|
Team Building, Part 4
People are not “Mr. Spock,” so it is important to consider the emotional aspects of team building, or what Kozlowski and Bell refer to as affective and motivational constructs. 1 They classify them in four terms: cohesion, collective mood, collective efficacy, and conflict. Looking at cohesion, the describe it in three ways: interpersonal cohesion, task cohesion,and group pride. They concluded “task cohesion is the critical element of group cohesion when the cohesion-performance relationship is examined, and that interpersonal cohesion might do little more than cause members to exert only as much effort as required to remain in the group.” 2 I find this conclusion conflicts with my observations. Despite the risk of being misunderstood, I think this is because we still socialize boys and girls differently and this difference shows up at work. My teams are composed mostly of women who, unless they think about it, instinctively place a higher priority on getting along than on getting it done. The task cohesion idea posited in the quotation is a peculiarly male socialization attitude—the pickup ball team being the paradigm. These differences also show up when considering conflict, which is discussed shortly. “Collective mood or group emotion captures the idea of group affective tone…two approaches can be used to understand group emotion. The top-down approach views the group as a whole…how the feeling and behaviors of individuals arise from group dynamics…The bottom up approach examines the ways in which individual level emotions combine at the team levels to influence outcomes…” 3 The research summarized suggests a tendency for group emotion to depend on the homogeneity of the individual members, but recent literature looking at the effects of team diversity were not available when Kozlowski and Bell did their review. This is one of the points where the Google research studies have expanded our understanding. Diverse teams can be highly productive, but developing the necessary communications skills takes more work. In medicine this has often shown up as using the air crew model of training as part of operating room safety. By developing standardized communications—the check list, for example—the team does not have to relearn how to communicate amongst themselves every time they gather with a different surgeon, a different anesthetist, or other team member. Collective efficacy, a belief that the team is functioning well, seems like an important attribute, but the concept of efficacy is fraught with problems, both at the individual and at the group level. “Based on supportive research findings, it is reasonable to assume that high collective efficacy is generally a desirable team characteristic. From a practical perspective, the relevant question is how can collective efficacy be fostered? Unfortunately [the research is incomplete]…making it difficult to provide firm recommendations on how managers and organizations can build efficacy at the team level.” 4 1 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. 31. 2 Ibid., p. 32. 3 Ibid., p. 33. 4 Ibid., p. 36. Conflict and divisiveness are also common features of teams, as in life generally. There are two conflict management strategies. The first “involves establishing conditions to prevent, control, or guide team conflict before it occurs. The second, reactive conflict management, “involves working through task, process, and interpersonal disagreements among team members.” Physicians as a group are conflict-avoidant, so rarely think in terms of trying to manage conflict and are typically lack the time needed to do reactive conflict management. So, when conflict arises, physicians are apt to withdraw, which does nothing to address the issue. Perhaps it would be helpful to distinguish between interpersonal conflict and task conflict. “…for groups performing routine tasks, both task conflict (disagreement about task conflict), and relationship conflict (interpersonal incompatibilities) were detrimental. However, for groups performing non-routine tasks, only relationship conflict was detrimental… Furthermore…top management teams low in interpersonal trust tended to attribute conflict to relationship-based issues, whereas top management teams high in interpersonal trust tend to attribute conflict to task-based disagreements. Thus, interpersonal trust may be an important variable to consider when managing conflict in teams.” 5 The opposite of conflict might be cooperation. Research suggests individualists are less apt, and collectivists more apt, to behave cooperatively.” Physicians, of course, are usually individualists, so even though they are conflict avoidant, won’t behave the way the collectivists might. A research study in hospitals found “that cooperation positively predicted both task and psychosocial outcomes, such that teams high in cooperation relied more heavily on informal modes of communication than did low cooperation teams.” 6 Establishing some baseline level of trust is a necessary pre-condition for success. Said another way, success is possible if and only if the physicians and the other team members trust each other. Some years ago, I led a series of discussions between interested physicians and hospital management trying to look at why distrust existed. Much discussion revolved around differences in temperament and communication preferences. Physicians tended to prefer informal, ad-hoc, contemporaneous communication, where mangers tended to prefer formal, agenda driven, scheduled communications. (The effort was not successful.) I had confirmation for this thesis when leading “open microphone” sessions for the medical directors for my dialysis provider where there is a fairly high level of trust. These sessions never had an agenda—the doctors were free to bring up whatever was on their minds. In preparation for these sessions, I had many conversations with the managers who wanted some idea what I thought might arise. Sometimes there was an ongoing controversy, but most of the time, I did not know. After most of these sessions, though, both doctors and managers came away with positive feelings, albeit for different reasons. The doctors felt good because their concerns were heard and shared. The mangers felt good because they found the doctors were more knowledgeable and thoughtful about the problems raised than expected. And so, trust was built, at least until the next conflict. 10 April 2018 5 Ibid., p. 37. 6 Ibid., p. 39. |
Further Reading
Building Team Effectiveness Emotional Intelligence for Physicians How do physicians rate in the domains of emotional intelligence? Leadership Skills Why Physicians Don't Lead Why don't physicians lead? Maybe a better question is how do you create opportunities for constructive leadership? |