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Reflections on the HEAVY LIFTING of Team Development

Continuing and Professional Development Blog 

September 2017

Imagine 80° temperatures, high humidity, five IHP health professions students and their faculty preceptor, squeezed into an Uber, along with rakes, brooms, work gloves, and yard bags:  for 45 minutes in heavy Boston traffic.

Topics of discussion: Boston traffic, living in Boston, commuting to IHP, college and work experiences, professional interests that brought them to their individual programs, shared fun interests, future plans! What a way to learn about each other!

That Uber ride was an introduction that bonded students in some hot and dirty work:  pruning, raking, sanding, painting and spreading VERY HEAVY bags of black mulch during their community service activity.  The end result, (and the beginning!):  a newly formed group, becoming friends, emerging as a novice team, ready to continue to grow.

Two weeks ago, the 2017-2018 IMPACT® cohort teams met for the first time: through early online introductions, table-based team activities, and large group discussions. When did I observe my wonderful student groups begin to evolve into interprofessional student teams? In the Uber!

Whether it’s an assigned task force, an education committee, or a clinical work unit, we strive to bring a group together to form high-functioning teams. However, a group is not a team, and simply gathering good, smart people together does not result in functional teams. Why?

A group is generally acknowledged to be a collection of persons with common, unifying interests or goals. A team is “a small number of people with complementary skills who are committed to a common purpose, set of performance goals, and approach for which they hold themselves mutually accountable”. (Katzenbach and Smith, 1993)

Despite the actionable phrases in the Katzenbach definition, research on team development and process indicates that mature teams do not “happen” as the result of a shared understanding of these principles. 

For example, in healthcare, many interprofessional team-building exercises guide groups through activities that are designed to enhance their understanding of the IPEC competencies, how to understand each other, how to communicate more effectively, on behalf of the team and the patient and the patient’s family and the community. It’s not easy: the tension between being an individual and being a team member is ever present, and acknowledging the anxiety that is inherent in creating a team helps everyone to embrace a shared accountability, not only for the achievement of the intended team work, but also for the process of how the team exists.

Tuckman’s “forming, storming, norming, and performing” (1965) or Wheelan’s four stages of team development: dependency/inclusion, counterdependency/fight, trust/structure, and work/productivity (2005), both describe models for team development that are embedded in the concept of “being separate” versus “being a part”.

Building a successful team, any team, is a heavy lift. It doesn’t happen overnight; it doesn’t happen through discussion and acceptance of theoretical constructs; it doesn’t happen through ice-breakers. It’s hard work that requires ongoing attention to the dynamic process of becoming and being a team.