teams and team management in nurse education
TRANSCRIPT
Teams and team management in nurse education
Malcolm Richardson
Nursing traditionally relied upon power-coercive and status-oriented management styles similar to those which have underpinned failing British industry but team work and team management styles underpin the success and excellence of organisations in industry and commerce. The author argues that such team work and team management can create the dynamic ‘problem-solving’ style required for the management of complex issues such as exist within nurse education today. The author presents an outline of teams, their characteristics and the models currently available for managing, building and mantaining teams.
INTRODUCTION
One of the failures of British management, viewed against successful competitors, is its con- tinued reliance upon the strategies of power coerciveness, reward and negotiation. This combined with a management culture of keep- ing a stiff upper lip, taking the medicine and not rocking the boat has also typified nurse manage- ment (Bendal 1975; Kichardson 1988; Wyatt 1978). The antithesis to this management style is team management and team work (Armstrong 1988; Belbin 1981; Harris & Harris 1989; Maregerison & McCann 1985, 1989; Mintzberg 1973).
Organisations which achieve excellence in- variably build that excellence via teams (Crosby
Malcolm Richardson BEd(Hons) DipN RNMH Programme Leader Mental Handicap Branch, Sheffield North Trent College of Nursing and Midwifery, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT. UK (Requests for offprints to MR) Manuscript accepted 20 November 1991
44
1979; Drucker 1980; Iacocca 8c Novak 1984; Kanter 1984; Peters & Waterman 1982). It follows, therefore, that if nurse education is to deliver excellence in today’s education market its managers must ensure the building of team management systems and teamwork. So what are such team management systems and teams like?
Teams: their characteristics
Belbin (1981), Adair (1986), Barret (19&S), and others note that teams are more than just a collection of people who work in the same place, have the same manager and similar jobs within a department. A team knows it is a team because members will describe that they share a common purpose requiring the unified efforts of all the members to achieve that purpose. Teams move in a shared direction of purpose having worked out their own ways, yet members do not ‘live in each other’s pockets’ or need total involvement in every decision. A team’s leader develops the leadership qualities of team members. In
addition, team members are able to support and
buf’fer one another against the stresses of‘ the
work place. The sense of‘ involvement created
helps to motivate people creatively thereby
reducing the opportunities f’or feelings of‘hurt,
paranoia and the destructive waste of‘ energies
that can otherwise be directed towards back
stabbing and infighting. Kecognition of‘ mutual
responsibility towards common objectives is
enhanced, the barriers of rivalry and jealousy
decreased and there is increased awareness
among members of each other’s pressures and
problems. The effective team knows where it is
going, sets realistic targets, uses resources ener-
getically and imaginatively. has a wide range of‘
alternatives f’or action and will investigate coping
strategies as necessary. In such a team, members
will trust each other to pursue their bit of’ the
common task. In dealings with the outside world
teams will behave sensitively and assertively.
To sum up, some advantages of‘teams are that
the) combine the variety of‘the members’ talents
cohrsively. Thereby the achievemems of‘
teamwork are potentially greater than the sum
of the individual contributions made and
superior to those of‘ groups acting in a non team
manner.
However. not just any group or mix ofindivid-
uals can form a successful team. ‘Teams are
successful because of the differences between
the individual members. Thus, teams of gif‘ted,
but like minded, ‘Leonardos’ are less likely to
succ caed than a learn of‘ comparatively ordinary
people each with dift‘erent attributes to bring to
the team’s activities (Belbin 1987).
(:urrently there are f’our main methods f’or
examining team skill mix in order to get the right
combination.
The first, described by Belbin, identifies eight
team roles (Table 1). Most people are strong in
one or Iwo of these (Belbin 1981). Belbin sug-
gests that an individual should concentrate upon
developing all but their two weakest team role
attributes since the weakest are likely to be
incompatable with excellence in the stronger.
‘I%e roles are Company Worker, Chairman,
Shaper, Plant, Kesource Investigator, Monitor
Evaluator, ‘l‘earn Worker and Completel
Finisher.
(1)
Fig 1 Team building -The MargerisonlMcCann team management resource
I‘he second method is that of Margrrison and
McCann who, in their Team Functions and
‘l‘eam Managernenr Wheel (Fig. I). advise that
success in a team tends to occur when members
are able to fulhl one or more of the f’ollowing
functions:
(;reator Innovator - a creative person who
brings high quality ideas
and innovative concepts
forkvard (broadly simi-
lar to Belbin’s Plant):
fab
le
1 U
sefu
l p
eop
le
to h
ave
in t
eam
s (B
elb
in
1981
)
Tvp
e S
ymb
ol
Typ
ical
fe
atu
res
Po
siti
ve
qu
alit
ies
Allo
wab
le
wea
knes
ses
Co
mp
any
Wo
rker
W
C
Co
nse
rvat
ive,
d
uti
ful,
pre
dic
tab
le.
Org
aniz
ing
ab
ility
p
ract
ical
co
mm
on
se
nse
, h
ard
-wo
rkin
g,
self
-dis
cip
line.
Lac
k o
f fl
exib
ility
, u
nre
spo
nsi
ven
ess
to u
np
rove
n
idea
s
Ch
airm
an
Sh
aper
CH
SH
Cal
m,
self
-co
nfi
den
t co
ntr
olle
d.
A c
apac
ity
for
trea
tin
g
and
wel
com
ing
al
l p
ote
nti
al
con
trib
uto
rs
on
th
eir
mer
its
and
w
ith
ou
t p
reju
dic
e A
. st
ron
g
sen
se
of
ob
ject
ives
.
No
mo
re
than
o
rdin
ary
in t
erm
s o
f in
telle
ct
or
crea
tive
ab
ility
.
Hig
hly
st
run
g,
ou
tgo
ing
, d
ynam
ic
Dri
ve
and
re
adin
ess
to
chal
len
ge
iner
tia,
in
effe
ctiv
enes
s,
com
pla
cen
cy
or
self
-dec
epti
on
.
Pro
nen
ess
to p
rovo
cati
on
, ir
rita
tio
n
and
im
pat
ien
ce.
Pla
nt
PL
RI
Ind
ivid
ual
isti
c.
seri
ou
s-
Gen
ius,
im
agin
atio
n,
min
ded
, u
no
rth
od
ox.
in
telle
ct,
kno
wle
dg
e.
Up
in
th
e cl
ou
ds,
in
clin
ed
to
dis
reg
ard
p
ract
ical
d
etai
ls
or
pro
toco
l.
Res
ou
rce
Inve
stig
ato
r
Mo
nit
or-
E
valu
ato
r
Tea
m
Wo
rker
Co
mp
lete
r-
Fin
ish
er
ME
TW
CF
Ext
rove
rted
, en
thu
sias
tic
curi
ou
s,
com
mu
nic
ativ
e
So
ber
, u
nem
oti
on
al,
pru
den
t.
So
cial
ly,
ori
enta
ted
, ra
ther
m
ild,
sen
siti
ve.
Pai
nst
akin
g,
ord
erly
, co
nsc
ien
tio
us,
an
xio
us
A c
apac
ity
for
con
tact
ing
p
eop
le
and
exp
lori
ng
an
yth
ing
n
ew.
An
abili
ty
to r
esp
on
d
to c
hal
len
ge.
Jud
gem
ent,
d
iscr
etio
n,
har
d-h
ead
edn
ess.
An
abili
ty
to r
esp
on
d
to
peo
ple
an
d t
o s
itu
atio
ns
and
to
pro
mo
te
team
sp
irit
.
A c
apac
ity
for
follo
w-
thro
ug
h.
Per
fect
ion
ism
.
Lia
ble
to
lo
se i
nte
rest
o
nce
th
e in
itia
l fa
scin
atio
n
has
pas
sed
.
Lac
ks i
nsp
irat
ion
o
r th
e ab
ility
to
mo
tiva
te
oth
ers.
Ind
ecis
iven
ess
at m
om
ents
o
f cr
isis
.
A t
end
ency
to
wo
rry
abo
ut
smal
l th
ing
s.
A r
elu
ctan
ce
to ‘
let-
go
’
Thruster Organiser
Explorer Promoter
Concluder Producer
Upholder Maintainer -
Assessor Developer -
keeps the team on task
and on schedule, pos-
sesses strong organis-
ational abilities (some
similarity to Belbin’s
Shaper):
_ an outgoing person,
looks for new oppor-
tunities to sell the team’s
strengths and skills,
brings ideas ecountered
and opportunities
encountered back to the
team (broadly similar to
Belbin’s Kesource
Investigator);
ability to ensure that the
team’s projects are fully
processed to completion
(broadly similar to
Belbin’s Company
Worker with an element
of Completer Finisher);
essentially has the sensi-
tivity and optimism to
motivate the team and
mediate conflict
between members,
helps to prevent burn-
out (broadly similar to
Belbin’s Team Worker);
quite a critical minded
person able to assess
and identify the most
promising idea, also an
aptitude for developing
the less practical ideas,
e.g. from the creator
innovator, towards a
workable option
(broadly similar to
Belbin’s Monitor
Evaluator);
Controller Inspector - mindf’ul of‘ detail and
exactitude (similar to
Belbin’s Completer
Finisher), focuses the
team upon its standards
ot work
achievrmenl :
and
Keporter Advisor -
Linker -
to some extent every
one has to perform in
this f‘unc&m. reporting
on theil- owm contri-
bution, but the team will
usually need a member
who has a distinct flair
fin deli\,er\ of report>.
draws rogether the
ef’forts Of 1 he team,
of’ten is the chail- person
(broadI\ snmilar IO
Belbin’s (Ihair). (Mar-
gerison K- McCZann
1985. l!oiY)
There are some clearly recognisable overlaps
between Belbin’s management team roles and
Margerison and McCann’s team management
resource, but these are not exact o\,erlaps. Psy-
chometric tests are available to help identif, an
individual’s capacity for fulfilling the functions
or roles. Such tests depend. howrvrr , upon the
honesty and/or self’ awareness of the person
completing the test so some caution dnd skill al-e
required in administering such testa. Belbin
f’ound that those individuals who refused to take
the psychometric tests invariably Kerr poor team
members. Some peopltr do not have a strong
leaning to any of‘ Belbin’s roles and similarlv
Belbin found they contributed littltz to the team’s
efforts (Belbin 198fi).
Thirdly Adair mistrusts the ,rttrlbution 01‘
personality qualities to I-oles in Ihe tram and
advises that a team needs a mix of skulls spread
around its members (Adair 1986i,. I‘hose skills
should be f’or analysis, reasoning. bvnthesis,
holistic thinking, valuing, inruition (flair).
memory (f’or what the team ha\ t’ learned and
temporarily forgotten) creativitv and numerac).
All members however mllst have ;I general abilitr,
to work in teams, and upon this point all thr
investigators agree. Kathet- like a ream of
huskies, some individuals are so Ilighl) individ-
ualisticor competitive that the? disrupt the team.
Building and maintaining a IWIII is a task
which belongs to the leader or rrl,magpr (Adair.
98 NURSE EDUCATION TODAY
;‘\ Achieving
the task I
and maintaining the Individual
Fig 2 Reproduced with permission from Adair J 1986 Effective team building, Gower, London
1986; Barrett 1987; Troisi 8c Kidd 1990). There are many team builing simulation exercises now published to aid this process, for example Woodcock (1979). Adair, in his three element model, offers team leaders and managers detailed guide lines for building and maintain- ing a team (Adair 1986). These three elements require attention to the achievement of the task, building and maintaining the team and developing the individual (Fig. 2). For example during a crisis it may be most important to ensure that the team achieves its task, leaving little time or energy for team and individual needs. Once the worst of the crisis is passed the team leader will need to ‘repair’ any damage to the team and ensure that individual needs receive attention. If these are ignored the tensions created during the crisis period may injure future team performance.
The fourth mode1 comes from Flynn and Combs who describe how the application of their recruitment and selection model has enabled them to recruit successful teams (Flynn & Combs 1990). Specific qualtities to be assessed include dependability, interpersonal skills, self moti- vation, integrity, leadership, communication and assertiveness. Selection also invoives simu- lated team work, interviews and checks on the candidates’ previous performance on aspects of integrity and accomplishments.
To some extent Flynn and Combs’ apparent success with these criteria appears to undermine Belbin’s view that individuals should, ideally, be matched with the team that requires their par- ticular role attributes. However, as part of the selection process involved simulated team work, and included members from the team with the vacancy, it is more likely that the selectors were able to identify in candidates the qualities or roles needed.
As an actual or potential team member or team leader in nurse education one may like or dislike the idea of psychometric testing employed by some of the above mentioned, yet even without such testing each of these writers offer models which can be used to inform team discussion about its strengths and weaknesses with a view to improving, where necessary, the balance of the team’s skills and performance (Adair 1986; Belbin 1981; Flynn 8c Combs 1990; Margerison & McCann 1985, 1989).
Teamwork and team management concepts appear to offer nurse education for the manage- ment of complex issues and constant change, but are the concepts workable in the real world of nurse education as successfully as in the real world of business? The recently formed colleges of nursing are certainly having to develop a business-like approach in the world of pur- chasers, providers and contract cultures. In the prevailing business-like c;llture can nurse edu- cation afford to hold on to more traditional management systems? Take, for example, the Margerison and McCann Team Management Kesource (Fig. 1) and relate it to a team of nurse teachers providing pre-registration nurse student education. The team is aware that cur- rent student numbers will probably diminish significantly in future years contracts to a point where fewer teachers may be needed. Unless the team can open up new markets and develop alternative existing markets for education, the team (or college) may have a limited future. The team meets to assess its market strengths, weaknesses and identify market opportunities with a view to creating innovative programmes to satisfy and stimulate the markets. An initial idea may come from a creative thinker in the team (Creator Innovator) but the team considers
UL’KSE. El)L’(: \ I IOh IOI).\\ 99
the idea too ambitious, too risky in its raw form.
Another team member, however. is able to assess
the potential value of‘the new idea and identifies
to the team how it can be modified and
developed into something more likely to succeed
(Assessor Developer skills). The person with the
creative flair and the Assessor Developer are
then ‘linked’ by the team leader to someone who
has skill in getring the hne detail of‘ a project
throttgh to completion (Concluder Producer).
In the meantime someone else (Explorer Pro-
moter) goes out to explore the depth ot‘market
potential and promote the new scheme. So the
team resource wheel revolves, each member of
the team may be able to f’ulfil one or more of‘ the essential resource skills that the team needs to
optimise its perfi)rmance. The team does not
rely upon the genius (or lack of‘ it) in an
.tuto( ratic leader.
This is not to say that building or maintaining
;t team in nurse education will be non-problem-
atic. For example. many colleges are multi-site
with some teams which cannot work f’ace-to-face
each day due to separation by distance. This may
make team building and management more
difficult yet the need to establish trust, willing-
ness IO contribute, sharing of‘competences and
resources, create equity of‘ work load and such
will hc an even greater requisite. In the multi-site
scenario the team leader/manager must create
opportunities to bring team members face-to-
face regularly. It becomes even more important
IO manage by walking about, listening, inf’orm-
ing, explaining, recognising ef‘f’ort and support-
ing. The accessibility and speed of electronic
c.omnlunicatiorls can also help such teams
remain in touch. Adair reminds us that members
of‘ dispersed teams need to be clear about the
tram’s core purposes such as why the team exists
at all and its contribution to the wider system
(.Idait- 1986).
As ‘t t‘urther example. team leaders may not
alway have the luxury of‘ picking the team
members to create a balance of‘ resources. Often
it will he an inheritance of‘an existing team with
its inhcxrent problems, strengths and weaknesses.
Contpetition between teams or their leaders
within a college could be disastrous. To counter
leader/managers are thenJsel\,e\ Ittemt~et~s 01.
management teams which likewise pool their
resources towards the achievemertt of corporate
purposes.
The management literature re\rals that fi)rnrs
of manipulation ma\ be collntrr-l”-od~tc-ti\l~ itI
the long run (Adaii- 19X6; Sennis Cc Nanus I!CVI;
Blake 1987). .4dair describes OIJP 01’ rhr tlloxt
difficult tasks 01 leadership to bc thy aMit\ to
treat everyone as 3 persoIJ rrgartlltss of how ttltb\,
treat you. This demands that ~‘ICIJ itt Ihe inoh,
trying circunislancrs the Icadr~ IJlItsl ;tc( I tic person of her best self. the pet3011 shy 1 rul\ is 011
her besr days. An extre111e1\ dt7Jl;l~JititJ~ i&21
that, iis tJunlatJs, leaders are tlot ,tt)lr I(, allaitt 01’
nlaintain lOO!C ‘Ilie titmi;i~St’ttt~~tt~ ‘LisloI.3, ot
IJIII-Sing Sh0M.s ;~tt ~tItth()rilariiItt. t‘\ rtl oppI-ctasi\c’
tradition the resitlu~s of \VtJic tt :II(’ still AI-ou~ltl.
For example ;I tlurst’ Iradrr I\ IJO tJcha\ cs 24
though bhr \~err on ;I CI-usatl~ to IllJet-arr the,
minds 01 nurses atld bring ;itJottt .I rt~c’:ir( IJ-
based, critic-ally-ttlindrtl profe~siott. tJlil\ It.r\r,
ititertlalised SOIJJY quite opprcG\ r’ ttl;ttJa~~tltrtlt
cotlceps whictl are utJcri~icatl\ .Ipplird ;III(~
undrt~tnitie borh t tie tlesirctl nli~~tott .ttltl t(‘Cttt)
work.
SUMMARY AND CONCLUSIONS
‘I‘eant work anri tC;lIJl Ill;lIJ;l~t’ttl~‘lll ‘.I\ IV\ (‘III create the d~IJ;itltic protllettt-\ol\ irlg rccjrtit (~1
filr the tJl;l1t;lg~‘tt1tYJ~ Of C OttJ/Jh’\ t\‘*llt’\ \,I( tl .I\
exist within tlurst~ ettuc~i~ic~IJ tod.tf \lo(lc~I~ lot assessing trittlt s~tYngrh5 ,ttttl \\c~;Lhtlc~~ws ;ltl(l
team tJtaIJagrt~ietlr arc rr;Iclil\ a~;ttlCtttl~~ I.:\isrittg
tC%tItJS (‘311 II%! rtJtW t0 ;ISSCSS I hei ~ft.C’tJ~:1h\ ;ltl(/
weaknesses and ~‘ht Itlt’it- tlt~\t~I,)1’tltt~tIl. Eat
new te;lrrt!, the s;llIl~ modris lll~l\ .IKL ihr WICT 111 ItI
pi-ocessr\. I.atcLr. Ie;tttl t)uiltling t3t.t c I\(,’ ftl;t\ I)t.
ttsetl 10 zt1;1rpet1 tl1e If3lll’S I”” lrlt it1,ltJ( t’. It1
addirion re;iItls 2t.e .t( Ittall\ ~ooti ;tt t~iil te-t-iti,<
me111t,rrs trotlt ItIe stre\sC~ ot (II<. \,or.l, ph C’,
freeing t,Iiergies I h;il tJt;i\ 0I ttt.I.\\ t,t’ 1’~ \\ .t\l t,d
destruc3i\,et\.
Fe\v tWTtlittIJtLtJl :1ttd ttl‘lIl;l~t’ltl~‘tl~ \\ \lClllr;
withitl tlur~ etluc.;rtiotl tlt,\clooc,rl \\illt IV,III~
work reqttit-rIrtettls it1 IlJirtc(. I‘tic-t cz <It (* 01)poi-
this it is necessarv to ensure that all team tunitiec. thei-cf;,I-c. tot. ,t Iali( ,I/ t (7 ttw ;rttc!
100 NURSE EDUCATION TODAY
overhaul of both management and recruitment systems in order to optimise the benefits that
existing teams may yield, and to create the organisational climate in which new teams may
begin and flourish. Nursing has been renowned
for its traditional reliance on status-bound and
hierarchical management systems. The new
colleges of nursing, if they are to survive in the
education market economy of today, must shat-
ter those traditions. The creation of team man-
agement structures is the hammer to shatter that
rock. Some cracks are already apparent. The
models of Teams and Team Management out-
lined above are largely untested in the field of
nurse education management.
References
Adair J 1986 Effective team building. Cower, London Armstrong M 1988 How to be an even better manager.
Kogan Page, London Barret P 1987 Team building. In: Stewart D M (ed).
Handbook of management skills. Cower, London Belbin R M 1981 Management teams. Heinemann,
Oxford Bendall E 1975 So you passed nurse. Royal College of
Nursing, London Bennis W, Nanus B 1985 Leaders: the strategies for
taking charge. Harper Row, London Blake R R, Mouton J S, Allen R L 1987 Spectacular
teamwork: how to develop the leadership skills for team success. Sidgwick &Jackson, London
Crosby P R 1979 Quality is free: the art of making quality certain. McGraw Hill, NewYork
Drucker P F 1980 Managing in turbulant times. Harper Row, New York
Flynn T, Combs D 1990 Staffing the self managing work team. Leadership and Organisational Development Journal 11, 1: 26-3 1
Harris P R, Harris D L 1989 High performance team management. Leadership and Organisation Development Journal 10,4: 28-32
Iacocca L A, Nova W 1986 Iacocca: an autobiography. Bantam, New York
Kanter R M 1984 The change masters. Allen & Unwin, London
Margerison C, McCann D 1985 How to lead a winning team. M.C.B. University Press, Bradford
Margerison C, McCann D 1989 How to improve team management. Leadership and Organisation Development Journal 10,5: 3-42
Mintzberg H 1989 Mintzberg on management: inside our strange world of organizations. Free Press, London
Peters T J, Waterman R H 1982 In search of excellence: lessons from America’s best run companies. Harper Row, London
Troisi N F, Kidd D J 1990 Achieving success in administration: learning from experience. NASSP Bulletin: March, 42-46
Richardson M 1988 Innovating androgogy in a basic nursing course: an evaluation of the self directed independent study contract with basic nursing students. Nurse Education Today 8: 3 15-324
Wyatt J F 1978 Sociological perspectives on socialisation into a profession: a study of student nurses and their definition of learning. British Journal of Educational Studies 26, 3: 263-276
Woodcock M 1979 Team development Manual. Cower, London