更新日期:2001-11-01 00:00:00

  • Reliability of global rating scales in the assessment of clinical competence of medical students.

    abstract::Undergraduate medical students of the Ben Gurion University were evaluated upon completion of their fourth- and sixth-year medical clerkships by a 17-item rating scale, a multiple choice question (MCQ) test and a patient-oriented oral examination by two academic staff members. Pearson's correlation coefficient between...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1987.tb01406.x

    authors: Keynan A,Friedman M,Benbassat J

    更新日期:1987-11-01 00:00:00

  • The place of primary health care in medical education in the United Kingdom: a survey.

    abstract::Primary health care has been held to be the foundation of any rational health system. The principle was fully endorsed by the Alma-Ata Conference in 1978, and has become the main policy of the World Health Organization. Important implications are involved for the education and training of doctors and other health care...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1983.tb00653.x

    authors: Walton HJ

    更新日期:1983-05-01 00:00:00

  • Ethnography in health professions education: Slowing down and thinking deeply.

    abstract:CONTEXT:Ethnography has been gaining appreciation in the field of health professions education (HPE) research, yet it remains misunderstood. Our article contributes to this growing literature by describing some of the key tensions with which both aspiring and seasoned ethnographers should productively struggle. METHOD...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.14033

    authors: Bressers G,Brydges M,Paradis E

    更新日期:2020-03-01 00:00:00

  • The impact of an individual tutorial session on MEDLINE use among obstetrics and gynaecology residents in an academic training programme: a randomized trial.

    abstract::Over the past decade, on-line databases have become increasingly popular among health care professionals. As a group, these 'end-users' report utilizing databases to keep abreast of medical progress, to conduct research and to address specific patient care issues. Throughout the literature, medical professionals ('con...

    journal_title:Medical education

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1046/j.1365-2923.1998.00229.x

    authors: Erickson S,Warner ER

    更新日期:1998-05-01 00:00:00

  • The place of science in the health professions.

    abstract::The central premise of this paper is that medical education today is being driven by intellectual and social imperatives to make fundamental changes in the way it prepares students to be the doctors of tomorrow. Fully aware that over the past 50 years at least eight major national commissions in the USA alone have mad...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1995.tb02897.x

    authors: Bloom SW

    更新日期:1995-01-01 00:00:00

  • Community-based medical education: feasibility and cost.

    abstract::The General Medical Council has issued a call for an increase in community-based medical education, and many medical schools are enhancing the community component of their curricula. This paper uses the experience of a community-based junior medical firm to explore the potential costs, and highlight some of the unreso...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1995.tb02804.x

    authors: Murray E,Jinks V,Modell M

    更新日期:1995-01-01 00:00:00

  • Cognitive flow in health care settings: A systematic review.

    abstract:INTRODUCTION:The state of cognitive flow, colloquially known as being 'in the zone', has been linked with enhanced performance, happiness, career satisfaction and decreased burnout. However, the concept has not been adopted strongly in health care training, continuing professional development, or daily practice. A syst...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/medu.14435

    authors: McQueen S,Jiang S,McParland A,Hammond Mobilio M,Moulton CA

    更新日期:2020-12-12 00:00:00

  • Assessing procedural skills in context: Exploring the feasibility of an Integrated Procedural Performance Instrument (IPPI).

    abstract:BACKGROUND:The assessment of clinical procedural skills has traditionally focused on technical elements alone. However, in real practice, clinicians are expected to be able to integrate technical with communication and other professional skills. We describe an integrated procedural performance instrument (IPPI), where ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2929.2006.02612.x

    authors: Kneebone R,Nestel D,Yadollahi F,Brown R,Nolan C,Durack J,Brenton H,Moulton C,Archer J,Darzi A

    更新日期:2006-11-01 00:00:00

  • Student population changes and progress in Belgian medical schools.

    abstract::The present study was designed to analyse the evolution of student populations--undergraduates and graduates--in the 11 Belgian medical schools from 1969 to 1982. During this period, an overall 44% drop in the number of entrants was observed, while the number of medical graduates continued to rise until 1977, when it ...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.1989.tb00810.x

    authors: Albert A,Firket H,Castermans A

    更新日期:1989-01-01 00:00:00

  • Associations between emotional intelligence and doctor burnout, job satisfaction and patient satisfaction.

    abstract:CONTEXT:The occupational health literature has long been dominated by stress-related topics. A more contemporary perspective suggests using a positive approach in the form of a health model focused on what is right with people, such as feelings of well-being and satisfaction. OBJECTIVES:Using a positive perspective an...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1111/j.1365-2923.2011.03985.x

    authors: Weng HC,Hung CM,Liu YT,Cheng YJ,Yen CY,Chang CC,Huang CK

    更新日期:2011-08-01 00:00:00

  • Changes in student approaches to learning with the introduction of computer-supported problem-based learning.

    abstract:OBJECTIVES:To study changes in student approaches to learning following the introduction of computer-supported, problem-based learning. SETTING:Medical students at the University of Oslo undertake a 12-week period of clinical placement during their 10th term. In this period they continue to undertake problem-based lea...

    journal_title:Medical education

    pub_type: 杂志文章

    doi:10.1046/j.1365-2923.2004.01786.x

    authors: Strømsø HI,Grøttum P,Hofgaard Lycke K

    更新日期:2004-04-01 00:00:00