060805L - TEAM BUILDING

Induction for Year 1 Medical Students at the Institute of Medicine, Universiti Brunei Darussalam on Saturday 5th August 2006 by Professor Omar Hasan Kasule

I. BACKGROUND READING (to be distributed 2 days before)

Key Words and Key Terms

·        Principles of group work

·        Groups: definition, classification:

·        Advantages of group work:

·        Disadvantages of group-work:

·        Group formation and break-up:

·        The ideal group

·        Members of the health care team:

·        Duality of teaching & care

·        The teacher's etiquette:

·        The student's etiquette:

·        Etiquette of care in the team

·        General group dynamics

·        Inter-personal interaction:

·        Positive behaviors and attitudes

·        Negative behaviors and attitudes

·        Gender issues

·        Gender-specific dressing

·        Free gender mixing

·        Seclusion

·        Lowering the gaze

Outline

PRINCIPLES OF GROUP WORK

·        Groups: Definition, Classification:

·        Advantages of Group Work:

·        Disadvantages of Group-Work:

·        Group Formation and Break-Up:

·        Characteristics of the Ideal Group:

ETIQUETTE of TEACHING & LEARNING in THE HEALTH CARE TEAM

·        Composition of the Health Care Team:

·        Dual Functions: Teaching &  hlth care 

·        The Teacher's Etiquette:

·        The Student's Etiquette:

ETIQUETTE of CARE DELIVERY in THE HEALTH CARE TEAM

·        Responsibility

·        Leadership

·        Skills

·        Difficult Tasks and Missions

·        Community Work

THE HEALTH CARE TEAM: GENERAL GROUP DYNAMICS

·        Basic Duties & Rights of Brotherhood:

·        Additional Duties & Rights

·        Etiquette of Inter-Personal Interaction:

·        Positive Behaviors and Attitudes

·        Negative Behaviors and Attitudes

THE HEALTH CARE TEAM: SPECIAL GROUP DYNAMICS

·        Two Genders

·        Gender-Specific Dressing

·        Free Gender Mixing

·        Seclusion

·        Lowering the Gaze

Synopsis

PRINCIPLES OF GROUP WORK

A group is several interdependent and interacting persons. Work is enjoined in groups that are united, cooperative, open and trusting. Group members must be similar, empathetic, supportive, and sharing. Separation from group is condemned. Group norms must be respected. Breaking norms, secretive behavior, concealment of information, and secret talks destroy groups. Group membership has benefits of integration, stimulation, motivation, innovation, emotional support, and endurance. Group performance is superior to individual performance. Group membership has the disadvantages of arrogance, suppression of individual initiative, member mismatch, and intra-group conflict. Group formation has 4 stages: forming (acquaintance and learning to accept one another), storming (emotions and tensions), initial integration (start of normal functioning), total integration (full functioning), and dissolution. Mature groups have group identity, optimized feedback, decision-making procedures, cohesion, flexibility of organization, resource utilization, communication, clear accepted goals, interdependence, participation, and acceptance of minority views. Groups fail when constituted on the wrong basis, when members cannot communicate, when there is no commonality (interests, attitudes, and goals), and when they have diseases of envy, hasad; hypocrisy, nifaq; rumor mongering, namiimah; back-biting, gaybah; lying, kadhb; show-off, riyah; pride, kibriyah; love of leadership, hubb al riyasa; spying on one another, tajassus; and negative thoughts about others, dhun al soo. In effective group members feel secure and not suppressed, members understand and practice sincere group dynamics, members are competent and are committed to the group and the leadership.

ETIQUETTE of TEACHING & LEARNING in THE HEALTH CARE TEAM

The hospital health care team is complex and multi-disciplinary with complementary and inter-dependent roles. Members have dual functions of teaching and delivering health care. Most teaching is passive learning of attitudes, skills, and facts by observation. Teachers must be humble. They must make the learning process easy and interesting. Their actions, attitudes, and words can be emulated. They should have appropriate emotional expression, encourage student questions, repeat to ensure understanding, and not hide knowledge. The student should respect the teacher for the knowledge they have. They should listen quietly and respectfully, teach one another, ask questions to clarify, and take notes for understanding and retention. They should stay around in the hospital and with their teachers all the time to maximize learning.

ETIQUETTE of CARE DELIVERY in THE HEALTH CARE TEAM

Each member of the team carries personal responsibility with leaders carrying more responsibility. Leaders must be obeyed except in illegal acts, corruption, or oppression. Rufaidah, a 7^th century nurse, was good model of etiquette. She a kind, empathetic, a capable leader and organizer, clinically competent, and a trainer of others. Besides clinical activities, she was public health nurse and a social worker assisting all in need. The human touch is unfortunately being forgotten in modern medicine as the balance is increasingly tilted in favor of technology.

THE HEALTH CARE TEAM: GENERAL GROUP DYNAMICS

Basic duties of brotherhood and best of manners must be observed. Encouraged are positive behaviors (mutual love, empathy, caring for one another; leniency, generosity, patience, modesty, a cheerful disposition, calling others by their favorite names, recognizing the rights of the older members, and self control in anger. Discouraged are negative attributes (harshness in speech, rumor mongering, excessive praise, mutual jealousy, turning away from other for more than 3 days, and spying on the privacy of others).

THE HEALTH CARE TEAM: SPECIAL GROUP DYNAMICS

Gender-specific identity should be maintained in dress, walking, and speaking. Free mixing of the genders is forbidden but professional contact within the limits of necessity is allowed. Patients of the opposite are examined in the presence of a chaperone. The gaze should be lowered. Modest and covering must be observed. Display of adornments that enhance natural beauty must be minimized.

Discussion issues on team-building (distributed during group discussion)

PRINCIPLES OF GROUP WORK

1.      Define and describe various types of groups, formal and informal

2.      List and describe advantages of group work

3.      List and describe disadvantages of group work

4.      Describe the processes and stages of group formation and group break up

5.      How is the set-up of the health care team different from other groups

6.      Describe characteristics of mature groups

7.      List and describe common causes of group break up

8.      What behavioral diseases destroy groups

9.      List and describe characteristics of an ideal group

ETIQUETTE of TEACHING & LEARNING in THE HEALTH CARE TEAM

10. Describe the composition of the health care team

11.  Describe the dual functions of teaching and delivering care

12.  Summarize the teacher’s etiquette

13.  Summarize the student’s etiquette

ETIQUETTE of CARE DELIVERY in THE HEALTH CARE TEAM

14.  Describe responsibility in a health care team

15.  Describe leadership in a health care team

16.  Describe the necessary skill matrix in a health care team

THE HEALTH CARE TEAM: GENERAL GROUP DYNAMICS

17. List and describe basic duties of brotherhood that must be fulfilled in a team
18. Describe additional duties of brotherhood to be fulfilled in a team

19.  Describe Islamic guidelines on the etiquette of inter-personal interaction

20. List and describe positive behaviors and attitudes

21.  List and describe negative behaviors and attitudes

THE HEALTH CARE TEAM: SPECIAL GROUP DYNAMICS

22. Describe guidelines on dress for both genders in a team

23. Describe legal guidelines on gender mixing in a health care team

24. Describe legal guidelines on seclusion in a health care team

25. Describe legal guidelines on lowering the gaze in a health care team

II. TEAM-BUILDING GAME

Instructions (to be distributed 40 minutes before the game)

 

OBJECTIVE

1. The objective of this game is to put into practice principles of effective team-work that were discussed before. Each team will have the task of making a strategy and an action plan that will enable a blind-folded member of the team to fulfill defined practical tasks.

EVALUATION

1. Each team will be given a score on each of 2 assessment areas (a) process evaluation ( team maturity and team effectiveness) (b) outcome evaluation (time needed tp complete the tasks).

INSTRUCTIONS FOR PLAYERS

1. You will be divided into several teams each consisting of 4-6 persons. Team allocations will be entirely random and you will have no say on the allocation process. Each team member will wear an identifying number supplied by the game organizers. All members are encouraged to dress in white if possible
2. You will be given 30 minutes to meet as a team and plan your strategy very carefully. You may even practice on the grounds. You however are not allowed to talk to members of the opposing teams or even to eavesdrop on their discussions.
3. Each team will have three tasks to perform. Each team will perform the tasks in a different sequence. The starting point for all the teams will be the same spot marked ( (ground zero).
4. You will have a total of 10-15 minutes for the blind-folded person to accomplish the task(s)
5. You must wear sports clothing with suitable shoes because the playing field will be rough and possibly wet and muddy.
6. You will select one member of the team to be the team leader. Blind fold the leader properly. A member of the judge panel will check that the blind-folding is proper before starting. If the blind-fold falls off, the person must go back to the start and have the blind fold reapplied but no extra time will be given.
7. You can talk to the blind-folded person but cannot push or pull him. He must make movements based on his/her own decision
8. You can include in your strategy any words or actions that confuse the blind-folded person from the opposing team. You however can not push or pull. You are also not allowed to put dangerous obstacles on the way

Tasks of the game (to be distributed 30 minutes before the first game)

The following are instructions to the leader on performance of various tasks. The leader will be helped by all team members who are allowed to move around him. They have to remember that they can guide the leader ONLY with verbal instructions. Physical contact will lead to disqualification or loss of points. Members of opposing teams can also move around the leader and can speak to him but cannot touch him/her.

Tasks for team #1

• Task 1: Go to the tree in area A. Pick up the green colored paper and read further instructions.
• Task 2: Go to the basin in area B. Fill the cup with water from the basin. Bring the cup filled with water to the person holding the flag pole. Ask him the question “Would you like a glass of water?”. If he/she says “Yes please”, give him the cup and he will give you the flag pole and an envelope. If he does not say this, please proceed to ask the next person until you find one who will give the right answer.
• Task 3: As fast as you can move to area C where there is a circle painted on the grass with a bull-eye at the center. Plant the flag pole at the bull eye.
•  End

Tasks for team #2

• Task 1: Go to the basin in area B. Fill the cup with water from the basin. Bring the cup filled with water to the person holding the flag poles. Ask him the question “Would you like tea or coffee sir?”. If he says “Tea is ok”, give him the cup and he will give you an envelope for your next task. If he does not say this, please proceed to ask the next person until you find one who will give the right answer.
• Task 2: Go to area C and plant the flag pole at the center of the circle painted in the grass. Then someone will hand you instructions for your next task.
• Task 3: As fast as you can move to area A and pick up a yellow colored paper. Read instructions for further actions.
•  End

Tasks for team #3

• Task 1: Go to area C and plant the flag pole at the center of the circle painted in the grass. Someone will hand you your next instruction.
• Task 2: Go to the tree in area A. Pick up a red colored paper and read instructions for your next task.
• Task 3: Go as fast as you can to the basin in area B. Fill the cup with water from the basin. Bring the cup filled with water to area C where someone is holding the flag pole. Ask him the question “Would you like tea, coffee, or water?”. If he replies “Water please”, give him the cup and he will give you an envelope for your next task. If he does not say this, please proceed to the next person until you find one who will give the right answer.

III. JUDGE’S SCORE SHEETS

INSTRUCTIONS TO THE JUDGES

1. One or 2 members of the panel will stay with a team continuously from the beginning to the end. You will attend their initial 30-minute strategy and planning session. They you will follow them as they work with their blind-folded person to walk from point A to point B.

2. Write notes continuously against each of the criteria that will be used to judge the process. Fill up the score sheet at the end of the process.

3. Make note of additional criteria that you think should have been included on the score sheet. Write them in the additional slots at the bottom of the score sheet. You may if you wish use some or all of them in your evaluation.

4. It is possible that some criteria may not be relevant. Do not score them or include them in the total score.

SCORING GROUP MATURITY

Type of Activity or Behavior	High (2)	Medium (1)	Low (0)
Giving and accepting feedback
Democratic decision making
Group cohesion
Flexibility of members
Use of all member resources
Members feel free to disagree
Everyone is free to express an opinion
Humor is the norm
Communication is effective
Group sets clear strategies and goals
Interdependence Among members
Shared participation and not dictatorship
Listening to and considering minority views
TOTAL

TOTAL SCORE AS A % OF THE MAXIMUM POSSIBE SCORE

SCORING GROUP EFFECTIVENESS:

Type of Activity or Behavior	High (2)	Medium (1)	Low (0)
Productivity
Positive handling of complaints
Positive conflict resolution
Commitment to goals
Action-orientation
dealing with apathy of some members
Encouraging creativity and innovation
Competence of team managers/leaders
Effectiveness of meetings and discussions
Effective communication
Trust among team members
Making sure decisions are understood by all
Feeling good as a team member
Principled behavior
TOTAL

TOTAL SCORE AS A % OF THE MAXIMUM POSSIBLE SCORE

SCORING OUTCOME

Team name	Time to accomplish task (in minutes)				Score (20-time in minutes)
	Task #1	Task #2	Task #3	Total
1. Muara
2. Seria
3. Belait

TOTAL SCORES

Team name	Maturity	Effectiveness	Outcome	Total	Points lost	Final score
1. Muara
2. Seria
3. Belait

IV. JUDGE’S NOTES & OBSERVATIONS ON GROUP MATURITY

1.       Giving and accepting feedback

2.       Democratic decision making

3.       Group cohesion

4.       Flexibility of members

5.       Use of all member resources

6.       Members feel free to disagree

7.       Everyone is free to express an opinion

8.       Humor is the norm

9.       Communication is effective

10.   Group sets clear strategies and goals

11.   Interdependence among members

12.   Shared participation and not dictatorship

13.   Listening to and considering minority views

14.

15.

V. JUDGE’S NOTES & OBSERVATIONS ON GROUP EFFECTIVENESS:

1.       Productivity

2.       Positive handling of complaints

3.       Positive conflict resolution

4.       Commitment to goals

5.       Action-orientation

6.       dealing with apathy of some members

7.       Encouraging creativity and innovation

8.       Competence of team managers/leaders

9.       Effectiveness of meetings and discussions

10.   Effective communication

11.   Trust among team members

12.   Making sure decisions are understood by all

13.   Feeling good as a team member

14.   Principled behavior

15.

VI. JUDGE’S OBSERVATIONS ON INDIVIDUAL GROUP MEMBERS

ID

Criteria for team maturity and effectiveness (distributed after the game)

I. MATURITY OF THE GROUP:

Giving and accepting feedback

Democratic decision making

Group cohesion

Flexibility of members

Use of all member resources

Members feel free to disagree

Everyone is free to express an opinion

Humor is the norm

Communication is effective

Group sets clear strategies and goals

Interdependence Among members

Shared participation and not dictatorship

Listening to and considering minority views

II. GROUP EFFECTIVENESS:

Productivity

Positive handling of complaints

Positive conflict resolution

Commitment to goals

Action-orientation

Apathy of some members

Encouraging creativity and innovation

Competence of team managers/leaders

Effectiveness of meetings and discussions

Effective communication

Trust among team members

Making sure decisions are understood by all

Feeling good as a team member

Principled behavior