Open AccessTeams, performance and trust: a perspective from the vanguard
Author(s) -
Osian James,
CR Bowman,
John R. E. Parker,
Oliver Luton,
Denise Robinson,
Luke Hopkins,
A. Powell,
Richard Egan,
Lewis Wg
Publication year - 2021
Publication title -
bulletin of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
eISSN - 1478-7075
pISSN - 1473-6357
DOI - 10.1308/rcsbull.2021.73
Subject(s) - clarity , medicine , patient safety , perspective (graphical) , family medicine , vanguard , triage , seclusion , psychology , psychiatry , health care , history , biochemistry , chemistry , archaeology , economics , economic growth , artificial intelligence , computer science
The aim of this study was to determine surgical trainees’ perspectives on team environment, function, performance and trust.Methods A 44-point anonymous survey was distributed to all doctors working in surgery in a single UK statutory education body. Responses were received from 116 doctors (17 foundation year 1 [F1] doctors, 50 senior house officers [SHOs], 49 specialist registrars [SpRs]).Results Psychological safety was associated with trainee grade, with SHOs showing the lowest results relating to perception of support (F1 88%, SHO 60%, SpR 82%, p=0.016) and ability to ask for help (F1 100%, SHO 71%, SpR 92%, p=0.043). Dependability among colleagues was perceived to be poorer by women than by men (70% vs 88%, p=0.009). Clarity of team structure was associated with grade and perceived to be poor by SHOs (F1 94%, SHO 60%, SpR 78%, p=0.014). Meaningfulness and impact of team achievement was also associated with grade (F1 77%, SHO 69%, SpR 94%, p=0.005). Inverse correlations were observed between the prevalence of harassment/bullying and markers of psychological safety (r s =-0.382, p<0.001), dependability (r s =-0.270, p=0.003) and clarity of team structure (r s =0.355, p<0.001).Conclusions Important deficiencies in psychological safety had an adverse effect on two in five SHOs. Countermeasures (enhanced stress resilience training) are needed to protect morale, patient safety and clinical out