Oxford Medical Training’s recent study into team behaviours within Medical Leadership has revealed some key issues:
- Inadequate sharing of feedback
- A reluctance to seek support when it is required
- A lack of clarity and focus upon team goals
- Limited attention to the development of processes
- A fundamental issue with trust
- The shortfalls are more pronounced with Medical Directors and Consultant level doctors who participated.
Research Method
138 participants comprising doctors of all levels, from FY1 to Consultants and Medical Directors, plus hospital and practice managers completed our one hour online CPD course, ‘Healthy Teams in Healthcare’. During this course they were introduced to various models related to the development, function and dysfunction of teams. They explored various aspects of these models, clarifying both how issues arise and the solutions to help avoid or resolve challenges. They then anonymously completed the ‘Healthy Team Member Self-Assessment’ before going on to create a reflective learning statement.
The ‘Healthy Team Member Self-Assessment’ comprises a series of subjective questions about the participant’s current circumstances, attitudes and behaviours. To each question, (for example ‘How clearly and explicitly do you feel your team’s goals are defined?’ or ‘How clearly can you describe your role and responsibilities in the team?’), there are five response options:
- Not relevant
- Not at all
- Not enough
- Reasonably
- Very
Results & Analysis
The results were analysed, revealing the following results from the respondents who selected ‘Not at all’ or ‘Not enough’. In their opinion:
Almost half are not proactive enough, or at all, in seeking honest feedback from fellow team members
43% state they do not effectively challenge fellow team members or give corrective feedback either enough or at all
More than 1/3 feel that their fellow team members are unwilling to give them honest, constructive feedback
42% do not discuss the support they require to fulfil their role with fellow team members either enough or at all
38% do not discuss progress toward team goals with colleagues either enough or at all
37% do not discuss the development of processes either enough or at all
It’s important to re-emphasise that these were the participants’ personal assessments and that very few respondents chose ‘Not relevant’ to any of the questions.
An initial thought may have been that the results were skewed by less experienced doctors. However, the numbers reporting ‘Not at all’ or ‘Not enough’ to a many of the questions were actually higher for the Medical Directors and Consultant level doctors who made up 27% of the respondents.
Consultant level doctors and Medical Directors:
were even less likely to be proactive to offer, seek or believe that their colleagues were willing to give honest constructive feedback
were even less likely to seek support when required or believe that their team members were willing to take on additional tasks to support them
were even less likely to believe that their colleagues are aligned to team goals were even less likely to trust their fellow team members
21% of Medical Directors and Consultant level doctors responded ‘Not enough’ to the question ‘What level of trust do you have in your fellow team members?’
Conclusions
It is likely that this final point about trust is at the root of a number of the other issues. In any team a lack of trust will inhibit interactions – directly impacting negatively upon performance and development as a direct result. In healthcare performance can be measured in many ways including efficiency, patient care and patient outcomes.
Other factors which may restrict team interactions include time pressures, the regular rotations required for junior doctor development leading to team instability, the prevalent culture and also the broad cultural diversity in the UK’s healthcare providers.
One probable key factor is a lack of doctors’ proactive development toward team participation and leadership skills. This is often delayed due to the high demands for technical and scientific progress. However, just like any other skill, team membership and leadership require intentional focus and practice if they are to develop. Modern healthcare has a high reliance upon teams and so development has to be recognised as essential, rather than a luxury. Waiting until a doctor reaches Consultant level – where any shortfall will be brought into sharp focus – before taking the first steps can only be adding to the challenges of modern Medical Leadership. It’s never too early and it’s never too late.
The good news is that there were very high scoring responses from the participants to questions regarding their levels of personal commitment and willingness to support fellow team members. That suggests that the desire is there. The challenge for Medical Leadership is to convert that positive energy into improvements in team interaction and trust.
Should you wish to find out more about the detail of the Healthy Teams in Healthcare study then please contact us by email: [email protected] or call us on 01315263700.
