evidence & practice / CPD / professional issues

LEADERSHIP

Promoting effective teamwork in the

healthcare setting
NS886 Ryan S (2107) Promoting effective teamwork in the healthcare setting. Nursing Standard. 31, 30, 52-59.
Date of submission: 21 October 2016; date of acceptance: 10 January 2017. doi: 10.7748/ns.2017.e10726

Sarah Ryan, Abstract

Nurse consultant in
rheumatology, Haywood
Hospital, Staffordshire and
Stoke on Trent Partnership
NHS Trust, Stoke on Trent,
England
Correspondence
Sarah.Ryan2@ssotp.
nhs.uk
Conflict of interest
None declared
Patients require access to various healthcare professionals to manage their healthcare needs.
Most nurses work in a team established to provide optimum care for patients. This article
explores the stages necessary to develop an effective healthcare team and identifies the
attributes required for effective teamwork. These include: effective leadership, a shared mental
approach (a common understanding of the roles and responsibilities of all members of the team),
respect among team members and shared training. Scenarios involving a rheumatology team
that includes the author are used to demonstrate how effective teams can be established in
practice, and the benefits of effective healthcare teams to staff well-being and patient care.
Keywords
healthcare teams, leadership, team behaviour, team building, team leader, team training,
teamwork

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Aims and intended learning
outcomes
The aim of this article is to improve the
reader’s understanding of the attributes
required for effective team building and to
enable optimal teamwork in the healthcare
setting. After reading this article and
completing the time out activities you
should be able to:
»» Identify the different stages in team
development.
»» Explain the role of the team leader, and
the qualities associated with effective
leadership.
»» Discuss how a common understanding of
the roles and responsibilities of members
of a team can improve teamwork.
»» Explain the main behavioural patterns
and motivational systems that different
team members might have.
»» Outline the advantages of shared training
for a team.
Relevance to The Code
Nurses are encouraged to apply the
four themes of The Code: Professional
Standards of Practice and Behaviour for
Nurses and Midwives to their professional
practice (Nursing and Midwifery Council
(NMC) 2015). The themes are: Prioritise
people, Practise effectively, Preserve safety,
and Promote professionalism and trust.
This article relates to The Code in the
following ways:
»» Nurses must work cooperatively to
practise effectively. This article explores
the stages necessary to develop an
effective healthcare team and identifies
the team attributes required to enable
effective teamwork.
»» It discusses various tools available to
measure team performance. The Code
states that nurses must work with
colleagues to evaluate the quality of their
work and that of the team.
»» It explores the leadership activities
necessary to lead an effective team
during the planning and action phases of
a team’s development. The Code states
that nurses must identify priorities,
manage time, staff and resources
effectively, and deal with risk to ensure
the quality of care or service they provide
is maintained and improved.

52 / 22 March 2017 / volume 31 number 30 nursingstandard.com

»» It indicates that each team should consider
the best ways for sharing information
and communicating. Ineffective
communication is associated with
compromised patient care, staff distress,
tension and inefficiency. The Code states
that nurses must maintain effective
communication with colleagues and share
information to identify and reduce risk.
Defining a team
A team consists of two or more people
who work interdependently towards
a shared outcome. The members of
a team may each have different roles
and responsibilities, yet they work in
a collaborative manner to achieve an
identified goal (Molleman et al 2010,
Chen et al 2011, Kimble 2011). For
example, in rheumatology, the healthcare
team might comprise various healthcare
professionals, including nurses,
physiotherapists, occupational therapists,
podiatrists, pharmacists and doctors.
Each member of the team has specialist
skills and expertise, yet all members
work together to achieve the optimum
health outcomes for the patient.
McCabe (2006) related teamwork to a
4x400 metre relay, in which it is necessary
for the athletes in the team to understand
each other’s strengths and limitations to
ensure the fastest runners are selected for
the sprint finish. An effective healthcare
team has a co-ordinated approach to
patient care, with explicit and consensual
division of responsibilities, so that every
member of the team is aware of their role
and what is expected of them to enable the
team to function in an optimal way (Vliet
Vlieland et al 2006).
TIME OUT 1
Draw a diagram of the structure and members of the team
you work in. Identify the main relationships you have
with different team members. Discuss with a colleague
possible opportunities for strengthening the relationships
that you have identified. Make brief notes on your
discussion.
Team development
This article explores the stages in
Tuckman’s (1965) model of team
development, the team attributes that
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are required for effective teamwork, To write a CPD article
understanding behavioural patterns of Please email gwen.
individual team members, and the benefits clarke@rcni.com.
of team training. Guidelines on writing for
publication are available
Tuckman’s model of team development at: journals.rcni.com/r/
Tuckman’s (1965) model is one of the author-guidelines
most widely used to explain how a team
develops. It is based on an examination
of 50 empirical research studies. It
remains widely used in many settings,
including healthcare, although it was
developed more than 50 years ago.
The model identifies three aspects that
determine how well teams perform
(Tuckman 1965):
»» Content – what the team does.
»» Process – how the team works towards
its objective.
»» Feelings – how team members relate to
one another.
Tuckman (1965) identified four stages
in the development of a team: ‘forming’,
‘storming’, ‘norming’ and ‘performing’
(Table 1). He maintained that a team
only becomes effective when it reaches
the performing stage, and that the time
taken for a team to move from one stage
to another is influenced by the type,
composition and leadership of the team
(Tuckman 1965). The model acknowledges
that some teams may never reach the
performing stage. Some teams may never
progress beyond the forming stage, while
other teams will accept storming as their
usual way of operating, with constant
challenges to authority. A fifth stage,
‘adjourning’ or ‘mourning’ was added in the
1970s to describe a team that has completed
an identified task and has subsequently
been disbanded (Tuckman and Jenson
1977). Tuckman’s (1965) model is useful
for understanding the functional stage of
a team. However, further elaboration is
required to enable understanding of a team’s
dysfunctional phase of development, which
occurs in the storming stage.
Applying Tuckman’s model of team
development to rheumatology practice
Patients with rheumatoid arthritis and
osteoarthritis have emphasised the need
for services to support them to manage the
volume 31 number 30 / 22 March 2017 / 53
evidence & practice / CPD / professional issues

physical, psychological and social effects be expected to provide advice on exercise,

of chronic pain (Ryan et al 2013). In the or whether this was the remit of the
following scenario, a nurse-led chronic physiotherapist.
pain team was established in response to
this need, to provide a service, including Storming
education and support for patients with In the storming stage of the service, team
chronic musculoskeletal pain. members challenged some of the tasks
that the managers of the service outside
Forming the team had proposed the team should
In the forming stage of developing the engage in, for example providing ongoing
service, team members engaged in defining counselling for patients with psychological
what the service would offer to patients needs, since none of the nurses in the
and how the service would function, newly-formed team had any experience in
including the frequency of the service, this area. This led to interpersonal conflict
its location and duration, and length of between the managers responsible for the
appointments. They referred to similar service and nurses in the team, who had
services for guidance and direction on different expectations of what the service
how to set up the service. Team members would offer.
experienced anxiety about what their roles
would involve. For example, questions Norming
were raised about whether the nurse would In the norming stage of the service, there was
an open exchange of views between team
TABLE 1. Tuckman’s model of team development members. There was clarification about
which core services would be offered by the
Stages Content Process Feelings team, and how additional services such as
Stage 1: Team members Team members search Individuals feel anxious and counselling would be accessed from external
Forming engage in task- outside the team for unsure of their roles. agencies, including the voluntary sector. This
orientated behaviour. guidance and direction. sharing of ideas resulted in acceptance of
Stage 2: Team members There is confrontation Individuals feel uncertain the different roles that team members would
Storming challenge the from the team leader in their roles and attempt to undertake and the development of trust
rationale for the and team members express their individuality. between team members.
tasks the team has isolate themselves
been asked to do and from the activities of
Performing
their responsibility the team.
for them. In the performing stage of the service,
all team members were communicating
Stage 3: There is an open The team starts to Conflict is replaced with
effectively, comfortable in their roles
Norming exchange of views in set up procedures to trust and an acceptance of
the team about the manage their tasks. other individuals and their and working collectively towards a
team’s performance. roles in the team. Individuals common goal of supporting patients with
are clear about individual chronic pain to optimise their physical,
roles in the team. Individuals psychological and social functioning.
ignore individual differences
and feel more accepting of TIME OUT 2
each other.
Think about the team in which you work. What stage
Stage 4: Roles are effectively The team collaborates Team members share of Tuckman’s (1965) model of team development do
Performing integrated in the to achieve its tasks. a common focus, you think your team has reached? Discuss with a
team. Problem- communicate effectively, colleague what your team should do to move towards the
solving and goal- and become more efficient performing stage. If the team is at the performing stage,
orientated activities and flexible. Individuals how can you ensure the team continues to work at this
are apparent. feel a sense of belonging stage? Make brief notes on your discussion.
to the team. They feel more
proficient, and confident of
the capabilities of the team. Subsequent models, including the
transforming-performing-reforming model
(Tuckman 1965) (White 2009), have simplified the sequence

54 / 22 March 2017 / volume 31 number 30 nursingstandard.com


of stages in Tuckman’s (1965) model of
team development, grouping the first three
stages together as the ‘transforming phase’,
which denotes the starting level of the team.
This is followed by the ‘performing phase’
that describes the team working towards an
identified goal, and the ‘reforming phase’,
in which the team reaches a new level of
performance (White 2009).
TIME OUT 3
Think about an effective leader with whom you have
worked. What was it about the leader that impressed
you? List the qualities you think make an effective leader.
Attributes required for effective
teamwork
There are many attributes required for a
team to work effectively. These include:
leadership; a shared mental approach; the
‘3Rs’ – respect, reward and recognition
(McCabe 2006); and team training.
Leadership
The type of leadership required to lead a
team differs according to the development
stage the team has reached. The work
of the team can generally be divided
into two phases: the planning phase
and the action phase (Dow et al 2013).
Leadership activities in the planning phase
include empowering and supporting
team members to participate actively
in reflection, reviewing past team
performance, developing goals and creating
an implementation plan for the next stage.
If the team does not consider the views of
all of its members in the planning stage,
this is likely to result in suboptimal team
cohesion and in the team goals necessary
for the action phase being inadequately
defined (Larson 1999). The leader may also
use the planning phase to determine which
team member is best suited to a specific
role (Dow et al 2013).
Leadership activities in the action phase
include providing organisational structure,
and managing internal and external
resources to enable team members to achieve
the goals identified in the planning stage
(Morgeson et al 2010). It is necessary for
effective leaders to know the skills and
knowledge possessed by each team member
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and to understand what each team member KEY POINT
requires in terms of support and resources The leadership style
to be able to achieve their goals. Some team used by the team leader
members may require clarification and is central to improving
reassurance that they are ‘heading in the the effectiveness of
right direction’, while other team members the team. Leaders who
might require their contribution to be are transformational,
acknowledged to re-energise their efforts empowering and
(Dow et al 2013). Leadership in healthcare communicate
should not be viewed as fixed, but rather positive support and
as ‘co-produced’, with leaders and team encouragement to
members working together to achieve agreed individual team members
goals (Carsten and Uhl-Bien 2013). have the greatest effect on
The leadership style used by the building and sustaining
team leader is central to improving the effective teams
effectiveness of the team. Leaders who (Wu et al 2010)
are transformational, empowering and
communicate positive support and
encouragement to individual team members
have the greatest effect on building and
sustaining effective teams (Wu et al 2010).
The following scenario about
medicines management in the community
demonstrates the importance of effective
leadership in the planning and action phase.
Medicines management in the
community
Several nurses were concerned that if
they reviewed a patient with an adverse
drug reaction while in the community,
they would not have immediate access to
the medical support they received when
conducting their clinic in the hospital
outpatient department. The leader of the
service development actively sought the
opinions and concerns of all team members
about how this issue could be managed.
The nurses involved in the service met and
devised guidelines on how adverse drug
reactions would be managed.
The leader was grateful for the clinical
input of the nursing team and made sure
the resources identified were provided,
for example telephone access to a
rheumatologist for guidance. The nurses
were reassured that their concerns had
been listened to and were acted on in the
action phase of team development.
Shared mental approach
A shared mental approach involves a
common understanding of the roles and
volume 31 number 30 / 22 March 2017 / 55
evidence & practice / CPD / professional issues
KEY POINT responsibilities of all members of the
A shared mental approach team, and is one of the main attributes
enables recognition of required for effective teamwork in the
the needs of other team healthcare setting (Burtscher et al 2011). A
members, enabling shared mental approach among members
individuals to identify of a team is often referred to as ‘being
changes in the clinical on the same page’, and can result in
situation and adapt an understanding and appreciation of
their response, where individual team members, and how team
necessary, to achieve goals can be achieved (Stout et al 1999).
the desired goals. For Personal attributes that contribute to a
example, if a team shares a shared mental approach and are evident in
commitment to reviewing effective teams include (Molyneux 2001):
patients on time in an »» Ability to delegate.
outpatient clinic, other team »» Ability to compromise.
members can recognise »» Ability to maintain confidentiality.
when a colleague’s clinic »» Approachability.
is running late and offer »» Awareness of one’s strengths and
their assistance, thereby limitations.
avoiding a long delay for »» Decisiveness.
patients waiting to be seen »» Effective organisation skills.
»» Empathy.
»» Openness to learning.
»» Patience.
»» Tolerance.
A shared mental approach enables
recognition of the needs of other team
members, enabling individuals to identify
changes in the clinical situation and adapt
their response, where necessary, to achieve
the desired goals. For example, if a team
shares a commitment to reviewing patients
on time in an outpatient clinic, other team
members can recognise when a colleague’s
clinic is running late and offer their
assistance, thereby avoiding a long delay for
patients waiting to be seen. Salas et al (2005)
referred to this as ‘backup behaviour’, where
each member of the team has a sufficient
understanding of the roles of other members
to enable supportive action to be taken
as required. If a shared mental approach
is not evident in a team, then individuals
are unlikely to be receptive to other team
members’ needs. This can result in each team
member considering their own needs, with
no sense of collective responsibility to achieve
the goals of the team.
Sharing information between team
members is an essential requirement for
developing a shared mental approach
(Weller et al 2014). Sharing information
positively predicted team performance in
56 / 22 March 2017 / volume 31 number 30
a meta-analysis of 72 studies, involving
4,795 teams in a range of industries
(Mesmer-Magnus and Dechurch 2009).
Ineffective communication is directly
associated with compromised patient care,
staff distress, tension and inefficiency in
healthcare teams (Lingard et al 2004).
Each team should consider the best ways
to share information and communicate
with each other. Regular team meetings
can provide an opportunity for all team
members to share their views, review what
is working well and identify aspects that
should be improved. Other methods, such
as distributing a team newsletter, may
enable members to feel connected in large
multidisciplinary teams, where it might be
difficult for the team to meet regularly.
TIME OUT 4
List the different ways members of your team
communicate with each other. Discuss with the team
whether these means of communication are working well,
and identify ways communication could be improved,
or effective communication maintained.
The 3Rs: respect, reward and recognition
For any team to work effectively, each team
member should receive respect, recognition
and reward from the team, on a regular
basis. These are collectively referred to as
the 3Rs (Box 1) (McCabe 2006).
Strength deployment inventory
The strength deployment inventory is
BOX 1. The 3Rs: respect, reward and
recognition
»» Respect – team members should feel respected by
their colleagues, leaders and organisation. The team
culture should foster trust and mutual respect among
its members.
»» Recognition – team members should know that
their contributions are recognised by the team and
their efforts are appreciated. This can be achieved by
thanking them for doing an effective job.
»» Reward – team members require individual rewards.
The specific nature of the reward depends on the
motivational value system of each member. Some
people seek extrinsic rewards such as pay, while
others favour intrinsic rewards, such as a sense of
achievement that they have supported others.
(McCabe 2006)
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an evidence-based tool that enables in their approach. It would be useful

exploration of the 3Rs. It was developed by to bear this in mind and ensure that
Ellis Porter in 1973, and uses relationship you allow enough time for the ‘green’
awareness theory to explain the premise individual to respond accordingly,
that people work effectively together when when requesting a decision from them.
they understand their own behaviour and This approach can enable individuals
that of their colleagues (Porter 1973). to begin to see the world through
The inventory enables team members to the eyes of their colleagues (McCabe
identify their own strengths, and increases 2006). Discussing the strength
awareness of how their behaviour might deployment inventory in teams can
affect other members of the team (McCabe increase understanding of the different
2006). The likelihood that conflict within value systems of individual team
a team will be reduced if a member of members. This can establish strong
the team relates to other individuals in a empathy in a group and encourages
way that respects the other individual’s a team culture where differences are
motivations. appreciated, respected and allowed for
The strength deployment inventory (McCabe 2006).
identifies three behavioural patterns »» Recognition – the team can discuss the
that reflect an individual’s underlying specific behaviours that motivate them
motivational values (Porter 1973): and those that disempower them in
»» Assertive-directing orientation (red) – the group exercises. This enables the group
individual’s sense of worth comes from to recognise the behavioural strengths
getting things done, achievement and and development opportunities in the
overcoming obstacles.
»» Altruistic-nurturing orientation (blue)
TABLE 2. Behavioural patterns and characteristics in the
– the individual has a high concern for strength deployment inventory
people and their welfare.
»» Analytical-autonomising orientation Behaviour Characteristics Motivational Traits
(green) – the individual has a pattern reward
requirement for order, self-dependence, Assertive- Demanding, Extrinsic »» Wanting to win so much that they
fairness and preservation of resources. directing competitive, rewards: public ‘step on the toes’ of others.
The characteristics and motivational orientation forceful, ambitious, accolades and »» Being in such a hurry to get things
(red) quick to act, awards. done that they disregard how
rewards associated with three behavioural
enterprising, others feel about things.
patterns of the strength deployment confident, assertive »» Being so sure they are right that
inventory (Porter 1973) are listed in and creative. they do not listen to the advice
Table 2. Healthcare professionals should of others.
also be aware of the traits associated with
these behavioural patterns (Table 2).
The strength deployment inventory Altruistic- Open, friendly, Intrinsic »» Wanting to help others so much
focuses on behaviour, values and rewards nurturing helpful, sincere, rewards: that they push their help on them.
(Porter 1973). It promotes the 3Rs in the orientation selfless, personal »» Wanting to maintain harmony, so
following ways: (blue) considerate, thanks. that they do not push for what
empathetic, they want.
»» Respect – the strength deployment
modest and »» Expecting that everyone is going
inventory promotes respect by supportive. to feel the same as they do.
understanding that different team
members have different behaviour Analytic- Cautious, precise, Prefer to be »» Wanting to be certain so much that
autonomising accurate, reserved, rewarded in an they delay reaching decisions.
patterns and character traits. For orientation principled, understated »» Being so concerned about what is
example, if you need a decision from (green) methodical, logical way, for right or wrong that they do not pay
a member of the team who has ‘green’ and fair. example for the attention to people’s feelings.
traits, then it would be unrealistic to quality of their »» Expecting that everyone will be as
expect an immediate decision because work rather concerned as they are with details.
the individual will want to check the than the results.
details and be thorough and precise (Porter 1973)

nursingstandard.com volume 31 number 30 / 22 March 2017 / 57

evidence & practice / CPD / professional issues
KEY POINT team (McCabe 2006). The organisational
Each professional group context in which a team operates has
in a multidisciplinary team a direct influence on team effectiveness
might often access team (Lemieux-Charles and McGuire 2006).
training and information »» Reward – the strength deployment
from different sources, inventory encourages individuals to share
thereby missing an which specific rewards motivate them
opportunity to understand (McCabe 2006).
the roles and priorities of
different team members TIME OUT 5
(Smith et al 2008). Such Using the strength deployment inventory (Porter 1973),
segregation of training identify which colour matches your behaviour pattern and
can result in different motivational rewards. Using the diagram of your team
professional groups having that you created in Time out 1, identify three individuals
different expectations in your team with whom you have an important working
of how things should relationship. Mark the colour associated with each of
be done (Hudson 2002), them. Note down how your working relationship with
each team member could improve, now that you can
contributing to disharmony
identify their way of working.
among team members
when teamwork is Team training
required (Weller et al 2014) Each professional group in a
multidisciplinary team might often
access team training and information
from different sources, thereby missing
an opportunity to understand the roles
and priorities of different team members
(Smith et al 2008). Such segregation of
training can result in different professional
groups having different expectations of
how things should be done (Hudson 2002),
contributing to disharmony among team
members when teamwork is required
(Weller et al 2014). Access to shared
training for a team can minimise the effects
of hierarchical structures that often exist
in the healthcare setting, which mean that
staff might feel that they cannot challenge
decisions made by more senior colleagues
(Brindley and Reynolds 2011). Team-
building events can provide the opportunity
to understand the needs and concerns of
different team members, and to devise a
shared vision of the values and goals of the
team, enhancing team effectiveness.
Team training using immersive simulation
can be an effective tool to stimulate
discussion about roles, responsibilities and
sharing information in relation to patient
management (Weller et al 2014). Simulation
involves the use of clinical cases to assist
healthcare professionals’ understanding of
how different professional groups view a
given situation, and how team members can
58 / 22 March 2017 / volume 31 number 30
support each other to maximise the team’s
contribution to patient care (Weller et al
2014). For example, in rheumatology, a
team discussion about the clinical care of a
patient newly diagnosed with rheumatoid
arthritis can help to clarify how the skills
and expertise of different members of
the team can best be used to optimise the
patient’s experience. If the clinician who is
diagnosing the condition is unaware of the
role of the nurse specialist in supporting
the patient to develop coping strategies
to minimise the effect of symptoms such
as joint pain and stiffness, they might
not consider making a referral to the
nurse specialist. Discussing clinical cases
at team training events also provides the
opportunity to develop mutual trust and
increases awareness of individual team
member’s contribution to patient care
(Weller et al 2014).
TIME OUT 6
List the features that can enhance team training
activities, based on your experience of team training
activities and the information in this article.
Measuring team performance
Valentine et al (2015) undertook a
systematic review of instruments used
to measure team performance. They
identified that the most commonly assessed
dimensions of team performance were
communication, co-ordination and respect.
Few assessment tools have been directly
linked to patient outcomes (Havyer et al
2014). However, there is evidence that
effective teamwork can have a positive
effect on patient outcomes in terms of
reducing pain (Castel et al 2013) and joint
inflammation (Vliet Vlieland et al 2006),
improving emotional and psychological
wellbeing (Castel et al 2013), and
increasing survival rates and satisfaction
in patients with cancer (Davies et al 2006,
Kesson et al 2012). Instruments available
to measure the performance of teams vary
in their behavioural processes and their
ability to capture all stages of teamwork
(Valentine et al 2015). Therefore, it is
important to consider the conceptual
basis of the tool and the context in which
it is being used, when selecting the most
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appropriate instrument to measure team increasing the opportunities for shared

performance. team training, team members can learn to
understand and respect how the individual
Conclusion contributions of team members can lead
Working in groups and teams in which to the team functioning in a collective,
there are different personalities and cohesive manner that benefits patient care
levels of self-awareness might affect the and improves team satisfaction.
cohesion of a team and can be challenging.
Relationships in the team can be enhanced TIME OUT 7
by awareness of the different behavioural Nurses are encouraged to apply the four themes of The
patterns of team members. This reduces Code (NMC 2015) to their professional practice. Consider
the likelihood of conflict occurring and how knowledge of effective teamwork in the healthcare
increases the likelihood of achieving the setting relates to The Code.
performing stage of Tuckman’s (1965)
model, at which teams become effective. TIME OUT 8
Effective leadership and a shared mental Now that you have completed the article, you might
approach among team members are like to write a reflective account as part of your
essential to enable optimal teamwork. By revalidation.

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nursingstandard.com volume 31 number 30 / 22 March 2017 / 59

evidence & practice / self-assessment questionnaire
Effective teamwork
TEST YOUR KNOWLEDGE BY COMPLETING SELF-ASSESSMENT QUESTIONNAIRE 886
 1. In Tuckman’s (1965) model of team development,
at which stage does a team become effective?
 a) Forming c
 b) Storming c
 c) Norming c
 d) Performing c
 2. What influences the time taken to move from
one stage to another in Tuckman’s model?
 a) Leadership of the team c
 b) Type of team c
 c) Composition of the team c
 d) All of the above c
 3. In Tuckman’s model, three aspects determine
how well teams perform at each stage: content,
process and feelings. In the process aspect of a
team’s performing stage:
 a) The team collaborates to achieve its tasks questions. The correct
c  b) Expecting that everyone feels the same as they do c
 b) Team members share a common focus,
communicate effectively and become more
efficient and flexible c
 c) Roles are effectively integrated in the team Subscribers making use
c that they do not pay attention to people’s feelings c
 d) Problem-solving and goal-orientated activities
are apparent c
 4. A leadership activity in the action phase is:
 a) Empowering and supporting team members to
participate actively in reflection out this page and add it to your
c  b) Enable team members to understand and respect
 b) Managing internal and external resources to enable
team members to achieve team goals c
 c) Creating an implementation plan c
 d) Reviewing past team performance c
 5. Which personal attribute does not contribute to
a shared mental approach in effective teams?
 a) Ability to compromise c
 b) Impatience c
 c) Ability to delegate c
 d) Awareness of one’s strengths and limitations c
 6. A shared mental approach in an effective team is
not indicated by:
 a) Recognition of the needs of other team members c
 b) A sufficient understanding of the roles of others to
enable supportive action to be taken as required c
 c) Ineffective communication associated with tension,
inefficiency and compromised patient care c
 d) Sharing of information between team members c
60 / 22 March 2017 / volume 31 number 30
 7. Which of the following is not one of the 3Rs team How to complete
members require for a team to work effectively? this assessment
 a) Respect c
This self-assessment
 b) Reward c
questionnaire will help you
 c) Reassurance c to test your knowledge.
 d) Recognition c It comprises ten multiple choice
questions that are broadly
 8. A characteristic associated with a person with linked to the article starting on
an analytic-autonomising orientation is: page 52. There is one correct
 a) Methodical c answer to each question.
 b) Considerate c »» You can test your subject
 c) Confident c knowledge by attempting
the questions before reading
 d) Supportive c
the article, and then go back
 9. Which trait may be associated with an individual over them to see if you would
with an altruistic-nuturing orientation? answer any differently.
 a) Being so sure they are right they do not listen »» You might like to read the
to the advice of others c article before trying the
answers will be published
 c) Wanting to be certain so much that they delay in Nursing Standard on
reaching decisions c
5 April.
 d) Being so concerned about what is right or wrong
of their RCNi Portfolio can
 10. Access to shared training for members of a team complete this and other
may: questionnaires online and save
 a) Result in different team members having different the result automatically.
expectations about how things should be done c Alternatively, you can cut
professional portfolio. Don't
the contributions of different professional groups
forget to record the amount
and individual team members c
of time taken to complete it.
 c) Maximise the effects of hierarchical structures c
You may want to write
 d) Hinder the team’s ability to support each other to
a reflective account based
maximise their contribution to patient care c
on what you have learned.
Visit journals.rcni.com/r/
reflective-account
This self-assessment questionnaire was compiled by Beth Knight
The answers to this questionnaire will be published on 5 April
The answers to SAQ 884 on nurse-patient relationships, which
appeared in the 8 March issue, are:
1. b 2. d 3. b 4. a 5. b 6. a 7. c 8. b 9. d 10. c
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