Working and Learning in ‘Teams’ in a New Era of Health-Care

Abstract

A major shift in medical practice is the move to coordinated interprofessional teamwork, often requiring several clinical teams working around a patient on a pathway of care. Doctors must now become expert communicators with colleagues. Evidence shows, however, that the majority of medical errors are grounded in poor teamwork. Teamwork is not traditionally a focus of communication skills training in medical schools, which has concentrated on the patient consultation. Before designing teamwork medical education fit for purpose for the emergent era of healthcare, we must conceptually clarify what we mean by ‘teams’. The new work order of team settings means that doctors need to develop identities as ‘interprofessional teamworkers’.

I have placed ‘teams’ in inverted commas because I see this as a problematic term—as this and subsequent chapters will explore. However, ‘team’ is a descriptor that is so embedded in health-care language that it is difficult to reinterpret or re-inscribe and harder to abandon. In the following chapter, I argue that ‘team’ is better thought of as process—as a verb rather than a noun. In this chapter, I warn against simplistic thinking that sees teams as jigsaws, with component parts that can be readily slotted together. ‘Team’ is a descriptor that lends itself to Jacques Derrida’s (1967) process of putting something ‘under erasure’ (team) where the term is suspended. This of course does not mean that medical and health-care professionals do not engage in meaningful collaborative activities, it means rather that ‘team’ may not yet be the best adequate summative descriptor for such activities. Therefore, I do not abandon the term, but signal to the reader that it is inadequate to describe the complexity of such meaningful collaborative activities (as well as many meaningless non-collaborative exchanges). ‘Team’ will then remain a suspended term or one with a severe health warning.