New Curriculum Teaches Health Care Faculty How to Work as a Team - and Show Others the Way
In 2005, the Association of American Medical Colleges assembled a group of health care faculty to design a curriculum on interdisciplinary teamwork — so that faculty could take their learning back to their peers and students to effect curriculum changes across professional schools. The association offered the curriculum twice between 2006 and 2008.
- Some 56 health professions faculty completed the course.
- The course indirectly supported institutional teams led or co-led by the scholars, with a total of more than 265 participants.
The association plans to offer the course again in 2009–10.
The Robert Wood Johnson Foundation (RWJF) supported this project with a grant of $197,666 from May 2006 to September 2007.
The academic accomplishments of health professions faculty are judged on an individual basis, according to Diane Magrane, M.D., the project director. Nevertheless, there is a growing emphasis in health care on interdisciplinary teamwork as fundamental to quality care and services. Academics must learn new skills (such as appreciating differences within groups and turning conflict into progress) if they are to model and teach teamwork skills to the next generation of clinicians, researchers and teachers.
"Teamwork is neither intuitive nor generally experienced in the course of professional training," according to Magrane. "Individuals coming together into organizational change teams have a lot to learn about teamwork skills and about each other in order to operate as a productive group."
In early 2005, the Association of American Medical Colleges assembled a faculty Discovery Team to develop a program that would train health professions faculty in effective teamwork. (See the Appendix for a list of team members.) By May 2006, the team had developed instructional materials and an online curriculum management system for delivering the program, based on the Blackboard Learning System.
RWJF has funded previous investment efforts to develop a blueprint for applying Paul Batalden's "microsystem" concept to medical education (see Grant Results) and to develop further Gordon Moore's Achieving Competence Together (ACT) interprofessional course on quality improvement. See Grant Results on the RWJF-funded program Partnership for Quality Education, section on ACT.
This project differed from the two just mentioned in that this course was for health professions faculty — so that participants could take their learning back to their peers and students to effect curriculum change across professional schools. Also, this project was expected to demonstrate a fairly low-cost model for faculty development around teamwork skills — and teaching those skills.
RWJF funding for the teamwork training program began in May 2006, with three objectives:
- Complete the course design.
- Conduct the course.
- Assess its effectiveness.
The six-month course (called Enhancing Team Effectiveness in 2006–07 and TeamWorks in 2007–08) was designed for health professions faculty members who were leading teams at their home institutions. For the course, participants were organized into "consultation teams" of five to seven members, with one or two faculty coaches. The coaches themselves also functioned as a team.
The course program included four phases:
- A month of preliminary work, using the online curriculum management system.
- A five-day meeting in September, which included meetings of the consultation teams. The consultation teams practiced team-building skills and discussed the challenges each faced on the teams at their home institutions.
- Team building and peer consultation within the consultation teams via conference calls and online communications from September to February.
- A two-day closing colloquium in February, which included:
- A review of the current literature on teams.
- Final consultation team meetings.
- Submission of final reports on institutional teams and responses to a survey of program scholars and coaches (see Assessing the Program).
- Consultation team presentations on lessons learned.
Curriculum subjects included:
- Formation of teams.
- Temperament differences and team creativity.
- Teams as tools for institutional change.
- Negotiation in teams.
- Learning in teams.
- Conflict and decision-making.
- Preparation for institutional enactment.
The association recruited program scholars through presentations at association meetings, listserv announcements, Web advertising and direct mail.
Assessing the Program
Project staff assessed responses of program participants from the 2006–07 class through:
- A 15-item online survey of program scholars and coaches, administered three times during the course.
- Case study reports for consultation and institutional teams.
Staff found that the Blackboard Learning System, on which the online curriculum management system was based, was difficult to adapt to both the association's own system and the needs of the program. See Lessons Learned.
The time demands of the course — it was longer than most professional development programs — made it difficult to recruit scholars from administrative staff, nursing and allied health fields. See Lessons Learned.
The association reported the following results to RWJF:
- Some 36 health professions faculty and staff completed the course in 2006–07, and 20 did so in 2007–08. Course participants included 35 M.D.s, 11 Ph.D.s and 10 with master's degrees. Seven came from nursing and allied health fields and eight from administrative staff.
- The course indirectly supported institutional teams led or co-led by the scholars, with a total of more than 265 participants. Team projects included:
- A program to bring team skills to anatomy instruction of medical students at Mount Sinai Hospital in New York.
- A St. Louis Children's Hospital retreat to organize and energize multidisciplinary clinical teams.
- Cross-campus workshops in team development at the M.D. Anderson Cancer Center at the University of Texas in Houston.
- Recognize that teamwork is often pioneering work. Training individuals in team skills and sending them back to institutions that may not have experience in this require courage on the part of the individual. "The program graduate risks becoming a missionary in a land that has not invited him/her." (Project Director)
- Work with medical school and hospital leadership to recruit participants in time-consuming staff development programs. Project staff said that the key to recruiting nonphysicians was working with medical school and hospital leadership to highlight the benefits of training diverse team members as an investment in institutional success. (Project Director)
- Have faculty engaged in team coaching experience the lessons themselves. Coaching as a team helps faculty members develop their own skills and gives them a head start in team development. (Project Director)
- Use teams of five to seven persons for maximum results. Team sizes of fewer than five provided insufficient conflict and diversity, whereas having more than seven led to difficulties in managing a collaborative unit. (Project Director)
- Give teams sufficient time "on-site" to learn about team member preferences and to develop shared processes for communication and decision-making, as a basis for online team exercises. The Internet and telephone conferencing were effective, but only after the on-site groundwork was laid. (Project Director)
- Identify appropriate technology to support both course management and virtual team development. Project staff and participants found that the Blackboard Learning System, which worked well for course management in their home institutions, was not user friendly for virtual team communications. (Project Director)
AFTER THE GRANT
The association devoted the summer 2008 issue of Faculty Vitae, the online newsletter of its Faculty Development and Leadership section, to "The Work of Teams in Academic Medicine."
The newsletter included a training module on "Tools for Effective Team Meetings" by a project coach, Yvette Pigeon, Ed.D.
After further analysis of the impact of the first two classes and the publication of findings, the association plans to offer the program again in September 2009. The association expects the program to be self-sustaining by then, according to the project director.
Several participants also have initiated team skills coaching at their home institutions, according to the project director.
GRANT DETAILS & CONTACT INFORMATION
Developing and Supporting Multidisciplinary Health Care Team Training
Association of American Medical Colleges (Washington, DC)
Dates: May 2006 to September 2007
Diane Magrane, M.D.
Steven P. Bogdewic, Ph.D.
Executive Associate Dean
Indiana University School of Medicine
James Gavin, M.D., Ph.D.
Emory University School of Medicine
R. Kevin Grigsby, D.S.W., M.S.W.
Penn State College of Medicine
Jean K. Johnson, Ph.D., M.S.N.
George Washington University School of Medicine and Health Sciences
Diane Magrane, M.D.
Associate Vice President for Faculty Development and Leadership
Association of American Medical Colleges
Linda Pololi, M.B.B.S., M.B.Ch.B.
Senior Scientist and Resident Scholar
Ajit Kumar Sachdeva, M.D.
Division of Education, American College of Surgeons
Valerie N. Williams, Ph.D., M.P.A.
Associate Dean for Faculty Affairs
University of Oklahoma College of Medicine
Oklahoma City, Okla.
Yvette Pigeon, Ed.D. (consultant)
Clinical Assistant Professor
University of Vermont College of Medicine
Gerald Drake, M.Ed.
Director of Faculty Leadership Education
Association of American Medical Colleges
Professional Development Specialist
Association of American Medical Colleges
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
The Work of Teams in Academic Medicine. Washington: Association of American Medical Colleges, 2008. Special issue of the online newsletter Faculty Vitae.
"Case Studies in Health Professions Team Development," Association of American Medical Colleges, fielded July 2006–February 2008.
"Institutional/Consultation/Faculty Coaches' Team Performance Assessment," Association of American Medical Colleges, fielded July 2006–February 2008.
Report prepared by: Paul Jablow
Reviewed by: Robert Narus
Reviewed by: Molly McKaughan
Program Officer: Jeane Ann Grisso