Effective teamwork within healthcare–Let’s finally make it happen! A realist evaluation

TY - JOUR

T1 - Effective teamwork within healthcare–Let’s finally make it happen! A realist evaluation

AU - A, Kehoe

AU - A, Ellawala

AU - D, Karunaratne

AU - P.A, Tiffin

AU - P.E.S, Crampton

N1 - Publisher Copyright: © 2025 Informa UK Limited, trading as Taylor & Francis Group.

PY - 2025/9/24

Y1 - 2025/9/24

N2 - Introduction: Effective teamwork is essential for the successful functioning of healthcare. Breakdowns in teamwork are frequently flagged as contributing to major patient safety issues. Current research indicates a lack of knowledge regarding key factors that impact upon teamwork and how medical educators can best prepare students. This study explores how doctors work within healthcare teams; exploring barriers and enablers to effective teamworking. Methods: A realist evaluation was used to understand the contextual influences and subsequent mechanisms that impact teamwork outcomes. Phase 1 included a realist literature review and scoping interviews with key stakeholders (n = 9). Phase 2 included 63 realist interviews representing a wide range of professional groups, roles and demographics across the UK healthcare. Results: The initial program theory developed in Phase 1 was refined during Phase 2, integrating and extending the dispersed and patchy current evidence on the contexts, mechanisms, and outcomes of teamwork. Enablers included building a positive and supportive culture, effective communication, leaders who are understanding and approachable, clearly defined roles and respect, and continuity and experience of those in newer roles. Barriers included high service demands and work pressures, power imbalances and negative hierarchy, a lack of support for those new to teams and organisations, poor communication, poor leadership, a lack of appreciation and understanding of the needs of differing groups within teams, and finally EDI issues. There were particular difficulties for those in newer roles. Discussion: We have identified that team dynamics are likely to be hindered by transient teams, lack of support, dysfunctional leadership and communication, and non-approachable colleagues. There are currently clear difficulties in how doctors interact with those in newer roles, and the ways in which team members are integrated into teams. This is the first research to develop a teamworking programme theory that can be used to support educators, institutions and regulators. Practice points Patient safety is often at risk through poor teamwork. Interprofessional education, and in particular teamworking, is something often expected but not actually taught to our healthcare staff. This research explicitly reveals what makes effective and ineffective teamwork. We have produced a programme theory that can be utilised by institutions going forward to promote better teamworking for doctors and other healthcare staff.

AB - Introduction: Effective teamwork is essential for the successful functioning of healthcare. Breakdowns in teamwork are frequently flagged as contributing to major patient safety issues. Current research indicates a lack of knowledge regarding key factors that impact upon teamwork and how medical educators can best prepare students. This study explores how doctors work within healthcare teams; exploring barriers and enablers to effective teamworking. Methods: A realist evaluation was used to understand the contextual influences and subsequent mechanisms that impact teamwork outcomes. Phase 1 included a realist literature review and scoping interviews with key stakeholders (n = 9). Phase 2 included 63 realist interviews representing a wide range of professional groups, roles and demographics across the UK healthcare. Results: The initial program theory developed in Phase 1 was refined during Phase 2, integrating and extending the dispersed and patchy current evidence on the contexts, mechanisms, and outcomes of teamwork. Enablers included building a positive and supportive culture, effective communication, leaders who are understanding and approachable, clearly defined roles and respect, and continuity and experience of those in newer roles. Barriers included high service demands and work pressures, power imbalances and negative hierarchy, a lack of support for those new to teams and organisations, poor communication, poor leadership, a lack of appreciation and understanding of the needs of differing groups within teams, and finally EDI issues. There were particular difficulties for those in newer roles. Discussion: We have identified that team dynamics are likely to be hindered by transient teams, lack of support, dysfunctional leadership and communication, and non-approachable colleagues. There are currently clear difficulties in how doctors interact with those in newer roles, and the ways in which team members are integrated into teams. This is the first research to develop a teamworking programme theory that can be used to support educators, institutions and regulators. Practice points Patient safety is often at risk through poor teamwork. Interprofessional education, and in particular teamworking, is something often expected but not actually taught to our healthcare staff. This research explicitly reveals what makes effective and ineffective teamwork. We have produced a programme theory that can be utilised by institutions going forward to promote better teamworking for doctors and other healthcare staff.

KW - curriculum

KW - evaluation

KW - Management

KW - medical education research

KW - multiprofessional

KW - phase of education

KW - postgraduate

UR - https://www.scopus.com/pages/publications/105017972864

U2 - 10.1080/0142159X.2025.2561782

DO - 10.1080/0142159X.2025.2561782

M3 - Article

C2 - 40991830

AN - SCOPUS:105017972864

SN - 0142-159X

JO - Medical Teacher

JF - Medical Teacher

ER -