title: The ABC of health care team dynamics: understanding complex affective, behavioral, and cognitive dynamics in interprofessional teams.
abstract: BACKGROUND
  Interprofessional teams form the basis of many health care problem-solving and decision-making mechanisms. However, more than 70% of medical errors are attributable to dysfunctional team dynamics. The recent suggestion that health care teams are more complex than nonmedical teams suggests that we require more sophisticated knowledge of team dynamics and processes.
  
  
  OBJECTIVE
  The mechanisms of dysfunctional interprofessional teams focusing on affective, behavioral, and cognitive effects are explored. We argue that interprofessional composition impacts team dynamics by increasing the likelihood of affective conflict, which mediates a decrease in elaborative behaviors and open-mindedness.
  
  
  METHODS
  The hypotheses are investigated using a cross-sectional, correlational design. Survey data received from 218 members of 47 interprofessional teams employed in an acute care setting, representing a 39% response rate, is used to investigate two moderated mediation pathways.
  
  
  RESULTS
  Analysis supports a significant relationship between interprofessional composition and affective conflict but only when team rate highly for professional identification. Results also support a dual moderated mediation pathway through which professional diversity has a dysfunctional effect on debate and open-mindedness.
  
  
  CONCLUSIONS
  A range of strategies emerge from the findings to minimize dysfunctional interprofessional team dynamics. These include the use of leadership strategies, such as transformational styles, reinforcement of shared values such as patient-centeredness, and development of a shared group identity.
authors.affiliation: Rebecca Mitchell, PhD, is Senior Lecturer, University of Newcastle, New South Wales, Australia. E-mail: Rebecca.mitchell@newcastle.edu.au. Vicki Parker, PhD, is Professor of Rural Nursing, University of New England, New South Wales, Australia. E-mail: Vicki.parker@hnehealth.nsw.gov.au. Michelle Giles, RN, is Clinical Nurse Consultant, Centre for Practice, Opportunity, and Development, Hunter New England Local Health Network, New South Wales, Australia. E-mail: Michelle.giles@hnehealth.nsw.gov.au. Brendan Boyle, PhD, is Senior Lecturer, Newcastle Business School, University of Newcastle, New South Wales, Australia. E-mail: brendan.boyle@newcastle.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mitchell
authors.forename: Vicki
authors.initials: V
authors.lastname: Parker
authors.forename: Michelle
authors.initials: M
authors.lastname: Giles
authors.forename: Brendan
authors.initials: B
authors.lastname: Boyle
mesh_terms: D000328:Adult; D000339:Affect; D003071:Cognition; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D006126:Group Processes; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007400:Interprofessional Relations; D010348:Patient Care Team