The collaborative health care team: the role of individual and group expertise.
BACKGROUND
Increasing costs of health care and rapid knowledge growth have led to collaboration among health care professionals to share knowledge and skills.


OBJECTIVE
To characterize the qualitative nature of team interaction and its relation to training health professionals, drawing on theoretical and analytical frameworks from the sociocognitive sciences.


METHODS
Activities in a primary care unit were monitored using observational field notes, hospital documents, and audio recordings of interviews and clinical interactions.


RESULTS
The demarcation of responsibilities and roles of personnel within the team became fuzzy in practice. Continuous care was provided by primary care providers and specialized care by intermittent consultants. The nature of individual expertise required was a function of the patient problem and the interaction goal. These team characteristics contributed to the reduction of unnecessary and redundant interactions.


CONCLUSIONS
Distributed responsibilities allow the team to process massive amounts of patient information, reducing the cognitive load on individuals. The uniqueness of individual professional expertise as it contributes to the accomplishment of team goals is highlighted, suggesting emphasis on conceptual competence in the development of individual professional education programs.
Cognitive Studies in Medicine, Centre for Medical Education, Faculty of Medicine, McGill University, 1110 Pine Avenue West, Montreal, Quebec, Canada H3A 1A3. patel@hebb.psych.mcgill.ca
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Patel
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Cytryn
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Shortliffe
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Safran
D003142:Communication; D006784:Hospitals, Teaching; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D010819:Physician's Role; D012017:Referral and Consultation; D012944:Social Support; D014481:United States