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

作者:Kaba Alyshah; Wishart Ian; Fraser Kristin; Coderre Sylvain; McLaughlin Kevin
来源:Medical Education, 2016, 50(4): 400-408.
DOI:10.1111/medu.12943

摘要

ContextThe 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? MethodsIn 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. ResultsDespite 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. ConclusionsIn 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. Discuss ideas arising from the article at discuss.

  • 出版日期2016-4