Jane Prichard

The educational impact of team‐skills training: Preparing students to work in groups

BACKGROUND Despite a vast literature on collaborative learning (CL), there is little research on preparing students to work collaboratively. AIMS This two-phase evaluation investigated whether team-skills training could enhance the performance of collaborative groups through the introduction of a team development programme to a group-based undergraduate key-skills unit. SAMPLE Phase 1 compared two consecutive cohorts of second-year students, Cohort 1 (N = 94) who received no preparation, and Cohort 2 (N = 113) who received team-skills training. Phase 2 added Cohort 3 (N = 88), who also received team-skills training, to extend the analysis. METHOD In Phase 1, students in both Cohorts 1 and 2 worked on a series of curriculum based key-skill tasks across two semesters. Students worked in one group in Semester 1 and were then formed into new groups for Semester 2. Effects of the training were measured by student group marks and key-skill ratings. RESULTS Marks and key-skill ratings were significantly higher for the trained cohort in Semester 1 (p < .01). However, in Semester 2 performance reduced for the trained cohort in comparison to Semester 1. To explore this further, Phase 2 of the study evaluated Cohort 3, where after training, collaborative groups remained intact throughout the academic year. Results for Cohort 3 showed no attenuation of performance effects in Semester 2. CONCLUSIONS Phase 1 results support the use of team-skills training to enhance CL group performance. The findings for Phase 2 suggest that these benefits may be lost if training groups are disrupted.

The Effects of Team-Skills Training on Transactive Memory and Performance:

The existence of effective transactive memory systems in teams has been found to enhance task performance. Methods of developing transactive memory are therefore an important focus of research. This study aimed to explore one such method, the use of a generic team-skills training program to develop transactive memory and subsequent task performance. Sixteen three-member teams were all trained to complete a complex collaborative task, prior to which half the teams (n = 8) completed a team-skills training program. Results confirmed that those teams that had been trained to develop a range of team skills such as problem-solving, interpersonal relationships, goal setting, and role allocation evidenced significantly higher team skill, transactive memory, and performance than those that were not trained in such skills. Results are discussed with reference to the wider transactive memory literature and the mechanisms through which team-skills training could facilitate the more rapid development of transactive memory.

Testing Belbin’s team role theory of effective groups

Belbin’s Team‐Role Theory is extensively used as a counselling and team development tool by organisations and management consultancies in the UK. However, there is little empirical support for his work, largely because there has been scant research. This study sought to redress this situation by testing Belbin’s proposal that teams in which a wide range of team‐roles are represented perform better than those where there is an imbalance of roles because certain roles are over‐represented. The task performance of six teams of four individuals identified as shapers by the Team‐Role Self‐Perception Inventory (Belbin, 1981), was compared with that of six mixed teams of four individuals; one co‐ordinator, one plant, one completer finisher, and one team worker. It was found that consistent with Belbin’s proposal the “mixed” teams performed better than teams consisting of shapers alone. Some possible explanations and implications of the findings are discussed.

Using computer decision support systems in NHS emergency and urgent care: ethnographic study using normalisation process theory

BackgroundInformation and communication technologies (ICTs) are often proposed as ‘technological fixes’ for problems facing healthcare. They promise to deliver services more quickly and cheaply. Yet research on the implementation of ICTs reveals a litany of delays, compromises and failures. Case studies have established that these technologies are difficult to embed in everyday healthcare.MethodsWe undertook an ethnographic comparative analysis of a single computer decision support system in three different settings to understand the implementation and everyday use of this technology which is designed to deal with calls to emergency and urgent care services. We examined the deployment of this technology in an established 999 ambulance call-handling service, a new single point of access for urgent care and an established general practice out-of-hours service. We used Normalization Process Theory as a framework to enable systematic cross-case analysis.ResultsOur data comprise nearly 500 hours of observation, interviews with 64 call-handlers, and stakeholders and documents about the technology and settings. The technology has been implemented and is used distinctively in each setting reflecting important differences between work and contexts. Using Normalisation Process Theory we show how the work (collective action) of implementing the system and maintaining its routine use was enabled by a range of actors who established coherence for the technology, secured buy-in (cognitive participation) and engaged in on-going appraisal and adjustment (reflexive monitoring).ConclusionsHuge effort was expended and continues to be required to implement and keep this technology in use. This innovation must be understood both as a computer technology and as a set of practices related to that technology, kept in place by a network of actors in particular contexts. While technologies can be ‘made to work’ in different settings, successful implementation has been achieved, and will only be maintained, through the efforts of those involved in the specific settings and if the wider context continues to support the coherence, cognitive participation, and reflective monitoring processes that surround this collective action. Implementation is more than simply putting technologies in place – it requires new resources and considerable effort, perhaps on an on-going basis.

Reconfiguring the emergency and urgent care workforce: mixed methods study of skills and the everyday work of non-clinical call-handlers in the NHS

Objectives: To examine the skills and expertise required and used by non-clinical call-handlers doing telephone triage and assessment, supported by a computer decision support system (CDSS) in urgent and emergency care services. Methods: Comparative case study of three different English emergency and urgent care services. Data consisted of nearly 500 hours of non-participant observation, 61 semi-structured interviews with health service staff, documentary analysis, and a survey of 106 call-handlers. Results: Communication skills and ‘allowing the CDSS to drive the assessment’ are viewed by the CDSS developers and staff as key competencies for call-handling. Call-handlers demonstrated high levels of experience, skills and expertise in using the CDSS. These workers are often portrayed simply as ‘trained users’ of technology, but they used a broader set of skills including team work, flexibility and ‘translation’. Call-handlers develop a ‘pseudo-clinical’ expertise and draw upon their experiential knowledge to bring the CDSS into everyday use. Conclusions: Clinical assessment and triage by non-clinical staff supported by a CDSS represents a major change in urgent and emergency care delivery, warranting a detailed examination of call-handlers’ skills and expertise. We found that this work appears to have more in common with clinical work and expertise than with other call-centre work that it superficially resembles. Recognizing the range of skills call-handlers demonstrate and developing a better understanding of this should be incorporated into the training for, and management of, emergency and urgent care call-handling.

An Integrative Model of the Role of Trust in Transactive Memory Development

This article extends transactive memory (TM) theory as it is currently conceptualized. We propose a new integrative model of the relationship between transactive memory system (TMS) development and trust. By using the TM encoding cycle, the model proposes that trust acts as an antecedent of TMSs and that wider perceptions of team members’ trustworthiness (benevolence and integrity) also affect the development and maintenance of effective TMSs in teams. Our conceptualization considers the effect of trust on both the knowledge structure and the transactive processes involved in TMSs. From our analysis, we provide a number of propositions and hypotheses relating to different stages of TMS development to be pursued by future research. Finally, we consider the managerial implications of our model.

Trusting technical change in call centres

Technical change is an on-going organizational challenge in call centres. While new technologies continually promise enhanced performance, not least by extending managerial control, the implementation of these technologies is an emergent process that requires effort by workers to establish new routines that embed innovations into everyday work. This article considers the role that trust may play in this process. Drawing on a theoretical framework which conceptualizes trust as an organizing principle of organizational activity, and placing this in a wider context where trust may be understood as an element of normative control in the workplace, the role of trust in technical innovation in three healthcare call centres is explored. The research reveals heterogeneous trusting relations between managers, staff and technical systems shaping the process of change and suggests that whilst managerialist efforts to generate trust maybe one element of this, the operation of trust at work is more complex.

Enhancing trust through training

INTRODUCTION The past decade has seen a considerable expansion in research that has looked at team training, addressing a range of questions about how to design training; how to implement it; and its impact on both team processes and performance. Despite this expansion, to date there has been relatively little attention given to the relationship between team training and the development of trust within teams. This is surprising as training and development professionals working in organizations regard trust as one of the most important skills that should be developed within teams due to its positive effects on team performance, organizational productivity and competitive advantage (Davis et al., 2000; McEvily et al., 2003; Rosen et al., 2006). It would therefore seem advantageous within a human resource (HR) context to implement training programmes that promote trust between team members in order to benefit the organization. Furthermore, it may be particularly beneficial for certain types of teams; for example, in virtual teams where lack of face- to- face contact limits trust development, and in culturally diverse teams where differences in cultural norms may reduce trust in others. To extend understanding in this area, this chapter considers the research on both the use of training to develop trust among team members and its efficacy. We highlight research on two distinct approaches to training – team- and task- skills training – considering their effectiveness and applicability to different contexts, as well as issues for future research. We begin by defining trust within a training context and consider the processes through which trust may develop in training.

Has the NHS 111 urgent care telephone service been a success? Case study and secondary data analysis in England

Objectives To explore the success of the introduction of the National Health Service (NHS) 111 urgent care service and describe service activity in the period 2014–2016. Design Comparative mixed method case study of five NHS 111 service providers and analysis of national level routine data on activity and service use. Settings and data Our primary research involved five NHS 111 sites in England. We conducted 356 hours of non-participant observation in NHS 111 call centres and the urgent care centres and, linked to these observations, held 6 focus group interviews with 47 call advisors, clinical and managerial staff. This primary research is augmented by a secondary analysis of routine data about the 44 NHS 111 sites in England contained in the NHS 111 Minimum Data Set made available by NHS England. Results Opinions vary depending on the criteria used to judge the success of NHS 111. The service has been rolled out across 44 sites. The 111 phone number is operational and the service has replaced its predecessor NHS Direct. This new service has led to changes in who does the work of managing urgent care demand, achieving significant labour substitution. Judged against internal performance criteria, the service appears not to meet some targets such as call answering times, but it has seen a steady increase in use over time. Patients appear largely satisfied with NHS 111, but the view from some stakeholders is more mixed. The impact of NHS 111 on other health services is difficult to assess and cost-effectiveness has not been established. Conclusion The new urgent care service NHS 111 has been brought into use but its success against some key criteria has not been comprehensively proven.

Risk work in NHS 111: the everyday work of managing risk in telephone assessment using a computer decision support system

The substitution of clinical with non-clinical staff to triage and manage calls in the NHS urgent care services is one of the number of measures designed to meet growing health services demand. The deployment of a Computer Decision Support System ‘NHS Pathways’ to support this work has created a new type of health worker and a new form of risk work. In this article, we examine how call handlers manage, experience and respond to risk in their everyday practice of telephone assessment. We draw on data from an ethnographic study of 5 NHS 111 sites involving 356 h of observation plus 6 focus groups with 47 health services staff in 2011–2012. We found that there was a ‘risk problem’ involving balancing the competing demands of assessing patients safely against rationing limited health resources. The new service used technology to support risk management but this technology also created risk work for call handlers, clinicians and patients. We found that call handlers engaged in risk work that involved interpretation, judgement and flexibility in using NHS Pathways. Call handlers also deferred some risk work to both clinicians and patients/callers. Risk work now involves ‘making the technology work’ and much of this work has been delegated to non-clinical call handlers. These new healthcare workers are interpreters of risk. Risk work creates a sense of responsibility (and sometimes anxiety) for these non-clinical call handlers.