The Role of Teamwork in the Professional Education of Physicians: Current Status and Assessment Recommendations

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Article-at-a-Glance

Background

The Institute of Medicine (IOM) has recommended that organizations establish interdisciplinary team training programs that incorporate proven methods for team management. Teamwork can be assessed during physician medical education, board certification, licensure, and continuing practice. Team members must possess specific knowledge, skills, and attitudes (KSAs), such as the ability to exchange information, which enable individual team members to coordinate.

Assessing Physician Teamwork

KSAs might be elicited and assessed across a physician’s career, starting in medical school and continuing through licensure and board certification. Professional bodies should be responsible for the development of specific team knowledge and skill competencies and for promoting specific team attitude competencies. Tools are available to assess medical student, resident, and physician competence in these critical team KSAs.

Challenges and Complexities in Team Performance Measurement

For teamwork skills to be assessed and have credibility, team performance measures must be grounded in team theory, account for individual and team-level performance, capture team process and outcomes, adhere to standards for reliability and validity, and address real or perceived barriers to measurement.

Section snippets

Teamwork and Patient Safety

A tired anesthesiologist is asked to place an epidural at 3:00 a.m. Midway through the procedure, the nurse notices that before securing the epidural space, he is drawing up lidocaine into the epidural syringe instead of saline. She states, “That’s interesting, is that how you do epidurals now?” The anesthesiologist looks at his hands, notices the error, and corrects it.

A nurse notices that a colleague is assigned to care for the next caesarian section patient, but that she also has to care for

Assessing Physician Teamwork

Measuring physician teamwork in professional medical education is a challenging proposition. Therefore, we have focused on process as opposed to outcome measures—where, we believe, the greatest challenges and opportunities for improvement reside.

In the sections that follow, we describe the roles of different regulatory bodies in assessing team performance of physicians, where and when these assessments might take place, and how performance might be measured. These issues, in combination with

Summary

In this section, we presented our recommendations as to how team KSAs might be elicited and assessed across a physician’s career, starting in medical school and continuing through licensure and board certification. We advocate that the various professional bodies be responsible for the development of specific team knowledge and skill competencies and for promoting specific team attitude competencies. In addition, we identified tools that could be used to assess medical student, resident, and

Challenges and Complexities in Team Performance Measurement

For teamwork skills to be assessed and to have credibility within health care, five challenges in physician team performance measurement must be carefully considered.

Conclusions

To successfully embed team training throughout a physician’s professional training, we recommend that the medical community continue to inform itself of the progress of this science through a variety of venues, such as specialized workshops and books. We recommend that the medical community enlist the help of team-training experts to apply these principles and guidelines to advance the care of patients. We believe that the timing is right to support such an initiative. A combination of

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      Measurement elements were approved with only minor semantic changes. The final teamwork measurement tool contained 28 teamwork indictors (see Table 4): 21 of the indicators reported by Baker et al. (2005); four items resulting from the de-confliction of two compound indicators; and two newly generated indicators. A repeated measures design was used.

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    The work described in this article was performed by the American Institutes for Research under contract to the Agency for Healthcare Research and Quality (AHRQ) and the TRICARE Management Activity, Department of Defense (DoD) (Contract No. 282-98-0029, Task Order No. 54). The views herein are those of the authors and are not to be construed as official or as reflecting the views of AHRQ, the DoD, or the United States Department of Health and Human Services.

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