title: A pre-post test evaluation of the impact of the PELICAN MDT-TME Development Programme on the working lives of colorectal cancer team members.
abstract: BACKGROUND
  The PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members.
  
  
  METHODS
  The impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course.
  
  
  RESULTS
  Across all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance.
  
  
  CONCLUSIONS
  Participation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK. cath.taylor@kcl.ac.uk
authors.forename: Cath
authors.initials: C
authors.lastname: Taylor
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Sippitt
authors.forename: Gary
authors.initials: G
authors.lastname: Collins
authors.forename: Chris
authors.initials: C
authors.lastname: McManus
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dawson
authors.forename: Michael
authors.initials: M
authors.lastname: Richards
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Ramirez
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D033183:Interdisciplinary Communication; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult