Lost in Translation – Faculty
Development for Facilitating Team
Communication
UW-BOISE INTERNAL MEDICINE
RESIDENCY FACULTY DEVELOPMENT
FEBRUARY 26, 2015
AMBER FISHER, PHARMD
ELENA SPEROFF, NP
BILL WEPPNER, MD MPH
JANET WILLIS, RN
What is an team?
Examples in Health Care?
 Clinic (Teamlet, PCMH/PACT)
 Ward team
 Emergency department
 Rapid response team
 Rehabilitation
 Palliative Care team
 PACT ICU
 These tend to be interprofessional
Definition of a interprofessional team
 “An interprofessional team is composed of members
from different health professions who have
specialized knowledge, skills and abilities” (IOM
2003)
Why do teams work well?
Characteristics of a high functioning
interprofessional academic team
 Common goal (patient-centered)
 Members synthesize observations from their
profession-specific expertise
 Collaborative work



In concern to achieve patient centered goal
Joint decision making is valued
Team members empowered to assume leadership in certain
areas/times (with varying levels of supervision)
 Communicate well!
Why do we care about interprofessional
communication?
 Well, we pretty much all work in teams
 There evidence improved outcomes and safety
(Cochrane Rev 2009:CD000072)


Quality of care, lower costs, decreased LOS, reduced errors
Improved trainee satisfaction
 Increasing graduate school education
 There is increased interest on teaching trainees how
to work in and lead interprofessional teams.
ACGME/ABIM Milestone Project
ACGME/ABIM Milestone Project
ACGME/ABIM Milestone Project
Parallel play to Collaboration
 One way to think of this (credit to Carole Warde, VA
SAIL):



Task work (individual roles & responsibilities)
Team work (understanding, trust, communication)
Team processes (daily huddles/rounds, consults, meetings)
 Progression of:
 Multidisciplinary teams
 Interdisciplinary teams
 Transdisciplinary teams
(and, yes we are doing a workshop at SGIM on it,
too...)
 Faculty development – “train the trainer”
 Trigger tapes of team interactions
 The good, the bad, the ugly
 Structured evaluation tool from VA SAIL
Goals
Measurable Learning Objectives:
1. Demonstrate strategies to effectively facilitate
communication in interprofessional teams.
2. Apply an evaluation tool that has been used successfully for
communication in interprofessional teams.
3. Practice skills in celebrating successes and addressing
challenging situations in interprofessional education.
Optional Objectives
4. Review key models of effective interprofessional team education.
5. Apply communication strategies to enhance interprofessional team
function.
Evaluation tool
Active listening
1
2
3
4
5
6
People interrupt; do not encourage speaker’s
story; are impatient to speak; judge responses;
Two conversations frequently occur at once
7
8
9
People listen without interruption or judgment;
elicit other’s perspective; reflect back
understanding; one person speaks at a time
Trust Building
1
2
3
4
5
6
People don’t share their feelings, thoughts or
weaknesses with honesty
7
Hold team members accountable for their behaviors
1
2
3
4
5
6
7
People ignore misunderstandings and
inappropriate behaviors; follow-up items aren’t
done, nor discussed; there are negative response
to being held accountable to tasks and behaviors
Make decisions by consensus
1
2
3
3
Conflict is avoided and discouraged;
disagreements are left unresolved before
moving to another subject
9
8
9
People respond to others’ inappropriate remarks;
address misunderstanding; follow up on the “to do”
list; remind each other of agreed upon duties.
4
5
6
Poor participation in discussions; different
opinions/solutions are discounted/judged;
confusion about decisions, or they are not made;
some members compromise their position
Conflict
1
2
8
People disclose feelings, weaknesses and relevant
experiences appropriately
7
8
9
Everyone participates openly in discussions;
different opinions are encouraged; everyone
suggests solutions, understands the decision and
can explain it; final decisions are a synthesis of
ideas, not a compromise
4
5
6
7
8
9
Teamlets learn from disagreement; members
challenge each other about conclusions and
opinions
Evaluation tool
Give Constructive Feedback
1
2
3
4
5
6
Giving feedback is avoided; occurs at an
inappropriate time; when given, it criticizes,
embarrasses or blames; behavior and effect on
others is not described; alternative action is not
suggested; responses of recipient are not heard;
ends on a negative note
Receive Constructive Feedback
1
2
3
4
5
6
Feedback is viewed as criticism; when received,
recipient is defensive, angry or avoidant; lack of
learning or change
Emotional Management
1
2
3
People are surprised that change could ever
occur in others; they are cynical and make
discouraging remarks that incite defensiveness in
others or tear down confidence
8
9
7
8
9
Feedback is appreciated; recipients feel safe and
supported; it is used as an opportunity to learn or
improve
4
5
6
People disregard or are insensitive to emotional
cues or others’ emotions. Negative emotions are
avoided.
Support Change in Others
1
2
3
7
Giving feedback is expected; behaviors and effect of
actions on others are described; constructive
changes are suggested; recipient response is
encouraged and heard; negative feelings in recipient
are avoided; ends on a positive note
7
8
9
People elicit, respond, name, understand and
support other’s emotions.
4
5
6
7
8
9
People help others to see change positively;
motivation and confidence for new behaviors are
encouraged with discussion of barriers and positive
remarks.
Workshop process
 Scenario #1 – all discuss evaluation tool TOGETHER
 (don’t write anything)
 Scenario #2 – use evaluation tool INDIVIDUALLY
 (write scenario # on top & hand in at end)
 Scenario #3 – use evaluation tool INDIVIDUALLY
 (write scenario # on top & hand in at end)
 Give feedback in comments