Perceived Team Effectiveness Research Articles

Improving students' perceptions of team effectiveness through an interprofessional community practicum course

Abstract In order to accomplish the improved population health component of the Triple Aim, it is necessary to develop students as collaboration-ready to serve in communities with skills to improve population health. The current paper examined the extent to which the experience in an IPE practicum course strengthened undergraduate students' skills and perceptions of the effectiveness of their team while they learned to address the needs of their community members. The educational format was a semester-long IPE Community Practicum experience, where student work in interprofessional teams to implement a project with a community partner. The students were asked to complete the Healthcare Team Fitness Test at the beginning and end of the semester, which served as the data for our analyses. The results suggested significant improvement over the course of the semester in students' perceptions of their team's cohesiveness, team members' contribution, shared learning, shared leadership, and change compatibility. The evidence presented suggests that participation in an interprofessional community practicum improved students' perceptions that their team was effective and functioned well together.

The Effects of the Transforming Care at the Bedside Program on Perceived Team Effectiveness and Patient Outcomes.

The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. The intervention (the TCAB program) was implemented in 8 units in a multihospital academic health science center in Montreal, Quebec, Canada. The impact of TCAB interventions was measured using the Team Effectiveness (TCAB teams, n = 50), and Clostridium difficile-associated diarrhea and vancomycin-resistant Enterobacter rates (patient safety) and Hospital Consumer Assessment of Healthcare Providers and Systems (patient experience; n = 551 patients). The intervention was composed of 4 learning modules, each lasting 12 to 15 weeks of workshops held at the start of each module, combined with hands-on learning 1 day per week. Transforming Care at the Bedside teams also selected 1 key safety indicator to improve throughout the initiative. Pretest and posttest differences indicate improvement on the 5 team effectiveness subscales. Improvement in vancomycin-resistant Enterococcus rate was also detected. No significant improvement was detected for patient experience. These findings call to attention the need to support ongoing quality improvement competency development among frontline teams.

From similitude to success: The effects of facial resemblance on perceptions of team effectiveness.

Scant empirical research has focused on how impressions of teams are formed based on members' collective appearance, even though team photos are omnipresent in visual communications and teamwork is a common theme to elicit positive responses. Across 4 studies, we show that a subtle increase in the facial resemblance among team members enhances observers' evaluations of team effectiveness. This resemblance effect is mediated by perceived cooperative intent among team players. Furthermore, we demonstrate a reversal of the resemblance effect through the moderating role of information valence and extend the finding from team perception to behavioral intention. These results hold across different manipulations, contexts, stimuli, and sample characteristics. Collectively, this research presents the first empirical evidence that inferences based on facial morphology persist well beyond evaluations of individuals to influence the way a team, as a whole, is perceived.

Development and validation of the primary care team dynamics survey.

To develop and validate a survey instrument designed to measure team dynamics in primary care. We studied 1,080 physician and nonphysician health care professionals working at 18 primary care practices participating in a learning collaborative aimed at improving team-based care. We developed a conceptual model and administered a cross-sectional survey addressing team dynamics, and we assessed reliability and discriminant validity of survey factors and the overall survey's goodness-of-fit using structural equation modeling. We administered the survey between September 2012 and March 2013. Overall response rate was 68 percent (732 respondents). Results support a seven-factor model of team dynamics, suggesting that conditions for team effectiveness, shared understanding, and three supportive processes are associated with acting and feeling like a team and, in turn, perceived team effectiveness. This model demonstrated adequate fit (goodness-of-fit index: 0.91), scale reliability (Cronbach's alphas: 0.71-0.91), and discriminant validity (average factor correlations: 0.49). It is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes).

Advanced practice nursing, health care teams, and perceptions of team effectiveness.

This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

Emotions and effectiveness: driving and restraining forces of a group development

More and more, teams are a strategic fator to achieve organizational success. This way, an effective management of a team will lead to fulfil organizational and team goals. Several authors (e.g. Agazarian & Gantt, 2003; Miguez & Lourenço, 2001) are demonstrating that groups evolve over time and the best way to manage a group is considering its evolutionary basis and working on its driving and restraining forces. The present research aimed to find out more about how emotions and perceived team effectiveness impact the group development, because teams are emotional entities and emotions are associated with several outcomes (as motivation and commitment) as also the perception of work team effectiveness can work on benefit of the group. This is a quantitative study conducted by questionnaire and the sample is composed by 26 teams, comprising 142 employees, from all departments of an industrial company. The results pointed differences among group development phases concerning a) the expression of negative emotions, b) faking and suppressing emotions and c) perception of team effectiveness and, d) it also reinforced, a positive association between positive emotions and perception of team effectiveness. In order to contribute to a better management of teams, this research presents some practical implications to improve a leader’s role in coordinating a team to fulfil grupal and organizational outcomes.

The Relationship between Patients' Perceptions of Team Effectiveness and their Care Experience in the Emergency Department

BackgroundEffective teamwork is important in the fast-paced Emergency Department (ED) setting. Most of the teamwork literature addresses the provider's perspective of teamwork rather than the patient's perspective. ObjectiveExamine the relationship between patients' perceptions of teamwork and care experience in the ED. MethodsWe conducted a cross-sectional survey study of adult patients seen at the University of Pennsylvania ED during the fall of 2011. Patients rated overall satisfaction, pain management, trust, and confidence in the team and likelihood of treatment compliance (outcomes) and four components of team effectiveness (role clarity, shared goals, relationships, and job satisfaction) on a Likert scale. We examined the relationship between patients' perception of teamwork and the outcomes using multivariate analysis, controlling for sociodemographic factors. ResultsWe collected 1010 surveys. Patients rated the individual components of teamwork equally, with about 70% rating teamwork as “Very High.” Most patients who rated teamwork highly also rated their confidence and trust in their providers highly (80–90%) compared to 20% of those who rated teamwork lower. The relative risk ratios between high and low teamwork were 4.1 (95% confidence interval [CI] 2.8–5.9) for overall satisfaction, 3.9 (95% CI 2.7–5.8) for satisfaction with pain treatment, 5.3 (95% CI 3.6–7.8) for confidence in providers, and 1.9 (95% CI 1.5–2.5) for likelihood to follow-up treatment recommendations. ConclusionsPatient satisfaction and willingness to adhere to treatment recommendations are highly correlated with patients' perceptions of ED teamwork.

A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture

Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2–3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2–3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings.

Factors affecting university teaching team effectiveness in detached working environments

This paper presents the outcomes of a study of the factors that contribute to teaching team effectiveness in situations where team members rarely meet face to face. Academic faculty within a university Business School were asked to report the degrees to which they believed that the module teaching teams to which they belonged contained members who (1) were satisfied and committed, and (2) regarded their teams as cohesive and as engaging in reliable and useful internal communications. All the teams covered by the study operated in ‘detached’ manners. Team members’ perceptions of the presence within their teams of trust, shared understanding, disparate educational orientations among participants and certain leadership styles were also examined. A model of the determinants of detached team effectiveness was constructed and tested. The respondents’ opinions vis-à-vis levels of satisfaction, commitment, cohesion and the value of internal team communications were then compared with metrics concerning student satisfaction and rates of progression on specific modules. Trust, shared understanding, differences in educational orientation among team members, conflict and the frequency of (though not the length of time spent on) communications emerged as major influences on perceptions of team effectiveness. Teams that were regarded as operating effectively appeared to be associated with higher student satisfaction and progression ratings.

Conceptual framework of acute care nurse practitioner role enactment, boundary work, and perceptions of team effectiveness

This article describes a new conceptual framework for acute care nurse practitioner role enactment, boundary work and perceptions of team effectiveness. Acute care nurse practitioners contribute positively to patient care by enacting an expanded scope of practise. Researchers have found both positive and negative reactions to the introduction of acute care nurse practitioners in healthcare teams. The process of role enactment, shifting role boundaries, and perceptions of team effectiveness has been studied disparately. A framework linking team structures and processes to desirable outcomes is needed. Literature was obtained by searching CINAHL, PsycInfo, MedLine, PubMed, British Nursing Index, Cochrane Library, JSTOR Archive, Web of Science, and Google Scholar from 1985-2010. A descriptive multiple-case study was completed from March 2009-May 2009. A new conceptual framework describing how role enactment and boundary work affect perceptions of team effectiveness was developed by combining theoretical and empirical sources. The framework proposes proximal indicators used by team members to assess their team's performance. The framework identifies the inter-related dimensions and concepts that different stakeholders need to consider when introducing nurse practitioners in healthcare teams. Further study is needed to identify team-level outcomes that reflect the contributions of all providers to quality patient care, and explore the patients' and families' perceptions of team effectiveness following the introduction of acute care nurse practitioners. The new framework can guide decision-making and research related to the structures, processes, and outcomes of nurse practitioner roles in healthcare teams.

Explaining variation in perceived team effectiveness: results from eleven quality improvement collaboratives

Explore effectiveness of 11 collaboratives focusing on 11 different topics, as perceived by local improvement teams and to explore associations with collaborative-, organisational- and team-level factors. Evidence underlying the effectiveness of quality improvement collaboratives is inconclusive and few studies investigated determinants of implementation success. Moreover, most evaluation studies on quality improvement collaboratives are based on one specific topic or quality problem, making it hard to compare across collaboratives addressing different topics. A multiple-case cross-sectional study. Quality improvement teams in 11 quality improvement collaboratives focusing on 11 different topics. Team members received a postal questionnaire at the end of each collaborative. Of the 283 improvement teams, 151 project leaders and 362 team members returned the questionnaire. Analysis of variance revealed that teams varied widely on perceived effectiveness. Especially, members in the Prevention of Malnutrition and Prevention of Medication Errors collaboratives perceived a higher effectiveness than other groups. Multilevel regression analyses showed that educational level of professionals, innovation attributes, organisational support, innovative culture and commitment to change were all significant predictors of perceived effectiveness. In total, 27·9% of the individual-level variance, 57·6% of the team-level variance and 80% of the collaborative-level variance could be explained. The innovation's attributes, organisational support, an innovative team culture and professionals' commitment to change are instrumental to perceived effectiveness. The results support the notion that a layered approach is necessary to achieve improvements in quality of care and provides further insight in the determinants of success of quality improvement collaboratives. Understanding which factors enhance the impact of quality improvement initiatives can help professionals to achieve breakthrough improvement in care delivery to patients on a wide variety of quality problems.

Perceived enablers and obstacles to team effectiveness

This study assesses employee perceptions of factors that have the potential to contribute to or influence team effectiveness (communication and conflict management, leadership and motivation, diversity, social loafing) and, of the level of perceived team effectiveness in the organization. Biographical influences were also evaluated. A sample of 75 employees was drawn using cluster sampling. Data was collected using a self developed, precoded questionnaire whose psychometric properties were statistically assessed. Data was analyzed using descriptive and inferential statistics. The results indicate that leadership and motivation and, diversity significantly contribute to team effectiveness. Also, social loafing does prevail and has the potential to hinder team effectiveness. Recommendations to enhance team effectiveness are presented

Authentic Leadership: An Empirical Test of Its Antecedents, Consequences, and Mediating Mechanisms

The recent economic crisis as well as other disasters such as the oil spill in the Gulf of Mexico or the nuclear disaster in Japan has fanned calls for leaders who do not deny responsibility, hide information, and deceive others, but rather lead with authenticity and integrity. In this article, we empirically investigate the concept of authentic leadership. Specifically, we examine the antecedents and individual as well as group-level outcomes of authentic leadership in business (Study 1; n = 306) as well as research organizations (Study 2; n = 105). Findings reveal leader self-knowledge and self-consistency as antecedents of authentic leadership and followers’ satisfaction with supervisor, organizational commitment, and extra-effort as well as perceived team effectiveness as outcomes. The relations between authentic leadership and followers’ work-related attitudes as well as perceived team effectiveness are mediated by perceived predictability of the leader, a particular facet of trust. We discuss the implications of our findings for theory and practice and provide suggestions for advancing theory and research on authentic leadership in the future.

Advanced Practice Nursing, Health Care Teams, and Perceptions of Team Effectiveness

This article summarizes the results of an extensive review of the organizational and health care literature of advanced practice nursing (APN) roles, health care teams, and perceptions of team effectiveness. Teams have a long history in health care. Managers play an important role in mobilizing resources, guiding expectations of APN roles in teams and within organizations, and facilitating team process. Researchers have identified a number of advantages to the addition of APN roles in health care teams. The process within health care teams are dynamic and responsive to their surrounding environment. It appears that teams and perceptions of team effectiveness need to be understood in the broader context in which the teams are situated. Key team process are identified for team members to perceive their team as effective. The concepts of teamwork, perceptions of team effectiveness, and the introduction of APN roles in teams have been studied disparately. An exploration of the links between these concepts may further our understanding the health care team's perceptions of team effectiveness when APN roles are introduced. Such knowledge could contribute to the effective deployment of APN roles in health care teams and improve the delivery of health care services to patients and families.

Team Effectiveness in Primary Care Networks in Alberta

Primary care networks (PCNs) are interdisciplinary programs in a geographical area that are designed to improve patient care, team collaboration and appropriate resource allocation. They are one of government's approaches to delivering quality healthcare with finite resources. The primary objective of this study was to explore the level of perceived team effectiveness in PCNs within three former health regions in Alberta. A descriptive, cross-sectional, exploratory, semi-structured questionnaire study design was employed. Respondents identified five themes for strategies to improve team effectiveness. Although many factors and strategies were identified, more work is needed to explore the study's findings.

Does conflict shatter trust or does trust obliterate conflict? Revisiting the relationships between team diversity, conflict, and trust.

This article explores the interplay between trust and conflict as antecedents of team effectiveness. In the first cross-sectional study, two alternative path models are tested in a sample of 174 teams (897 participants) with the emergent states of task conflict, relationship conflict, and trust acting as mediators between team demographic diversity (gender and nationality) on the one hand and perceived team effectiveness on the other. In one model trust is considered as an antecedent for the two types of conflict, while in the other the two types of conflict precede the emergence of trust. Although the fit indices for the model in which trust is considered the antecedent of conflict were slightly better, both models fitted the data well. The interdependence of trust and conflict was further explored in a second longitudinal study (49 teams), and the results showed that trust emerging in the initial team interaction phases is a good predictor for the emergence of both task and relationship conflict in further stages of team development.

Psychometric test of the Team Climate Inventory-short version investigated in Dutch quality improvement teams

BackgroundAlthough some studies have used the Team Climate Inventory within teams working in health care settings, none of these included quality improvement teams. The aim of our study is to investigate the psychometric properties of the 14-item version of the Team Climate Inventory in healthcare quality improvement teams participating in a Dutch quality collaborative.MethodsThis study included quality improvement teams participating in the Care for Better improvement program for home care, care for the handicapped and the elderly in the Netherlands between 2006 and 2008. As part of a larger evaluation study 270 written questionnaires from team members were collected at baseline and 139 questionnaires at end measurement. Confirmatory factor analyses, reliability, Pearson correlations and paired samples t-tests were conducted to investigate construct validity, reliability, predictive validity and temporal stability.ResultsConfirmatory factor analyses revealed the expected four-factor structure and good fit indices. For the four subscales – vision, participative safety, task orientation and support for innovation – acceptable Cronbach's alpha coefficients and high inter-item correlations were found. The four subscales all proved significant predictors of perceived team effectiveness, with participatory safety being the best predictor. As expected the four subscales were found to be stable over time; i.e. without significant changes between baseline and end measurement.ConclusionThe psychometric properties of the Dutch version of the TCI-14 are satisfactory. Together these results show that the TCI-14 is a useful instrument to assess to what extent aspects of team climate influence perceived team effectiveness of quality improvement teams.

Does Conflict Shatter Trust or Does Trust Reduce Conflict in Teams? Revisiting the Relationships between Team Diversity, Conflict, Trust and Team

This paper explores the interplay between trust and conflict - two important emergent states in teams - as antecedents of team effectiveness. Two alternative path models are tested in a sample of 139 teams (729 respondents), with the emergent states (task conflict, relationship conflict and trust) acting as mediators between on the one hand team demographic variety (gender and nationality) and cognitive disparity (knowledge and cognitive motivation) and on the other perceived team effectiveness. In one model trust is considered as an antecedent for the two types of conflict, while in the other the two types of conflict precede the emergence of trust. Both models fitted the data well and received equally strong support. These results are interpreted using the complex adaptive system perspective. In line with this framework we argue that the interplay between these emergent states is much more complex than a simple unidirectional causation.

Influence of transactive memory on perceived performance, job satisfaction and identification in anaesthesia teams

There is an increasing awareness in the medical community that human factors are involved in effectiveness of anaesthesia teams. Communication and coordination between physicians and nurses seems to play a crucial role in maintaining a good level of performance under time pressure, particularly for anaesthesia teams, who are confronted with uncertainty, rapid changes in the environment, and multi-tasking. The aim of this study was to examine the relationship between a specific form of implicit coordination--the transactive memory system--and perceptions of team effectiveness and work attitudes such as job satisfaction and team identification. A cross-sectional study was conducted among 193 nurse and physician anaesthetists from eight French public hospitals. The questionnaire included some measures of transactive memory system (coordination, specialization, and credibility components), perception of team effectiveness, and work attitudes (Minnesota Job Satisfaction Questionnaire, team identification scale). The questionnaire was designed to be filled anonymously, asking only biographical data relating to sex, age, status, and tenure. Hierarchical multiple regression analyses revealed as predicted that transactive memory system predicted members' perceptions of team effectiveness, and also affective outcomes such as job satisfaction and team identification. Moreover, the results demonstrated that transactive memory processes, and especially the coordination component, were a better predictor of teamwork perceptions than socio-demographic (i.e. gender or status) or contextual variables (i.e. tenure and size of team). These findings provided empirical evidence of the existence of a transactive memory system among real anaesthesia teams, and highlight the need to investigate whether transactive memory is actually linked with objective measures of performance.

The Impact of Communal Knowledge Repositories and People-Based Knowledge Management on Perceptions of Team Effectiveness

Managers have increasingly implemented knowledge databases and knowledge-sharing training to improve team effectiveness. The authors examine whether intranet-based repository use and perception of accurate team knowledge of who knows what were related to perceived team effectiveness. They found that the perception that one's team had accurate who-knows-what knowledge is positively related to perceived team effectiveness. Repository use is not positively related to perceived team effectiveness. Remote work and tenure are not significant moderators of these relationships. These findings imply that perception of an accurate cognitive map of who knows what is more important to perceived team effectiveness than accessing information from repositories, regardless of remote work status or organizational tenure.