Unveiling Intraprofessional Dynamics: Learning Teamwork in Acute Care Consultations Between Paediatric and General Practice Residents

TL;DR

This study explores how pediatric and general practice residents learn to collaborate effectively during high-pressure acute care consultations, focusing on emotional and cognitive teamwork dynamics.

Contribution

The study introduces an intraprofessional consultation training (IPCT) based on the Teamwork-ABC model to improve teamwork skills in acute care settings.

Findings

Residents gained insight into attitudes and emotions shaping teamwork and developed strategies for managing emotional dynamics.

The IPCT fostered shared mental models and alignment, though applying these in high-pressure clinical settings remained challenging.

Residents reported increased self-reflection and empathy, aligning with the concept of mentalising.

Abstract

Effective remote collaboration under high-pressure conditions—such as physicians consulting each other by phone about acutely ill patients—is a complex aspect of teamwork. Despite its importance for patient outcomes, medical training has often overlooked the emotional and cognitive dynamics that shape teamwork. To address this, we developed an intraprofessional consultation training (IPCT) for paediatric (P) and general practice (GP) residents, based on the Teamwork-Attitude, Behaviour, Cognition (ABC) model, to enhance teamwork skills in acute care. This study examined what residents learned about consultation dynamics, their intended behavioural changes, and how these translated into practice.

This qualitative study involved GP and P residents from the Radboud University Medical Centre, Nijmegen, the Netherlands and three affiliated non-academic teaching hospitals. The IPCT included video reviews, reflections, and role-playing. Residents completed reflection forms and set intentions. Two months later, a follow-up questionnaire was administered. Template analysis, guided by the “ABCs of teamwork” framework, was conducted. Learning outcomes and transfer were assessed using the Kirkpatrick model.

Twenty-six residents (12 GPs, 14 Ps) participated. The IPCT fostered shared mental models and alignment. Residents primarily gained insight into the attitudes and emotions shaping teamwork, becoming more aware of their own and others’ emotions and interactional dynamics. Although they applied these insights in practice, managing complex intraprofessional dynamics remained challenging.

Residents developed strategies to navigate emotional dynamics of teamwork, aligning with the concept of mentalising—self-reflection, empathy, and relational interpretation. Yet applying these strategies in clinical practice remained challenging within the existing high-pressure medical work culture and warrants attention.

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