1. Unit 6-Team and Small Group Communication
Component 16- Professionalism/Customer Service in the Health Environment
Unit 6-Team and Small Group Communication
Welcome to professionalism/customer service in the healthcare environment.
Unit six: team and small group communication.
This material was developed by The University of Alabama at Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC

2. Health IT Workforce Curriculum Version 2.0/Spring 2011
Learning Objectives
Learn definition of group communication and tiered characteristics of groups
Explore goals, norms, and cohesiveness of groups
Address stages of team communication
Introduce communication networks and sociograms
In this unit we will be learning the group communication definition and what are called tiered (pronounced teared, like crying) characteristics of groups. In addition, we will explore goals, norms, and cohesiveness of groups. We address stages of team communication related to the formation and dismissal of a small team. Finally, networks and sociograms are introduced.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

3. Small Group Communication
Characteristics
Interdependent members
Common goal or purpose
Verbal and nonverbal components
Size
Varies depending on goal
Between 5 and 12 members
Value of odd number
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 196.
Small group communication is the process of sharing information with members of a group who are interdependent based on a common goal. Both verbal and nonverbal means are used. Team size can vary depending on the goal of the team. Generally, teams between 5 and 12 members are common. Some teams are composed of an odd number of people to allow for a majority vote. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p )
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

4. Tiered Characteristics of Groups
A way to categorize groups
Rank-based measure
Categorized on amount of time spent on
Process orientation
Content orientation
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 197.
Tiered characteristics serve as a way to categorize groups along a rank measure. A common tier used is focused on process orientation . Process Orientation addresses the time spent in the group setting relating to, and getting along with, people in the group. Content orientation refers to the time spent discussing the tasks and goals of the group. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 197.)
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

5. Additional Group Distinction
Decision-making continuum
Unilateral decision-making
Top-down approach
Shared decision-making
Synergistic groups
Wright KB, Sparks l, O’Hair HD. Health Communication in the 21st Century. Malden: Blackwell Publishing; 2008.
Teams or groups can be also categorized in terms of a decision-making continuum.
At one end of the continuum is unilateral decision-making. This is where all decisions are made in a top-down approach. An example would be a health care team that includes a physician and his or her employees such as a registered nurse, clerical staff etc. If the physician makes all the decisions and the rest of the staff carry out the decisions that would be an example of unilateral decision making.
At the other end of the continuum is shared decision-making, which typically is an interdisciplinary team model where decisions are made by the team.
(Wright KB, Sparks l, O’Hair HD. Health Communication in the 21st Century. Malden: Blackwell Publishing; p )
We will now discuss synergistic groups , which are very successful shared decision making groups.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

6. Synergistic Healthcare Groups
Attempt to accomplish something individuals cannot accomplish by themselves
Three key elements
Creating a sense of ownership
Developing team synergy
Becoming performance-based
Synergistic healthcare groups are those where the individuals work together to accomplish something that the individuals could not accomplish by themselves. The healthcare delivery process is very interdependent and requires teamwork in order to function properly.
Synergistic groups have three key elements. They are 1) creating a sense of ownership, 2) developing team synergy and 3) becoming performance-based. (Wright KB, Sparks l, O’Hair HD. Health Communication in the 21st Century. Malden: Blackwell Publishing; p )
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Health IT Workforce Curriculum Version 2.0/Spring 2011

7. Synergistic Healthcare Groups
Attempt to accomplish something individuals cannot accomplish by themselves
Three key elements
Creating a sense of ownership
Developing team synergy
Becoming performance based
The first key element of synergistic groups, creating a sense of ownership, includes building and maintaining trust, and commitment to the team and mission. It also includes instilling a sense of accomplishment.
The second key element, developing team synergy, includes assuring congruence between individual members and the group mission, being a good listener, and encouraging individual participation and empowerment. Group conflict management and active consensus building must also occur.
Finally, the third key element , becoming performance-based, entails prioritizing and setting goals, establishing decision-making rules, and measuring results.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

8. Cohesiveness of Groups
Groups can be measured by cohesion
Measured by the use of words like “us” or “we” in discussions rather than words like “I” or “me”
The frequency of the use of these terms can also be an indicator of cohesion
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 201.
Similar to the process and content of group membership, cohesion or cohesiveness can also be measured on a continuum. Cohesion refers to pulling together and being unified in purpose. A cohesive group can be measured when group members use the words, “we” or “us” rather than words like “I” or “me. How often “we” “us”, or “I” is used can indicate the extent of group cohesiveness.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

9. Factors Contributing to Group Cohesiveness and Outcomes
Goal clarity
Similarity among group members
Democratic leadership styles
Higher group cohesion yields benefits
Increased interaction
Ability to influence other group members
Increased goal orientation
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998, p. 201.
There are several factors associated with group cohesiveness and outcomes. These include:
Goal clarity where each group member fully understands the goals of the group
Similarity among group members, how alike they are and
Democratic leadership styles, where group members share in decision-making
In addition, research suggests that higher group cohesion yields numerous benefits. For example, higher cohesiveness yields increased member interaction, increased attention by group members, and higher attendance in meetings.
Group members will also be able to more effectively influence other group members. All of this will lead to higher productivity as measured by meeting group goals, as well as less conflict within the group.
(Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998 , p. 201.)
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Health IT Workforce Curriculum Version 2.0/Spring 2011

10. Group and Individual Goals
Effective small groups have a set of clear objectives that support the goals
Types of group goals
Individual goals
Different for each member
Not always related to the group purpose
Group goals
Shared by the group members
Related to their interdependence
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998, p. 198.
According to research, small groups with a clear set of objectives and goals function most effectively.
There are two types of group goals. Individual goals refer to the goal that each individual has set for him or herself. Note that the individual goals may or may not be related to the purpose of the group. For instance, one group member may participate in the group to help with his or her understanding of an organization. Another group member might have an individual goal of having more visibility with people from outside of her department.
The second type of goal is a group goal. These are usually shared by the group members and are related to their inter-dependence as members of the group. Remember, the group was called together because they have the right mix of skills or knowledge to accomplish a goal.
Both types of goals occur simultaneously. That is, the members have both their own individual goals and also shared group goals.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

11. Characteristics of Effective Group Goals
Realistic
Clearly stated at the outset
Restated frequently .
There are several characteristics of effective group goals. Realistic goals are goals that can be achieved by the group members. Goals that are not possible to achieve can lead to frustration and detachment by members of the group.
Effective group goals are both realistic and clearly stated. They will also be restated frequently to be sure the group continues to be “on the same page.’ All individual members must be able to easily understand what the goals are. Realistic and understandable group goals are more likely to be completed successfully. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998, p. 198.)
And as we said, one way to keep the group focused on the goals is to restate them at the beginning of every meeting or as frequently as needed.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

12. Health IT Workforce Curriculum Version 2.0/Spring 2011
The Role of Objectives
Steps necessary to complete each group goal
Meaningful objectives
Use the “SMART” objective criteria
Specific (concrete, detailed, well defined)
Measureable (numbers, quantity, comparison)
Achievable (feasible, actionable)
Realistic (considering resources)
Time-Bound (a defined time line)
Objectives are the steps necessary to complete each goal
Objectives must be meaningful. A tip here is to use the SMART objective criteria to help you define and write objectives.
Objectives should be:
Specific, meaning they are concrete, detailed and well defined. They should also be
Measureable. That means stating them in terms of numbers, a quantity, or by comparison. They must be
Achievable, which means it is possible for the group to achieve them and they must also be
Realistic. This means the group can meet the objectives, given the time and resources they have. The objectives should be
Time Bound. That is, there should be a defined time line for an objective to be completed.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

13. Health IT Workforce Curriculum Version 2.0/Spring 2011
Small Group Norms
Rules of behavior associated with group membership
Overt norms
Written or stated rules for all members
Covert norms
Rules for all members that are not written or stated
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 199.
Small group norms refer to the rules of behavior associated with group membership. There are two categories of small group norms.
The first category is overt norms. Overt norms refer written or verbally stated rules of behavior or ways to get the group work done. This might include a written dress code or a way to name versions of files.
The second category is covert norms. This refers to rules that are neither written nor stated, but ones that most people in the group understand. An example of this could be an understanding that business casual does not mean wearing jeans. While violation of overt norms may result in a written or verbal reprimand, if someone violates covert norms, it might be met with expressions of surprise or disapproval and other forms of non-verbal communication rather than formal discipline.
Violation of covert norms can still negatively affect the group and it’s work.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

14. Leadership Communication Behaviors in the Group Setting
Provide guidance in achieving goals
Use effective communication skills
Personal communication with group members results in better communication between group members
Assist with overcoming obstacles
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 203.
Group leaders provide guidance to group members to help them achieve the goals and the supporting objectives.
In doing so, effective communication skills are required. Research suggests that group leaders who communicate personally with group members help create groups that have better communication between members. In turn, this increases the sense of belonging among members of a group, which is another example of group cohesiveness.
Moreover, effective group leaders utilize their position and communication skills to assist group members with overcoming obstacles that are encountered.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

15. Health IT Workforce Curriculum Version 2.0/Spring 2011
Group Member Roles
Many group roles relate to communication
Initiator-contributor
Information seeker
Information giver
Opinion seeker
Opinion giver
Collaborator
Coordinator
Orienter
Recorder
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange 1998, p. 205.
Within a group the members assume different roles related to accomplishing the task. It is estimated that about 75% of group roles relate to communication. There a variety of such roles. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998, p )
The initiator-contributor suggests new ideas or shares a different way of viewing the group task.
The information seeker asks for clarification regarding the problem being discussed.
The information giver provides facts or personal experience relevant to problems discussed.
The opinion seeker clarifies values involved with the goal or task.
The opinion giver states his or her beliefs relevant to the group discussion.
The elaborator expands upon ideas discussed using an example or providing support for a suggestion made.
The coordinator summarizes ideas and suggestions made by the group members.
The orienter defines the current position of the group in regard to the goals.
The recorder writes these suggestions or other actions agreed upon by the group.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

16. Other Group Member Roles
Additional member roles can be categorized in terms of group communication that has a positive or negative focus
Additional member roles can be described in terms of positive roles such as those that contribute to building a strong group and making progress towards the goals. Roles can also have a negative effect on the group, such as a dissenter who creates barriers rather than offering solutions to problems. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998 , p )
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

17. Group Building and Continuation
Encourager
Harmonizer
Gatekeeper
Standard setter
Roles that help build strong groups and help groups make progress include being
An encourager, who praises and accepts all members’ contributions
A harmonizer, who arbitrates differences among group members
A gatekeeper who helps communication flow, including allowing all members to state their opinion
A standard setter who reminds members as needed of the goals and objectives of the group
In summary, roles that contribute to strong groups include a variety of positive and/or neutral actions within the group setting.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

18. Negative Group Member Roles
Aggressor
Blocker
Self-confessor
A few negative roles within groups include:
An aggressor who disapproves of other members values, statements, and perspectives
A blocker who is extremely negative toward suggestions by others and who focuses the attention on his or her own accomplishments
A self-confessor, who tries to focus the attention of the team on his or her own unrelated personal comments
In summary, negative group members engage in activities that do not support a strong group.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

19. Team Stages and Communication
Orientation
Conflict
Cohesion
Working
Termination
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998,p. 215.
There are five stages often mentioned that groups go through as they are formed and do their work (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998,p. 215.)
They are: Orientation, Conflict, Cohesion, Working and Termination
On the next few slides we will cover these stages in more detail.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

20. Team Stages and Communication
Orientation
Planning stage
Orientation, often referred to as forming, is the first stage groups go through. During this stage members plan their work in their new roles as part of the group. It is at this stage that group members need to learn the basics of conflict resolution, effective communication skills, and the notion of group decision-making. Communication at this level includes safe non-controversial topics like the weather, and very little sharing of personal information such as family news or hobbies.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

21. Team Stages and Communication
Orientation
Conflict
Procedures for getting work done
Group norms
Cohesion
Agreement on goals and objectives
The next two stages are Conflict and Cohesion.
Conflict, often referred to as storming, is the second stage of groups coming together, and can be recognized when the team faces interpersonal and social issues. This is where group members may experience frustration, anger, and overall conflict. It may be necessary for the group leader to address the conflict. but some conflict is a natural part of any group process. Effective leadership can guide the team members though this difficult period. Communication at this stage focuses on procedures for getting work done and group norms.
Finally, the third stage is cohesion, often referred to as norming, when the group comes to a point where they reach agreement on goals and objectives. Communications in this stage include personal sharing such as vacation news, supportive helpful comments, and minimal negative comments.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

22. Team Stages and Communication
Orientation
Conflict
Cohesion
Working
Termination
The final two stages of a group coming together are working and termination.
The fourth stage, working, also referred to as conforming , occurs when the team members are working together to achieve the objectives and goals. Communication noticed in this stage includes more positive comments, effective problem-solving suggestions and more in-depth personal sharing such as news about children.
The fifth stage, termination, also referred to as adjourning, occurs at the end of the team’s work. It may be due to completing all goals, or, perhaps, the allotted time for the group to work together is over. Communication at this stage surrounds expressions of feelings about the team’s work, closure statements such as thanking others for their help and a summary discussion of what the team accomplished.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

23. Communication Networks
Information interaction in small group settings
Made up of senders and receivers
Network layouts
Vary based on organizational preference
Dependant on group dynamics and goals
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p. 208.
In any team, communication is critical for success.
Communication networks consist of those who are sending a message, as a speaker would, and those who are receiving the message or listening to a speaker. Messages can also be communicated through , phone, or posted notices.
A small group or team may have a particular way, or preference, for how it shares information, both within the group and with others outside the group, such as management. Communication networks can look different depending on the group’s preference , which may be based on the culture of the organization and/or the style of the group leader. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; 1998, p. 208.)
For example, in one group all information is readily shared with many senders and receivers while others may formally, and selectively, control access to information with few senders and few receivers.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

24. Health IT Workforce Curriculum Version 2.0/Spring 2011
Sociograms
A sociogram is a visual way of displaying team communication, showing who talks to or shares information with others. Lines with arrows drawn between circles, representing team members, indicate the flow and direction of the information, that is the person sending the information and the person receiving the information. Thicker lines between group members indicate more frequent communication. Arrowheads indicate whether the communication is one or two-way. (Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford: Appleton and Lange; p )
In the diagram on the slide you can see that Jackie and Kathy have frequent two-way communication while Steve tends to be isolated and only communicates to Beth. Kathy is in a central position indicating that she communicates with more people than those on the outer edge, such as Shaw or Frank.
Sociograms can help show teams or groups and their communication patterns, which may be more open or less sharing, so that obstacles or problems with communication can be addressed and improved.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011

25. Health IT Workforce Curriculum Version 2.0/Spring 2011
Summary
Definition of group communication
Characteristics of tiered groups
Goals, norms, and cohesiveness of groups
Stages of team communication
Common communication networks and sociograms
In summary, in this lecture we have addressed group communication in terms of its definition and characteristics. Moreover we have discussed group goals, group norms, group objectives, and the cohesiveness of groups. Third, we have identified each stage of team communication from initiating a team to completing a team. Finally, we have identified communication networks and their supporting sociograms.
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Health IT Workforce Curriculum Version 2.0/Spring 2011

26. Health IT Workforce Curriculum Version 2.0/Spring 2011
The material for this unit has been adapted from the following sources:
Northouse LL, Northouse PG. Health communication: strategies for health professionals. 3rd ed. Stamford, CT: Appleton and Lange; 1998.
Wright KB, Sparks l, O’Hair HD. Health Communication in the 21st Century. Malden: Blackwell Publishing; 2008.
Component 16/ Unit 6
Health IT Workforce Curriculum Version 2.0/Spring 2011