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Pulling together and pulling apart: influences of convergence and divergence on distributed healthcare teams.
- Source :
- Advances in Health Sciences Education; Dec2017, Vol. 22 Issue 5, p1085-1099, 15p
- Publication Year :
- 2017
-
Abstract
- Effective healthcare requires both competent individuals and competent teams. With this recognition, health professions education is grappling with how to factor team competence into training and assessment strategies. These efforts are impeded, however, by the absence of a sophisticated understanding of the the relationship between competent individuals and competent teams . Using data from a constructivist grounded theory study of team-based healthcare for patients with advanced heart failure, this paper explores the relationship between individual team members' perceived goals, understandings, values and routines and the collective competence of the team. Individual interviews with index patients and their healthcare team members formed Team Sampling Units (TSUs). Thirty-seven TSUs consisting of 183 interviews were iteratively analysed for patterns of convergence and divergence in an inductive process informed by complex adaptive systems theory. Convergence and divergence were identifiable on all teams, regularly co-occurred on the same team, and involved recurring themes. Convergence and divergence had nonlinear relationships to the team's collective functioning. Convergence could foster either shared action or collective paralysis; divergence could foster problematic incoherence or productive disruption. These findings advance our understanding of the complex relationship between the individual and the collective on a healthcare team, and they challenge conventional narratives of healthcare teamwork which derive largely from acute care settings and emphasize the importance of common goals and shared mental models. Complex adaptive systems theory helps us to understand the implications of these insights for healthcare teams' delivery of care for the complex, chronically ill. [ABSTRACT FROM AUTHOR]
- Subjects :
- PHYSICIAN practice patterns
UTILIZATION review (Medical care)
MEDICAL education
HEALTH education
MEDICAL communication
MEDICAL students
HIGHER education
HEART failure treatment
COMPARATIVE studies
COOPERATIVENESS
GROUNDED theory
HEALTH care teams
INTERPERSONAL relations
INTERVIEWING
RESEARCH methodology
MEDICAL cooperation
RESEARCH
RESEARCH funding
QUALITATIVE research
GROUP process
EVALUATION research
Subjects
Details
- Language :
- English
- ISSN :
- 13824996
- Volume :
- 22
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Advances in Health Sciences Education
- Publication Type :
- Academic Journal
- Accession number :
- 125968227
- Full Text :
- https://doi.org/10.1007/s10459-016-9741-2