Helping fluid teams work: A research agenda for effective team adaptation in healthcare

Wendy L Bedwell, P Scott Ramsay, Eduardo Salas

Although membership changes within teams are a common practice, research into this phenomenon is relatively nascent (Summers et al.; Acad Manag J 55:314-338, 2012). The small literature base, however, does provide insight into skills required for effective adaptation. The purpose of this effort is to provide a brief research synopsis, leading to research hypotheses about medical team training. By generalizing previous scientific findings regarding skills required for effective membership adaptation in different kinds of teams, we posit mechanisms whereby teamwork training might also support adaptation among medical teams (Burke et al.; Qual & Saf Health Care 13:i96-i104, 2004 and Salas et al.; Theor Issues Ergon Sci 8:381-394, 2007). We provide an overview of the membership change literature. Drawing upon literature from both within and outside of the medical domain, we suggest a framework and research propositions to aid in research efforts designed to determine the best content for helping to create adaptable medical teams through team training efforts. For effective adaptation, we suggest ad hoc teams should be trained on generalizable teamwork skills, to share just "enough" and the "right" information, to engage in shared leadership, and to shift from explicit to implicit coordination. Our overarching goal was to present what is known from the general research literature on successful team adaptation to membership changes, and to propose a research agenda to evaluate whether findings generalize to member changes in medical teams.