Individuals Make the Team: Recognizing Individual Learners Ashlesha Dayal, MD Assistant Professor Nadine T. Katz, MD Associate Professor Albert Einstein College of Medicine Montefiore Medical Center Bronx, NY

Objectives Establishing that people within a team assume a Role Establishing that people within a team assume a Role Recognizing different team roles and their importance to the team interaction Recognizing different team roles and their importance to the team interaction Understanding basic tenets of feedback and remediation Understanding basic tenets of feedback and remediation Using knowledge of team roles to offer individualized and specific feedback Using knowledge of team roles to offer individualized and specific feedback

What is a Team? A cooperative unit created to achieve one or several goals A cooperative unit created to achieve one or several goals Team dynamics – unseen “natural forces” that strongly influence how a team reacts, behaves or performs Team dynamics – unseen “natural forces” that strongly influence how a team reacts, behaves or performs Team dynamics – dependent on the individual makeup of the team – Team dynamics – dependent on the individual makeup of the team – the learners

Recognizing Team Dynamics Looking for the forces that influence team behavior Forces include Forces include Personality styles Personality styles Tools and technology Tools and technology Organizational culture Organizational culture Team processes/ methodologies/ procedures Team processes/ methodologies/ procedures Most important force is Team Roles (incorporating Personality Styles)

Team Roles Belbin described a team role as “a tendency to behave, contribute and interrelate with others in a particular way” Belbin described a team role as “a tendency to behave, contribute and interrelate with others in a particular way” Identification is an effective way to assess strengths and weaknesses of individual members Identification is an effective way to assess strengths and weaknesses of individual members Provides opportunity for recognition of ways to improve performance and offer targeted feedback Provides opportunity for recognition of ways to improve performance and offer targeted feedback Belbin, R. Meredith, 2003 Management Teams: Why They Succeed or Fail Oxford Press

Team Roles – Action Oriented Shaper: challenging, dynamic, thrives on pressure Shaper: challenging, dynamic, thrives on pressure Implementer: Disciplined, reliable, conservative and efficient Implementer: Disciplined, reliable, conservative and efficient Completer finisher: Painstaking, conscientious, anxious Completer finisher: Painstaking, conscientious, anxious

Team Roles: Action Oriented Strengths Weaknesses Shaper: challenging, dynamic, thrives on pressure Shaper: challenging, dynamic, thrives on pressure Implementer: disciplined, reliable, conservative, efficient Implementer: disciplined, reliable, conservative, efficient Completer finisher: Painstakingly conscientious, anxious Completer finisher: Painstakingly conscientious, anxious Prone to provocation/ offends easily Somewhat inflexible/ slow to respond to new possibilities Inclined to worry unduly/ reluctant to delegate

Team Roles – People Oriented Coordinator: Mature, confident, clarifies goals, delegates well Coordinator: Mature, confident, clarifies goals, delegates well Team worker: cooperative, mild, perceptive and diplomatic Team worker: cooperative, mild, perceptive and diplomatic Resource investigator: Extrovert, enthusiastic, communicative Resource investigator: Extrovert, enthusiastic, communicative

Team Roles: People Oriented Strengths Weaknesses Coordinator: mature, confident, clarifies goals, delegates well Coordinator: mature, confident, clarifies goals, delegates well Team worker: cooperative, mild, perceptive, diplomatic, averts friction Team worker: cooperative, mild, perceptive, diplomatic, averts friction Resource investigator: extrovert, enthusiastic, communicative, makes contacts Resource investigator: extrovert, enthusiastic, communicative, makes contacts Can be seen as manipulative/ offloads personal work Indecisive in crunch situations Over optimistic/ loses interest after initial enthusiasm

Team Roles – Cerebral Plant: creative, imaginative, unorthodox Plant: creative, imaginative, unorthodox Monitor evaluator: sober, strategic, and discerning Monitor evaluator: sober, strategic, and discerning Specialist: single minded, self starter, dedicated Specialist: single minded, self starter, dedicated

Team Roles: Cerebral Strengths Weaknesses Plant: creative, imaginative, unorthodox, solves difficult problems Plant: creative, imaginative, unorthodox, solves difficult problems Monitor evaluator: sober, strategic and discerning, judges accurately Monitor evaluator: sober, strategic and discerning, judges accurately Specialist: single minded, self starter, dedicated Specialist: single minded, self starter, dedicated Ignores incidentals/ very preoccupied Lacks drive and ability to inspire others Narrow contribution, dwells on technicalities

Feedback Feedback is an essential component in education because it shapes future performance Feedback is an essential component in education because it shapes future performance The distinction between feedback and evaluation sets the stage The distinction between feedback and evaluation sets the stage Feedback is formative, behavior based Feedback is formative, behavior based Evaluation is summative; judgments expressed as normative statements Evaluation is summative; judgments expressed as normative statements

Feedback Students and residents often report that they do not receive feedback Students and residents often report that they do not receive feedback Most students and residents are inexperienced at seeking out feedback and need to have time assigned Most students and residents are inexperienced at seeking out feedback and need to have time assigned Most faculty are not skilled at giving feedback Most faculty are not skilled at giving feedback

Feedback – Helpful Techniques Feedback is enhanced by good interpersonal relationships Feedback is enhanced by good interpersonal relationships Neutral, private location is optimal Neutral, private location is optimal Must be timely Must be timely Student buy-in is key to success Student buy-in is key to success Follow-up is essential Follow-up is essential Avoid overload Avoid overload

The Feedback Sandwich Discuss observations of skills and behaviors done well Then identify specific areas in need of improvement Finish with suggestions, alternative behaviors and positive comments

Feedback Tenets Think before speaking Think before speaking Feedback should represent shared goals Feedback should represent shared goals Feedback should be expected by the learner and be well timed Feedback should be expected by the learner and be well timed Feedback should be based on first hand data Feedback should be based on first hand data Feedback should be regulated in quantity Feedback should be regulated in quantity Reynolds and Ende, Teaching and Learning in Medical Surgical Education…

Feedback Tenets Feedback should deal with specific performances, not generalizations Feedback should deal with specific performances, not generalizations Feedback should be phrased in descriptive, non-evaluative language Feedback should be phrased in descriptive, non-evaluative language Feedback should deal with decisions and actions, not assumed intentions or interpretations Feedback should deal with decisions and actions, not assumed intentions or interpretations Reynolds and Ende, Teaching and Learning in Medical Surgical Education…

Feedback Tenets Feedback should include guidelines for improving performance (action plan) Feedback should include guidelines for improving performance (action plan) Feedback should be based on consistent standards and procedures Feedback should be based on consistent standards and procedures Feedback should be followed up Feedback should be followed up Feedback should be understood by the learner Ask him/her to repeat it Feedback should be understood by the learner Ask him/her to repeat it

Guidelines For Feedback Providers Specify that this is the feedback session Specify that this is the feedback session Constructive feedback allows for change Constructive feedback allows for change Document feedback given and the response Document feedback given and the response Especially in non-responsive situations Especially in non-responsive situations Cite specific examples offered in the feedback session Cite specific examples offered in the feedback session Set date for follow up and follow through Set date for follow up and follow through Check for student understanding Check for student understanding

Feedback in “Problem Situations” Target the feedback to the particular learner Target the feedback to the particular learner Importance of knowing roles in team settings Importance of knowing roles in team settings Importance of knowing rules of feedback Importance of knowing rules of feedback

Remediation Develop active management plan for remediation and document it Target plan to appreciate the “team role” Target plan to appreciate the “team role” Follow-through has to be persistent Follow-through has to be persistent Document all feedback and responses Document all feedback and responses Define student’s accountability and explain consequences of failure to change Define student’s accountability and explain consequences of failure to change Enlist help when necessary-know escalation procedure at your school Enlist help when necessary-know escalation procedure at your school

Wrap Up Team dynamics are most influenced by team roles assumed by the individual learner Team dynamics are most influenced by team roles assumed by the individual learner Three main role categories are action oriented, people oriented and cerebral Three main role categories are action oriented, people oriented and cerebral Knowledge of roles and characteristics offer chance for individualized feedback Knowledge of roles and characteristics offer chance for individualized feedback Knowledge of basic feedback tenets is critical to receptive response Knowledge of basic feedback tenets is critical to receptive response

The remainder of the session will concentrate on providing focused feedback to particular students and situations, using the concepts of team roles, rules of feedback, and plans of remediation.

Team RoleStrengthsAllowable Weakness Plant (PL)Creative, unorthodoxIgnores incidentals Resource Investigator (RI)Enterprising, develops contactsOver-optimistic Co-ordinator (CO)Good chairperson, clarifies goalsManipulative Shaper (SH)Challenging, dynamicProvocative Monitor Evaluator (ME)Discerning, judges accuratelySlow moving Team Worker (TW)Cooperative, diplomaticIndecisive Implementer (IMP)Efficient, disciplinedInflexible Completer Finisher (CF)Conscientious, painstakingReluctant to delegate Specialist (SP)Single minded, seeker of knowledge Contributes on a narrow front

Team Role Strengths Allowable Weaknesses Plant (PL) Creative, unorthodox Ignores incidentals Resource Investigator (RI)Enterprising, develops contactsOver-optimistic Co-ordinator (CO)Good chairperson, clarifies goals Manipulative Shaper (SH)Challenging, dynamicProvocative Monitor Evaluator (ME)Discerning, judges accuratelySlow moving Team Worker (TW)Cooperative, diplomaticIndecisive Implementer (IMP)Efficient, disciplinedInflexible Completer Finisher (CF)Conscientious, painstakingReluctant to delegate Specialist (SP)Single minded, seeker of knowledge Contributes on a narrow front

I The PLANT (PL), the RESOURCE INVESTIGATOR (RI), the SHAPER (SH), the MONITOR-EVALUATOR (ME), the CO-ORDINATOR (CO), the IMPLEMENTER (IMP), the TEAM WORKER (TW) and the COMPLETER- FINISHER (CF)PLANTRESOURCE INVESTIGATORSHAPERMONITOR-EVALUATORCO-ORDINATOR IMPLEMENTERTEAM WORKERCOMPLETER- FINISHER