When a team is functioning well, each member has their role to play, and even though some contributions may stand out more than others, as long as everyone is clear about and accepts their own and others’ responsibilities, the team can accommodate members who contribute less.
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The reasons that lead to a team falling apart are primarily due to unclear individual responsibilities from the outset or deviations from the initial agreements. Deviations can manifest as some individuals backing out when they should help others, or interfering in others’ actions without being invited.
Team collaboration is defined as the mutual assistance and interaction among all members working together. Building a team involves not only creating one-on-one helper-helper relationships but also establishing mutual trust among all members.
Astute leaders will notice that in any newly formed team, the first thing all members need to do is build harmonious relationships with their new colleagues and the formal leader. Establishing such relationships takes time and effort to work through.
Before team members reach a state of willingness to help one another and before they have clear identities within the team and find suitable roles, leaders need to help them find answers to the following four basic psychological questions. Just as in any helping situation, leaders should play the role of process consultant in the early stages, creating an atmosphere that allows team members to find answers to these questions.
Four Basic Psychological Needs
- Who am I? What is my role in this team?
- How much control and influence do I have in this team?
- Will my goals and needs be met in this team?
- How close are the relationships between individuals in this team?
01-Our ability to play different roles according to the needs in various life situations.
Whenever we enter a new environment, we need to make immediate decisions and choose one of the roles we have played before as our role in that environment. This process can create tension and anxiety until the role is determined. From this perspective, successful surgical teams value the interdependence of team members and make it clear that each member is indispensable for completing the task. When selecting team members, it is essential not only to focus on their professional skills but also to assess their teamwork abilities, requiring team members to be helpful and unselfish. On the other hand, unsuccessful surgical teams often give themselves an indispensable role, and their team members are like assistants hired by them, ready to be replaced at any time. When choosing them, only professional skills are considered, and teamwork abilities are not taken into account. Therefore, it can be concluded that even if your status in the team is lower than that of other members, when you are seen as an indispensable contributor rather than a replaceable resource, you will have a higher sense of status.
02-Although people do not necessarily demand equality with others in the team, they always hope to have a certain degree of influence.
Therefore, a crucial step in the formation of a team is to set aside time for members to communicate about the impact each person hopes to bring to the team and how to adjust themselves based on the needs of others. During this process, team members can understand each other’s professional skills, clarify which skills are more critical to the team’s performance, and realize that each person will have an impact on the team’s performance. This is fully reflected in the training process of successful surgical teams, while in unsuccessful surgical teams, all “skilled supporters” know very well that they were asked to help by the surgeon, and the surgeon is the only irreplaceable person, so they underestimate their importance and do not wholeheartedly devote themselves to their work. Moreover, without participating in preoperative training together, they cannot understand what the surgeon wants and needs help with.
03-“Why I should join this team in the first place: What are my goals and needs? Does our team have the ability to achieve this goal?” Successful surgical teams clarify this before inviting others to join the team.
If a candidate has insufficient interest in joining the team, meaning their goals and needs do not match the surgical plan, they will not receive an invitation from the beginning. Conversely, unsuccessful surgical teams tend to be more arbitrary when choosing “assistants.” Some candidates may not initially want to join the team, but because of their lower status, they often do not have the courage to refuse. In other words, when looking for team members to work together in the long term, it is essential to determine whether the candidate’s needs and goals align with the team through an interview process.
04-The degree of personal emotional involvement of team members: whether they are only pursuing excellence in their assigned tasks or willing to be part of a collective where they can freely share personal goals and information, and have a lot of daily interactions with other members.
Each of us is constrained by our roles, and when we join a new team, we often want to test how much the team’s requirements exceed or fall within our capabilities. To ensure that everyone understands this, we need to organize regular training and team-building activities so that we can identify any mismatches before the need for real responsibility arises.
In the early stages of team formation, as members gradually get to know each other, the answers to the questions mentioned above will become apparent in their interactions. Team members will gradually reveal themselves during this process and observe how others perceive and evaluate them. In this way, members gain face with each other. Through self-assessment and mutual acceptance, members have the foundation for their interactions with each other.
Our role in a team depends on the size of our contributions to the team and the level of support we expect from others. Team members have different skills and needs, which result in differences in their own influence and status. In the early stages of a team, the goal is for members to accept each other. This is crucial for building mutual trust among members and ensuring excellent team performance. However, mutual acceptance does not mean that team members have to like each other. An effective team is not always harmonious, but team members must understand each other, trust that their partners are capable of doing their part to ensure the team’s tasks are accomplished.
Leaders forming teams must be aware that until the four questions mentioned above are clarified, team members will be burdened with anxiety and will not be able to fully dedicate themselves to the tasks that need to be completed. The more important and complex the work is, the more time should be spent helping each team member adjust their mindset so that they can truly focus on the tasks at hand. When team members are still troubled by questions like “Who am I?”, “How much influence do I have?”, “Will my needs be met?”, and “Is the team too formal or too casual?”, they cannot establish a strong foothold in an efficient team.
Leaders should give team members enough time to find the answers to these four questions on their own. Therefore, when a team is initially formed, activities such as dinners or group sports are often organized to allow team members to get to know each other and adapt before diving into work.
Failed teams often rush to start working before the division of responsibilities among members is clear. However, even if team members have assigned roles, they may not be able to effectively fulfill their duties due to concerns about how others in the team perceive them before finding the answers to the four questions mentioned above. Failed surgical teams serve as an example: the lead surgeon mistakenly assumed that the “assistants” they found were all professionals and that they would naturally perform their roles, leading to the ultimate failure of the team. These lead surgeons overlooked the importance of building trust and support relationships among team members.
In reality, mutual understanding among members is an interactive process of mutual questioning, and trust and a willingness to support each other are formed through interactions.
This process of adaptation should continue in the early stages of teamwork, during training debriefs, and in subsequent practical experiences. It is crucial for team members to constantly reflect on their performance in the early stages for two reasons: 1) analyzing the achievement of tasks to summarize work performance and identify effective and improvement areas, and 2) providing team members with the opportunity to re-discuss and negotiate their roles and collaboration plans.
In the process of reflection, it is important to minimize hierarchical differences so that every member can express their opinions about unclear and unequal responsibilities they perceive.
The U.S. Army uses the “after-action review” method (the purpose of this method is to learn, not to reward or punish; the focus is on taking rapid action based on experience, rather than repeated analysis) to create an atmosphere in which soldiers and leaders have equal rights and can express their views on what happened during the action and its causes. Similarly, during the summary reflection of surgical operations, it is important to allow nursing assistants, nurses, and senior surgeons to feel that they have equal rights and can express their observations from their professional perspectives. In surgical procedures, the ability to break down hierarchies and clearly communicate about matters of life and death must be practiced repeatedly in such a reflection process.
I refer to this feedback process, which involves evaluating team performance and task progress based on achieving goals, as reflection. I consider providing and receiving feedback as a key communication process in the helping relationship, which is especially important for creating a team atmosphere.
In summary, highly effective teams share a recognized characteristic: every member of the team has a clear understanding of their responsibilities within it, and they are willing to fulfill these responsibilities. They believe that the team treats them fairly and reasonably, and the more they contribute to performance, the more formal and informal rewards they receive. In this sense, they assist each other, and the team becomes cohesive.
Each person in the team is both a beneficiary and a contributor because the relationships among them are collectively built. When the task requires it, everyone can take on the role of an expert/doctor, and in unexpected situations that require immediate inquiry, everyone can quickly switch to the role of a process consultant.
When a team operates well, each person plays their part, and even though some contributions may stand out, as long as everyone is clear about and accepts their own and others’ responsibilities, the team can accommodate members who contribute less. The reasons for a team falling apart are usually related to unclear individual responsibilities from the outset or deviations from the initial agreements. These deviations can manifest as some individuals avoiding helping others when they should or interfering with others’ actions without being asked.
For example, once my wife and I were preparing a family dinner together, and we had divided our tasks in advance. However, I suddenly rushed over to help her stir the vegetables in the pan, which disrupted her operation according to the recipe, making her feel overwhelmed. She promptly informed me that my actions were a disturbance rather than help, so I quickly stopped, and our teamwork got back on track. However, in some situations, deviating from established responsibilities can actually mean unexpected assistance, such as when I decisively turned off the oven when I smelled burnt food, which my wife greatly appreciated.