Center for Health Professions Education & Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Department of Surgery and Faculty Education, Western University, London, Ontario, Canada.
Teach Learn Med. 2024 Apr-May;36(2):163-173. doi: 10.1080/10401334.2022.2163400. Epub 2023 Jan 10.
Interprofessional healthcare team (IHT) collaboration can produce powerful clinical benefits for patients; however, these benefits are difficult to harness when IHTs work in stressful contexts. Research about stress in healthcare typically examines stress as an individual psychological phenomenon, but stress is not only a person-centered experience. Team stress also affects the team's performance. Unfortunately, research into team stress is limited and scattered across many disciplines. We cannot prepare future healthcare professionals to work as part of IHTs in high-stress environments (e.g., emergency medicine, disaster response) unless we review how this dispersed literature is relevant to medical education. The authors conducted a narrative review of the literature on team stress experienced by interprofessional teams. The team searched five databases between 1 Jan 1990 and 16 August 2021 using the search terms: teams AND stress AND performance. Guided by four research questions, the authors reviewed and abstracted data from the 22 relevant manuscripts. Challenging problems, time pressure, life threats, environmental distractors, and communication issues are the stressors that the literature reports that teams faced. Teams reacted to team stress with engagement/cohesion and communication/coordination. Stressors impact team stress by either hindering or improving team performance. Critical thinking/decision-making, team behaviors, and time for task completion were the areas of performance affected by team stress. High-quality communication, non-technical skills training, and shared mental models were identified as performance safeguards for teams experiencing team stress. The review findings adjust current models explaining drivers of efficient and effective teams within the context of interprofessional teams. By understanding how team stress impacts teams, we can better prepare healthcare professionals to work in IHTs to meet the demands placed on them by the ever-increasing rate of high-stress medical situations.
跨专业医疗团队（IHT）的合作可为患者带来显著的临床效益；然而，当 IHT 在压力环境下工作时，这些效益很难实现。医疗保健领域的压力研究通常将压力视为个体的心理现象，但压力不仅是以人为中心的体验。团队压力也会影响团队的表现。不幸的是，关于团队压力的研究有限且分散在多个学科领域。除非我们回顾分散的文献如何与医学教育相关，否则我们无法培养未来的医疗保健专业人员在高压力环境（例如，急诊医学、灾难应对）中作为 IHT 的一部分工作。作者对跨专业团队经历的团队压力文献进行了叙述性综述。该团队使用“团队 AND 压力 AND 表现”等搜索词，于 1990 年 1 月 1 日至 2021 年 8 月 16 日期间在五个数据库中进行了搜索。在四个研究问题的指导下，作者从 22 篇相关手稿中审查并提取了数据。具有挑战性的问题、时间压力、生命威胁、环境干扰和沟通问题是文献报告团队面临的压力源。团队通过参与/凝聚力和沟通/协调来应对团队压力。压力源通过阻碍或改善团队绩效来影响团队压力。批判性思维/决策、团队行为和完成任务的时间是受团队压力影响的绩效领域。高质量的沟通、非技术技能培训和共享心智模型被确定为应对团队压力的团队绩效保障。审查结果调整了当前解释跨专业团队中高效和有效团队驱动因素的模型。通过了解团队压力如何影响团队，我们可以更好地为医疗保健专业人员在 IHT 中工作做好准备，以满足不断增加的高压力医疗情况对他们的要求。
