Importance of teamwork in the medical line: a personal review based on Gibb's model

Author: Iloka Benneth Chiemelie 

Published: 27/1/2014

Introduction

In the course of undertaking this essay, discussions will be presented in areas that focus on understanding teams and team working in the medical line. The analysis as will be presented in the discussion will seek to reflect and also identify the learning needs of the author and such understanding will be presented in the paper. the author will also adopt the Gibb’s Reflection Cycle (1988) ( see appendix i) as the framework that will be used to reflect on roles played in a team and also identify learning needs from such analysis in order to enhance the overall performance of the author in the medical setting with view on increase patient care within this area. While the choice of Gibb’s have been made, it is important to understand that other reflective models (such as Johns, 2000 and Rolfe et al. 2001) also exist in this field, but the choice of Gibbs (1988) is based on the understand that it has been often used in the healthcare setting, and it makes use of a quasi-problem solving approach, thus providing the right link to analyse issues exactly as they are presented. In the view of the discussion, key terms will also be defined and elaborated in order to expand understanding. The main objective however, is to conduct an in-depth analysis of the key concepts that are associated with change management, reflection-based form of learning, and understanding the issue of leadership and management. A concluding summary of the analysis will also be presented.

Be it in the global or national sense, health services have been known to undergo stages of intensive change because of the increasing level of technological advancement, issues in the social and economic sense. Thus, this makes it important that managers make themselves familiar with the changes that exist in their organization (National Health Service 2013).

Teams: who are they or what does it mean?

A number of factors influence the chances of organizations to make quality healthcare available, and team management is one of such factors, involves aligning the effective performance of the team with set goals in the organizational settings. One of the drivers that determine how people can effectively work as team members is that defined by the Nursing and Midwifery Council (NMC) (2008) in the settings of the Code of Professional Conduct which highlights the needs for all nurses to work as team members.

The main purpose why healthcare organization develops teams is for them to accomplish set tasks, and it has been established that team performance can serve as a source of distinctive competitive advantage in the organization (Baker et al 2006). A strong team is marred in competitive interaction between its members that enhances the motivation level of these members and the development of a culture that is based on high performance. Although it is important to understand that working independently has its own advantages such as the lack of dependence on others, reduced level of conflict and enhances decision making process, it is necessary to also understand that independent working can actual becomes an obstruction to the achievement of goals as a result of the absence of collaboration, skill pools and vast expertise that perform the function of increasing proactive and creative thinking that are geared towards increased problem solving competence.

Bringing individual to form a team can (but not always) enhance the chance of achieving goals in a much more effective and efficient way when compared with trying to achieve such success independently. Additionally, there is an increase in emphasis on the importance of understanding and training people that possess the right teamwork skills. This increase is also noted in the healthcare industry, as organizations are not becoming more dynamic but this comes along with a higher degree of instability. The outcome will be an increase in the level of reliance on teams and increased level of complexity in the view of team composition, required skills and actual level of risk involved.

If organizations will achieve a higher degree of reliability with particular reference to the healthcare setting, team work is very important. The basic features of a given team and strategies used for the purpose of reviewing team training must also be given critical attention in order to improve the overall performance of individuals involved in the team as such will have direct positive influence on terms of enhancing reliability in the team.

Teams do come in varying shapes and sizes, and this makes it difficult to define a team based on common grounds (Markiewicz and West 2011). Irrespective of the experienced difficulties when it comes to defining a team, it must be noted that a team can be described as a group of people that operate together under clear and shared valued, and working together for the purpose of achieving a common goal (Markiewicz and West 2011). The above definition will be chosen in this setting as it provides common terms that are in line with the health settings. However, group is in contrast with the definition of a team as it is seen a collection of individuals that coordinate their individual efforts (Jelps and Dickinson 2008).Belbin (1994) presented the definition of a team as being more than just group of people, who have job titles, but more towards the gathering of individuals with these individuals having specific roles to play and also being able to understand other members in the team.

Normally, team members do seek to perform more of the effective roles that do come naturally to them. The main objective of a team seem to be best linked with those that work in health and social care settings because of the emphasises it draws on the expertise level and also degree of competence.

Belbin (1994) made known that it is necessary for team members to take specific roles when it comes to defining functions and if such functions are to be conducted effectively. The identification of team roles is necessary in order for the team members to understand how the can fully contribute towards the purpose of meeting set team goals. The adoption of Belbin’s team role inventory (Belbin, 1988) can help team members in defining their respective role within the team and promote efficacy in the process. The appendix (ii) demonstrates Belbin’s Team Roles. Despite the fact that the team role invention was developed back in the 1994, it is still very important and pretty much adopted in the modern management and leadership activities (Mullins, 2013).

Although there are acknowledgements that adopting inventories like the one defined by Belbin (1994) can serve as a source of needed help in defining the role and functions of teams members in any given team, it is also important to adopt a precautionary measure with such tools. This is because it can be prone to stereotype and label people once they have been identified with specific role description. There is also the possibility of such inventories trying to matters (such as role) and overly simple issue into firm consideration that major issue sit should address. As is the case for most of the tools used in validating and testing reliability, it should also be given serious considerations. The advantage of this tool is based on its ability to actually objectify things that can be subjective in nature such as role of team members. 

In the view of the above discussions, the author performed personal self-assessment by adopting Belbin (1994) in the course of determining individual role performed in the team for the purpose of adopting finding from such analysis as a reflection of the author’s contribution to team members.

An understanding of what team-working is all about

The Chartered Institute of Personnel and Development (CIPD) (2013) presented the definition of team work as a form of work practice which makes use of teams, in which the team comprises of limited number of people, and these people work together for the purpose of achieving common and shared objectives at work, with the aim of achieving these objectives in such a way that it allows each member of the team to make distinctive contribution.

The importance of team working is continuously rising in the health care setting. In the past, roles were based on well-defined by normally strict division of responsibilities with most of the job title laying down suggestion on the suggestion of roles that each perform will perform. However, the increasing level of technological and education advancement has resulting in a subsequent increase in of importance placed on flexibility within the workplace. The traditional hierarchy approach has been slowly replaced with a much flatter structure in the organization, in which the employees are expected to fill different roles (Mullins, 2013; Gopee and Gallaway 2008), and these changes are increasingly becoming a common norm in the health care system.

There are a number of requirements needed in the course of developing an effective team working system. Effective teamwork is a produce of when the size, membership and resources used in a team are brought to match the specific task designed for such teams, and it is also crucial for each of the member to aware of the roles they need to play (Mullins, 2013). In the course of making selection for the potential members of any given team, it is also important to seek for those members who have the ability of productively working with other and possess high drive for increased growth and development of the team (Constructing Excellence 2004).

Change management

Change management can be visualized as a structural approach adopted for the purpose of ensuring that change made in any setting are smoothly and carefully implemented, and that the benefit gained from such changes can be made sustainable (Constructing Excellence 2004). The understanding gained from this definition is that any kind of change made must be structured, and the plan should be done in such a way that such change can be made sustainable. In any case, the rapid level of changes in the health care system means that change management comes with numerous challenged under such settings.

Irrespective of the setting where it is experienced, change management is an important and kind of unavoidable competent of the modern health care system (Institute of Health and Clinical Excellence and World Health Organization 2010). Effective management of change calls for the need to understand the complexity of such concepts, and the recognition that change management is not just about understanding the starting point of the process or the finishing point, but instead, it is a constant process that should be managed with every new issues that arises in the course of such process, ensuring swift implementation and evaluation, and monitoring the process on continuous bases in order to ensure that the outcome are successful (Illes 2005).

Reflective practice

The process of reflective practice can be described as having the ability to aid an individual’s evaluation of their own personal understanding, in terms of their skills, knowledge and competence. Conducting a reflection of an activity before, during or after such activity can result in clear identification of the learning, reviewing outcomes and helping to evaluate person’s gained experience (Schön, 1995). The purpose of such is to identify what the person has learned with the purpose of finding new approaches or innovating existing approaches in order to increase effective practice in the future. Under the settings of teams, reflection can also serve the purpose of helping team member make more effective contribution to team working activities.

Learning is the outcome of different incidence and experience from an individual’s professional and personal life (Moon, 2004; Boud et al, 1994). It is a conscious reflection that adopts systematic approach which provides the individual with the opportunity of understanding themselves more, learning about the team members, task performed in the organization, professional practice, as well as their own abilities and skills.

The author’s personal reflection

The analysis in this section will adopt Gibbs’ (1988) reflective cycle, which has been described as popular model for reflection (Cumbria.ac.uk, 2013). The model includes 6 stages of reflection and is presented below.

Description

The author’s role can be described as a “supervisor” in the quality and control section of the health care system. Reflection shows that the author can be sometimes too critical of other team members (Belbin 1994).

Feeling

The author was personally aware of the fact high level of criticism levelled wielded on the author but it is important that the author does that in order to increase the overall performance of co-team members by ensuring that they are fully informed of their works which they did well and which they failed to turnout as needed.

Analysis

In terms of analysing reasons behind the author’s action, it is important to understand that it was because the author desires continued growth of the team and is a high fan of perfection because it is through such perfection that the team will be able to ensure quality performance and reliability. As noted by Jelps and Dickson (2008), working in a team requires the members to maintain some level of awareness and ability to openly and effectively communication in order to measure their level of sensitiveness to other members. Thus, it is normal that the author was openly critical of the team members. The needs for teams to talk in line with their desired objectives have also been discussed by West et al (2004).

Action plan

While it is important to communicate with the team members on issues that relate to the teams, it is also important to note that how such communication is done can actually lead to negative effects on the members (King, 2011). Thus, the author is in line with the ideas of Connor and Pakora (2007) that is based on developing an effective team working without being too critical of team members in order to reduce the negative effectives that it can have.

Conclusion

In the view of the above analysis, it can be seen that the author has been successful in analysing issues as well as potentials that related to personal performance in a team work with reference to the author’s personal life and this is important because it aids the understanding of weakness and deriving measure to increase the performance of the person generally (Tuckman 1965).

Thus, while the objectives of this research has been meet, the author desires an effective change by reducing the level of criticism bestowed on the other members of the team, in order to increase the overall effectiveness of the author’s individual performance for the sole purpose of increasing the performance of the team.

References

Alderfer, C. (1969) “An Empirical Test of a New Theory of Human Need” Psychological Review Vol 4 No 2 pp 142-175

Baker, D.P., Day, R. and Salas, E. (2006) “Teamwork as an Essential Component of High-Reliability Organizations” Health Service Research Vol 4 No 4 (Part 4) pp 1576-1598

Belbin, M. (1994) “Management Teams: Why They Succeed or Fail”. Butterworth Heinemann, Oxford

Boud, D., Keogh, R. and Walker, D. (1994) “Reflection: Turning Experience into Learning”. London. Kogan Page.

Chartered Institute of Personnel and Development (2013) “Teamwork: Resource Summary” http://www.cipd.co.uk/hr-resources/factsheets/teamworking.aspxl last accessed October 2013

Connor, M. and Pakora, J. (2007) “Coaching and Mentoring at Work” Maidenhead. McGraw Hill

Gibbs, G. (1988) “Learning by Doing: A Guide to Teaching and Learning Methods”. Oxford: Further Educational Unit.

Gopee, N. and Gallaway, J. (2008) “Leadership and Management in Healthcare” Thousand Oaks. Sage

Hogan, R. and Hogan, J. (2005) “What we Know About Leadership.A View fromthe Dark Side” International Journal of General Psychology.Vol 9 pp 40-51

Illes, V. (2005) “Really Managing Healthcare” Milton Keynes Open University Press

Jelps, K. and Dickson, H. (2008) “Working in Teams”. London. Polity Press

Johns, C. (2000) “Becoming a Reflective Practitioner: a Reflective and Holistic Approach to Clinical Nursing, Practice Development and Clinical Supervision” Oxford Blackwell Science.

King, J. (2011) “Understanding Yourself as Leader” in Swanwick, T. and McKimm, J. (Eds) ABC of Clinical Leadership”. Ch 11 pp 50-53. Wiley Blackwell. Oxford

Markiewicz, L. and West, M.(2011) “Leading Groups and Teams” in Swanwick, T. and McKimm, J. (Eds) ABC of Clinical Leadership”. Ch 4 pp 14-18. Wiley Blackwell. Oxford

Maslow, A. (1954) “Motivation and Personality” New York Harper

Moon, J. (2004) “A Handbook of Reflective and Experiential Learning: Theory and Practice”. London. Routledge.

Mullins, L.J. (2013) (10^th Ed) “Management and Organisational Behaviour” Harlow, FT Publications.

National Health Service (2013) “Focus on Change Management”http://www.connectingforhealth.nhs.uk/systemsandservices/icd/informspec/careerplan/phi/personal/learningweb/leadership/change/focusLast accessed October 2013

National Institute of Health and Clinical Excellence and World Health Organisation (2010) “Health Systems and Health-Related Behaviour Change:
a Review of Primary and Secondary Evidence” London. NICE

Nursing and Midwifery Council (2008) “The Code of Professional Conduct”. London. NMC

Rolfe, G., Freshwater, D. and Jasper, M. (2001) “Critical Reflection in Nursing and the Helping Professions: a User’s Guide”. Basingstoke: Palgrave Macmillan.

Schön, D.A. (1995) “Reflective Practitioner. How Professionals Think in Action” Aldershot Avery. Arena

Tuckman, B. (1965) “Developing Sequence in Small Groups”. Psychological Bulletin Vol 63 No 6 pp 384-399

West, M.A., and Markiewicz, L. (2004) “Building Team Based Working: A Practical Guide to Organisational Transformation” British Psychological Society. Oxford. Blackwell

West, M.A., Hurst, G., Richter, A. and Shipton, H. (2004) “Twelve Steps to Heaven: Successfully Managing Change Through Developing Innovative Teams” European Journal of Work and Organizational Psychology Vol 13 No 2 pp 269-299

Appendices

Appendix (i) Gibb’s Reflective Cycle (Source: Gibbs 1988)

Figure 1: Gibb’s reflective cycle

Source as adapted from: Cumbria.ac.uk (2013)

Appendix (ii) Belbin Team Roles (Source: Belbin, 1994)

Role	Strengths	Allowable Weaknesses
Plant	Creative, imaginative, free-thinking. Generates ideas and solves difficult problems.	Ignores incidentals. Too preoccupied to communicate effectively
Resource investigator	Outgoing, enthusiastic, communicative. Explores opportunities and develops contacts.	Over-optimistic. Loses interest once initial enthusiasm has passed
Coordinator	Mature, confident, identifies talent. Clarifies goals. Delegates effectively.	Can be seen as manipulative. Offloads own share of work
Shaper	Challenging, dynamic, thrives on pressure. Has the drive and courage to overcome obstacles.	Prone to provocation. Offends people's feelings.
Monitor evaluator	Sober, strategic and discerning. Sees all options and judges accurately.	Lacks drive and ability to inspire others. Can be overly critical.
Team worker	Co-operative, perceptive and diplomatic. Listens and averts friction.	Indecisive in crunch situations. Avoids confrontation
Implementer	Practical, reliable, efficient. Turns ideas into actions and organises work that needs to be done.	Somewhat inflexible. Slow to respond to new possibilities.
Completer finisher	Painstaking, conscientious, anxious. Searches out errors. Polishes and perfects.	Inclined to worry unduly. Reluctant to delegate.
Specialist	Single-minded, self-starting, dedicated. Provides knowledge and skills in rare supply.	Contributes only on a narrow front. Dwells on technicalities