title: Are we at risk of groupthink in our approach to teamwork interventions in health care?
abstract: BACKGROUND
  The incidence of medical error, adverse clinical events and poor quality health care is unacceptably high and there are data to suggest that poor coordination of care, or teamwork, contributes to adverse outcomes. So, can we assume that increased collaboration in multidisciplinary teams improves performance and health care outcomes for patients?
  
  
  METHODS
  In this essay, the authors discuss some reasons why we should not presume that collective decision making leads to better decisions and collaborative care results in better health care outcomes.
  
  
  RESULTS
  Despite an exponential increase in interventions designed to improve teamwork and interprofessional education (IPE), we are still lacking good quality data on whether these interventions improve important outcomes. There are reasons why some of the components of 'effective teamwork', such as shared mental models, team orientation and mutual trust, could impair delivery of health care. For example, prior studies have found that brainstorming results in fewer ideas rather than more, and hinders rather than helps productivity. There are several possible explanations for this effect, including 'social loafing' and cognitive overload. Similarly, attributes that improve cohesion within groups, such as team orientation and mutual trust, may increase the risk of 'groupthink' and group conformity bias, which may lead to poorer decisions.
  
  
  CONCLUSIONS
  In reality, teamwork and IPE are not inherently good, bad or neutral; instead, as with any intervention, their effect is modified by the persons involved, the situation and the interaction between persons and situation. Thus, rather than assume better outcomes with teamwork and IPE interventions, as clinicians and educators we must demonstrate that our interventions improve the delivery of health care.
authors.affiliation: Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alyshah
authors.initials: A
authors.lastname: Kaba
authors.affiliation: Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Ian
authors.initials: I
authors.lastname: Wishart
authors.affiliation: Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kristin
authors.initials: K
authors.lastname: Fraser
authors.affiliation: Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Coderre
authors.affiliation: Office of Undergraduate Medical Education, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: McLaughlin
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D000066491:Clinical Decision-Making / Q000379:methods; D003299:Cooperative Behavior; D003695:Delivery of Health Care / Q000592:standards*; D055317:Evidence-Based Practice; D006126:Group Processes; D006801:Humans; D007400:Interprofessional Relations; D000070516:Intersectoral Collaboration; D017063:Outcome Assessment, Health Care / Q000592:standards; D010348:Patient Care Team / Q000592:standards*; D011340:Problem Solving; D011364:Professional Practice / Q000592:standards; D011787:Quality of Health Care; D012107:Research Design