Why team collaboration is key to a successful surgical project

Three takeaways for effective team collaboration in a surgical space.

Our ten Discovery Award winning teams are midway through the development of their surgical training prototypes for the Global Surgical Training Challenge. These teams are unique, due to both their multinational and multidisciplinary make-up, both of which are required to make these surgical training prototypes a success. Team members have come together from multiple countries all over the world, and each team is composed of surgical education specialists, clinicians and technologists including; engineers, software developers and product designers.

Leading international teams can be challenging, particularly with regards to communication and project management across cultural differences and multiple time zones. In addition, many of our  team members have never met in person due to the pandemic, meaning they have had to conduct all their interactions online. As a result, using the right project management tools is critical in moving these projects forward. 

The importance of strong leadership

To date, teams competing in the Global Surgical Training Challenge have benefitted from interaction with our panel of expert judges and the prestigious mentoring programme that was established in collaboration with the Royal College of Surgeons in Ireland. To build on this support, we brought the teams together in a series of workshops to facilitate their continuous learning journey as a cohort, and to encourage peer-to-peer learning. The first of these interactive workshops was focused on overcoming some of the project and team management issues. 

To help our teams build effective ways of working together, a panel of international experts in the field reflected on their own experiences working and leading international teams in the surgical space, with Dr Catherine Mohr, President of the Intuitive Foundation, the Challenge funder, moderating the panel. We are very grateful to our panelists:  

• Dr Tihitena Negussie, Lifebox Global Clinical Director and Pediatric Surgeon, Ethiopia.
• Professor Ciaran O’Boyle, Professor of Psychology, Founding Director of the RCSI Centre for Positive Psychology and Health, Ireland. 
• Professor Dhanajaya Sharma, Professor, Head of Department of Surgery, Government Medical College and Allied Hospitals, Jabalpur, India

All our panelists agreed that effective team work is hard to achieve, and team leadership is incredibly important, especially when team members come from different cultures, or have different professional backgrounds and specialties.

Three key take-aways for improving  team management

Natural team roles

Professor O’Boyle introduced the idea of bringing natural team roles (tendency to behave, contribute and connect with others in a particular way) into the dynamic. The teams learnt that the factors that influence teamwork are largely psychological, and the psychology that we bring with us to the team is in fact a much better predictor of success than technical expertise. This especially applies to healthcare professionals, as they are usually solely trained for the technology of their disciplines and not to lead teams.

Productive conflict in a multicultural context and the role of hierarchy

“In multicultural environments there’s a huge need for mutual understanding and respect for initiatives to be successful,” Professor O’Boyle

Professor O’Boyle also stressed the importance of productive conflict as one of the drivers of team effectiveness. Productive conflict is not something to be avoided, as its resolution strengthens mutual trust and confidence. Conflict is natural, especially among teams where individuals come from different cultural contexts. They bring different views, levels of experience and perspectives. 

“If there is no trust then there is a fear of conflict,” Professor O’Boyle.

In addition, different cultures can have a very distinct approach to communication, or attitudes about what conflict is and how to deal with it. For example, some cultures foster a strict hierarchy in teams, with a junior team member unlikely to contradict the opinion of their senior member. 

Professor Sharma explained how teams can benefit from a more structured hierarchical system and why hierarchy should not be always seen as a negative thing. They recommended each team should be led by a senior person who can guide the conversation and make sure participants can reach a consensus in a reasonable time frame.  The role of the team leader should be established right from the beginning, so everybody knows who is playing this role and respects that.

Dr Negussie shared some of the challenges she has been facing when providing clinical leadership across Lifebox’s programmes. She agreed that the leader plays a vital role in facilitating smooth communication within the team and in making sure all the members are listened to and understand each other’s point of view.

Professor O’Boyle presented the four ways high performing teams think about conflict:

• Accept that conflict is inevitable and can be a very positive driver, generating energy within the team. However, be aware that conflict can be incredibly destructive if not addressed in the right way.
• Establish basic housekeeping of team meetings well in advance. This includes setting clear goals and roles, rules on how meetings will run, and the mechanism through which team members will have their say.
• Encourage the miner in the group — the person who, like a coal miner, can go beneath the surface and dig out what may be hidden conflicts, then brings them to the surface. 
• Create a culture in which team members give each other permission for dealing with conflict and supporting these kinds of discussions.  Every team member is a facilitator, which allows these conversations to happen.

Other resources

Our panel of experts shared some practical management tools and additional resources that can help teams to stay on schedule while working on projects with high levels of complexity and short time frames.

• The Thomas Kilmann Conflict questionnaire is an accessible resource when dealing with conflict . It offers five ways of dealing with conflict and allows one to pick the right approach to  different kinds of conflict. Team members can learn about their own conflict style as well as the conflict style of others on the team.
• Time Management Matrix by Stephen Covey presents the difference between importance and urgency and explains why ‘good is good enough’. Covey discusses why real value lies in doing things that are important but not urgent and how not to spend the majority of our time on minor tasks in the attempt to achieve perfection.