Team Building, Part 3
In the previous article, I considered the team’s response to the newcomer and the importance of the socialization that occurred when that person began work. Focusing on the process is necessary to understand the “how,” but doesn’t address the “why.” Kozlowski and Bell note the literature emphasizes three cognitive methods in understanding team function: team mental models, transactive memory, and team learning. They identify four content domains underlying team mental models.
“(1) equipment model—knowledge of equipment and tools used by the team; (2) task model—understanding about the work that the team is to accomplish, including its goals or performance requirements and the problems facing the team; (3) member model—awareness of team member characteristics, including representations of what individual members know and believe, their skills, preferences, and habits; and (4) teamwork model—what is known or believed by team members with regard to what are appropriate or effective processes. Related to team mental models, but at a much higher level of generality, are conceptualizations of Team Climate. Team climate represents group-level shared perceptions of important contextual factors that affect group functioning, and via mediating climate perceptions affect group outcomes.”
In dialysis units, the first two items—the equipment and task models—are usually done, but I find dealing with the member and teamwork model has been much more difficult to instill. Where the nurse managers have been able to lead the individuals on the staff to see themselves as a team, team coherence has been achieved. Despite informal coaching from me, I have found this a difficult concept for many of the nurse managers to master. I have the impression that many people have never had the opportunity to be part of a high functioning team in any part of their lives, so lack belief that such a thing is either possible or desirable. But it is necessary if team coherence is to develop.
“Team coherence is presumed to form on the basis of developmental processes that unfold over time, shared experiences, and leader facilitation. Complementary cognition and behavior, along with shared affect and climate perceptions, provide a foundation for essential teamwork capabilities. When a team is guided by a shared comprehension of its task situation and its corresponding goals, strategies, and role linkages, it is able to adapt to task variations and to maintain synchronicity without explicit directives. This sharing represents an integration of taskwork and teamwork capabilities…These research findings suggest that the development of team mental models is a promising leverage point for interventions to improve team effectiveness.”
The second cognitive device is termed “transactive memory,” which is “is a group-level shared system for encoding, storing, and retrieving information; a set of individual memory systems which combines knowledge possessed by particular members with shared awareness of who knows what.” Managers typically dislike this, as it makes changes that much harder to achieve, but teams use it because transactive memory “reduces cognitive load, provides access to an expanded pool of expertise, and decreases redundancy of effort.” Said another way, transactive memory is a way for individuals to tap the tacit knowledge of team members to resolve problems. It is quick, easy, but sometimes wrong.
The third cognitive model is team learning, which refers “to permanent changes in the knowledge of an interdependent set of individuals associated with experience, which can be distinguished conceptually from individual learning.” I first encountered this concept many years ago in a presentation by Peter Senge, who promoted the term “learning organization.” I subsequently used many of the concepts to develop our continuous quality improvement efforts before it was hijacked by the government and converted in “QAPI.” The process did result in team learning as we figured out things that worked as well as things that did not work. Unfortunately, the increased regulatory scrutiny has made the cost of experimentation high and reduced the time available to do the deep learning necessary to make real improvements. It is also conceptually difficult to distinguish between group learning and individual learning, which is then distributed through changes in mental models or transactive memory. Despite these caveats, I think CQI, as originally conceived, and the mental model of a learning organization have powerful resonances for medical teams and medical organizations and should be exploited more widely.
But teams are composed of people, not computers, so achieving team coherence has an affective as well as a cognitive component, which we will consider in the next article in this series.
1 April 2018
  Kozlowski, S. W. J. & Bell, B. F. (2001). Work groups and teams in organizations. Retrieved 14 March 2018 from Cornell University, ILR School site: http://digitalcommons.ilr.cornell.edu/articles/389/html, p. 27.
 Ibid., p. 28.
 Ibid., p. 29.
 Senge P. The Fifth Discipline: The Art & Practice of the Learning Organization. (New York: Currency Doubleday, 1990.)
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