Mutual understanding in multi-disciplinary primary health care teams.

Empirical research on multi-disciplinary health care teams has yet to explore the development of mutual understanding between team members in the course of their collective clinical decision-making. This paper addresses this gap in the literature directly by examining changes in mutual understanding and the extent to which its facilitation is shared by individual members of multi-disciplinary health care teams. A Habermasian theoretical framework is used to operationalize mutual understanding. Social network analysis is used to analyze survey data on team-based clinical decision-making collected from multi-disciplinary health care teams in a Canadian province. The results of the study indicate that mutual understanding between team members ebbs and flows over the course of their collective clinical decisions. Further, as the extent of mutual understanding within the team increases, its facilitation becomes more equally shared among team members. The paper closes by specifying a practical outcome of the future work: a typology of clinical decisions that health care teams are able to use as an evaluation tool to assess how effectively they are making collective clinical decisions. As an evaluation tool, the typology would foster open and deliberative discussion, enable critical self-reflection, and thereby further enhancing mutual understanding within the teams.