Presentation
Developing a team coach for healthcare teams: What does it take?
DescriptionTeam coaching, originally conceptualized by Hackman & Wageman (2005), drives three main benefits for a team: an increase in group effort (Liu et al., 2009; Rousseau et al., 2013), better interpersonal processes via improvements in psychological safety (Edmondson, 1999; Graen et al., 2020), and lastly, an increase in team knowledge and learning (Azanza et al., 2022; Miller and Stewart, 2013; Schaubroeck et al., 2016). Though not yet extensively examined in healthcare, team coaching has produced a number of positive outcomes for healthcare teams, such as: improvements in surgical outcomes (Maynard et al., 2021); improvements in supervisor-supervisee relationships (Cochrane et al., 2007); and a promotion of voice in surgical teams (Farh & Chen, 2018). Given the three main problems the field is currently facing – such as increased levels of burnout (Rotenstein et al., 2021), a lack of psychological safety (O’Donovan and McAuliffe, 2020), and other issues, regarded as “communication mistakes” (Clapper & Ching) – team coaching seems to be extremely well-positioned to address these problems. Yet, the team coaching literature suffers from a lack of conceptual clarity and disagreements on which type of coaching should be implemented (Graves, 2021; Jones et al., 2019; Traylor et al., 2020), which has negatively impacted team coaching’s ability to become a well-developed intervention. Moreover, the literature is often unclear in its methodology, making replicability difficult, and the refinement of the tool hard to achieve.
For this reason, the proposed presentation has three main objectives: 1) to describe the state of the literature and offer a quick overview of team coaching, 2) to describe the leader-behavioral approach (the main way of conceptualizing team coaching, see Traylor et al., 2020), and finally, 3) to define explicit strategies an internal team coach can take to increase these three areas: group effort, psychological safety, and team knowledge and learning. Moreover, the proposed presentation will describe why these three areas are important to positive group functioning. By doing this, this presentation contributes to the literature in two ways: 1) offering conceptual clarity on what team coaching can do using existing empirical evidence and 2) establishing explicit evidence-based strategies that healthcare workers can use in order to implement team coaching within their teams.
Increasing group effort
Burnout has consistently been linked to decreases in quality of care, quality indicators, and perceptions of safety (Salyers et al., 2017). One aspect of burnout is emotional exhaustion, which has been tied to a reduction in work effort (del Carmen et al., 2019). Part of this picture is that over time, healthcare clinicians have experienced a loss of autonomy, more exhaustion, and increasing administrative requirements (del Carmen et al., 2019). To alleviate this, interventions need to foster a supportive environment with realistic work expectations (Brindley et al., 2019) – an achievement quite difficult in such a dynamic and demanding clinical environment. Team coaching has been shown to increase a team’s group effort – and we posit that in order to help alleviate burnout, team leaders can use team coaching. In order to do this, team coaches should aim to establish clear, concise team goals and moreover, make sure the team understands their own role in accomplishing the collective. To do this, leaders can clarify the mission at hand (i.e., setting a specific goal, see Seijts & Latham, 2012) and pivot the team in either a learning (a goal focused on acquiring knowledge and skill) or performance (a goal focused on a desired end result) goal orientation. Goal-setting is one of the most established theories in organizational psychology (Locke & Latham, 2013). Difficult goals can increase team performance when teams have a high learning orientation (Park et al., 2013). The key takeaway for team coaches in regard to motivation is to set goals, give roles, and encourage team members along the way. In the proposed presentation, we seek to expand on how team coaches can set goals and what norms they can establish to help increase feelings of autonomy and accountability within their team.
Improvements in interpersonal processes via psychological safety
Psychological safety enables effective teams ( Aranzamendez, et al., 2014; Kessel et al., 2012; O’Donovan and McAuliffe, 2020). In healthcare, psychological safety is vital and needed, as many work-situations involve high-stakes. For this reason, it is vital for team members to be able to speak up even amidst hierarchical structures, and in psychologically safe environments, team members will feel as though they can 1) speak up if there is a mistake, 2) raise concerns if possible, and 3) become more engaged (Tannenbaum and Salas, 2021). In order to increase psychological safety, and hence, improve interpersonal processes, team leaders can encourage a learning orientation and ensure role clarity (Frazier et al., 2016). Moreover, there is a variety of literature linking different types of leadership styles (such as ethical, transformational, and transparent leadership) to psychological safety, so team leaders can implement specific behaviors from these styles to foster it. Other behaviors include increasing voice within one’s team (e.g., encouraging team members to speak up; Hu et al., 2018) being transparent with one’s team (which includes open communication, sharing relevant information, and giving feedback; Yi et al., 2016). In the proposed presentation, we will take a deep dive into these behaviors, break them down, and offer a list of simple strategies clinicians can take with them to readily implement.
Increasing team knowledge and learning
Team learning is a process where knowledge, skills, and affective states are realized through shared experience and interactions betweens team members (Kozlowski & Illgen, 2006) – an extremely vital process for healthcare teams, in order for them to learn from past failures. For team coaches to facilitate the development of a team’s shared mental model, they need to attend to specific behavior based on how the model was developed and where the team is at in their developmental journey (Lawrence & Whyte, 2017).
Team coaches can oversee the affective states that can mitigate the adaptation of the teams shared mental model throughout their existence. The affective states that are derived from team learning, mainly collective efficacy and cohesion, drive team performance (Lindsley, Brass, & Thomas, 1995; Stagl et al., 2008). For team coaches to effectively support teams in building collective efficacy and cohesion, they need to encourage team members to work interdependently through a higher frequency of interpersonal interactions for the team to be effective (Elm et al., 2023). Similarly, team coaches should encourage team members to collaborate so more information can be processed by other team members, bringing attention to the team’s collective knowledge and interactions that result in higher levels of team performance. The proposed presentation will go over specific strategies, such as debriefs (Tannenbaum & Cerasoli, 2012) that team coaches can use to improve mental models, as well as other strategies that can help a team coach monitor affective states as relevant to the team’s goals.
**All references available upon request, they did not fit in here.
For this reason, the proposed presentation has three main objectives: 1) to describe the state of the literature and offer a quick overview of team coaching, 2) to describe the leader-behavioral approach (the main way of conceptualizing team coaching, see Traylor et al., 2020), and finally, 3) to define explicit strategies an internal team coach can take to increase these three areas: group effort, psychological safety, and team knowledge and learning. Moreover, the proposed presentation will describe why these three areas are important to positive group functioning. By doing this, this presentation contributes to the literature in two ways: 1) offering conceptual clarity on what team coaching can do using existing empirical evidence and 2) establishing explicit evidence-based strategies that healthcare workers can use in order to implement team coaching within their teams.
Increasing group effort
Burnout has consistently been linked to decreases in quality of care, quality indicators, and perceptions of safety (Salyers et al., 2017). One aspect of burnout is emotional exhaustion, which has been tied to a reduction in work effort (del Carmen et al., 2019). Part of this picture is that over time, healthcare clinicians have experienced a loss of autonomy, more exhaustion, and increasing administrative requirements (del Carmen et al., 2019). To alleviate this, interventions need to foster a supportive environment with realistic work expectations (Brindley et al., 2019) – an achievement quite difficult in such a dynamic and demanding clinical environment. Team coaching has been shown to increase a team’s group effort – and we posit that in order to help alleviate burnout, team leaders can use team coaching. In order to do this, team coaches should aim to establish clear, concise team goals and moreover, make sure the team understands their own role in accomplishing the collective. To do this, leaders can clarify the mission at hand (i.e., setting a specific goal, see Seijts & Latham, 2012) and pivot the team in either a learning (a goal focused on acquiring knowledge and skill) or performance (a goal focused on a desired end result) goal orientation. Goal-setting is one of the most established theories in organizational psychology (Locke & Latham, 2013). Difficult goals can increase team performance when teams have a high learning orientation (Park et al., 2013). The key takeaway for team coaches in regard to motivation is to set goals, give roles, and encourage team members along the way. In the proposed presentation, we seek to expand on how team coaches can set goals and what norms they can establish to help increase feelings of autonomy and accountability within their team.
Improvements in interpersonal processes via psychological safety
Psychological safety enables effective teams ( Aranzamendez, et al., 2014; Kessel et al., 2012; O’Donovan and McAuliffe, 2020). In healthcare, psychological safety is vital and needed, as many work-situations involve high-stakes. For this reason, it is vital for team members to be able to speak up even amidst hierarchical structures, and in psychologically safe environments, team members will feel as though they can 1) speak up if there is a mistake, 2) raise concerns if possible, and 3) become more engaged (Tannenbaum and Salas, 2021). In order to increase psychological safety, and hence, improve interpersonal processes, team leaders can encourage a learning orientation and ensure role clarity (Frazier et al., 2016). Moreover, there is a variety of literature linking different types of leadership styles (such as ethical, transformational, and transparent leadership) to psychological safety, so team leaders can implement specific behaviors from these styles to foster it. Other behaviors include increasing voice within one’s team (e.g., encouraging team members to speak up; Hu et al., 2018) being transparent with one’s team (which includes open communication, sharing relevant information, and giving feedback; Yi et al., 2016). In the proposed presentation, we will take a deep dive into these behaviors, break them down, and offer a list of simple strategies clinicians can take with them to readily implement.
Increasing team knowledge and learning
Team learning is a process where knowledge, skills, and affective states are realized through shared experience and interactions betweens team members (Kozlowski & Illgen, 2006) – an extremely vital process for healthcare teams, in order for them to learn from past failures. For team coaches to facilitate the development of a team’s shared mental model, they need to attend to specific behavior based on how the model was developed and where the team is at in their developmental journey (Lawrence & Whyte, 2017).
Team coaches can oversee the affective states that can mitigate the adaptation of the teams shared mental model throughout their existence. The affective states that are derived from team learning, mainly collective efficacy and cohesion, drive team performance (Lindsley, Brass, & Thomas, 1995; Stagl et al., 2008). For team coaches to effectively support teams in building collective efficacy and cohesion, they need to encourage team members to work interdependently through a higher frequency of interpersonal interactions for the team to be effective (Elm et al., 2023). Similarly, team coaches should encourage team members to collaborate so more information can be processed by other team members, bringing attention to the team’s collective knowledge and interactions that result in higher levels of team performance. The proposed presentation will go over specific strategies, such as debriefs (Tannenbaum & Cerasoli, 2012) that team coaches can use to improve mental models, as well as other strategies that can help a team coach monitor affective states as relevant to the team’s goals.
**All references available upon request, they did not fit in here.
Event Type
Oral Presentations
TimeWednesday, March 279:15am - 9:37am CDT
LocationSalon A-4
Simulation and Education