William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, London, UK.
BMJ Qual Saf. 2013 Mar;22(3):225-32. doi: 10.1136/bmjqs-2012-001418. Epub 2013 Jan 29.
Effective working in multidisciplinary teams (MDTs) is promoted as essential in ensuring good healthcare outcomes, suggesting that an understanding exists of the relationship between outcomes and the attributes needed by individuals to function effectively in the MDT. While the characteristics of effective teamwork have been described, the attributes needed by individual MDT members have not been investigated. To address this, the study focuses on newly qualified Foundation Year 1 (FY1) doctors, creating and testing a tool to evaluate their performance in the MDT.
Repertory grid technique was used to elicit attributes needed by FY1 doctors to function effectively in the MDT. Study participants (all experienced MDT members) used these to evaluate MDT working by FY1 doctor colleagues. Data on 57 FY1 doctors were collected from 95 MDT members working in five hospitals. Participants also ranked the attributes in terms of importance for effective team functioning and rated an 'Ideal' FY1 doctor.
The repertory grid permitted differentiation between groups of FY1 doctors' MDT performance. FY1 doctors who undertook interprofessional training were rated no differently than UK-trained graduates without such training. UK-trained graduates were rated significantly higher on all attributes than non-UK-trained graduates. Overall, FY1 doctors were rated lower than the 'Ideal'. Factor analysis and rankings suggested tensions between clinical attributes needed for good team functioning and more 'social' attributes.
This study demonstrates the potential of repertory grid methodology in eliciting attributes that are important for effective teamworking, and using these to evaluate MDT working by FY1 doctors.
有效的多学科团队(MDT)工作被认为是确保良好医疗效果的关键,这表明人们已经了解到团队成果与个人在 MDT 中有效运作所需的属性之间的关系。虽然已经描述了有效的团队合作特征,但尚未研究 MDT 成员所需的属性。为了解决这个问题,该研究集中在新获得的基础培训第一年(FY1)医生身上,创建并测试了一种评估他们在 MDT 中表现的工具。
采用 repertory grid 技术来引出 FY1 医生在 MDT 中有效运作所需的属性。研究参与者(均为经验丰富的 MDT 成员)使用这些属性来评估 FY1 医生同事的 MDT 工作。从 5 家医院的 95 名 MDT 成员中收集了 57 名 FY1 医生的数据。参与者还根据对有效团队运作的重要性对属性进行了排名,并对“理想”FY1 医生进行了评分。
repertory grid 允许区分 FY1 医生 MDT 表现的群体。接受跨专业培训的 FY1 医生与没有接受过此类培训的英国培训毕业生的评价没有区别。英国培训的毕业生在所有属性上的评分都明显高于非英国培训的毕业生。总体而言,FY1 医生的评分低于“理想”。因子分析和排名表明,在良好团队运作所需的临床属性和更多的“社会”属性之间存在紧张关系。
本研究表明 repertory grid 方法在引出对有效团队合作重要的属性方面具有潜力,并使用这些属性来评估 FY1 医生的 MDT 工作。