1
Q
what key concepts are found in Drinka’s article? (2)
A
- the essential elements of interprofessional knowledge leadership
- types of leaders
2
Q
according to Drinka, what are the essential elements of interprofessional leadership (6)
A
- environment
- situation
- leaders (formal and informal)
- team members (followers, peers)
- power
- communication
3
Q
according to Drinka, interprofessional (IP) leadership should be viewed as…
A
- a system rather than a set of qualities one person possesses
4
Q
describe the essential element of Environment r/t Drinka’s article (13)
A
includes:
- social structure
- roles
- physical setting
- organization
- structures for communication
- history
- team culture
- politics
- phase of member/team development
- interest & availability of staff members
- reliability of technology
- interactions within & outside work
- internal or external backdrop for the IPC team
all things which impact leadership
5
Q
according to Drinka, who is considered a formal leader?
A
- someone given a designated title by the organization or team
6
Q
according to Drinka, who is an informal leader
A
- anyone who moves the work of the team forward
7
Q
according to Drinka, who is a non-leader
A
- someone who refuses to assume any leadership
8
Q
according to Drinka, some teams work best w ______ r/t leaders
A
- several informal and formal leaders
9
Q
describe the following of formal leaders by the team according to Drinka
A
- at times, the formal leader of the group is not followed by the majority –> people will follow a more appropriate informal leader
10
Q
according to Drinka, the essential element of Situation refers to?
A
- the tasks at hand that require a team’s attention
11
Q
according to Drinka, the situations may be… (4)
A
- complex/simple
- normal/abnormal
- straightforward/ambiguous
- high/low stress
12
Q
according to Drinka, the nature of the Situation should dicate ____
A
who takes the lead
13
Q
according to Drinka, team members have the role of…
A
- accepting or rejecting leadership
14
Q
according to Drinka, what should be continuously assessed r/t team members
A
- whether leaders are performing necessary tasks
15
Q
according to Drinka, leadership is related to…
A
- social power
16
Q
according to Drinka, what are major sources of power with IP leadership (6)? which of these become less important over time?
A
- commitment
- professional knowledge
- energy
- organizational skills
- ability & willingness to teach & learn
- charisma –> becomes less imp over time
17
Q
describe the essential element of Communication r/t Drinka’s article
A
- each member of the team is responsible to ensure his or her communications are being received & understood by other team members
18
Q
according to Drinka, what are different types of leaders/why individuals might assume professional leadership? (5)
A
- prior experience/training
- natural leaders
- reluctant leaders
- now you see them, now you dont
- resentment of the physician as leader
19
Q
describe the relationship between prior experience/training and assuming leadership according to Drinka (2)
A
- may be a factor in why some people are willing to lead
- feel that their experience has prepared them to take the lead
20
Q
describe the relationship between natural leaders and assuming leadership according to Drinka
A
- people may be perceived as natural leaders by the team and appointed regardless of experience
21
Q
describe the relationship between reluctant leaders and assuming leadership according to Drinka (2)
A
- chosen by team despite not feeling ready
- may comply w consensus as they feel obligated or refuse the responsibility
22
Q
describe the relationship between “Now you see them, now you don’t” leaders and assuming leadership according to Drinka (3)
A
- people who withdraw from leadership for temporary (ex. maternity leave) or permanent reasons
- team may not view them as a leader if gone too much
- some people have a hard time withdrawing from leadership as they fear they will be less powerful/respected on their return
23
Q
according to Drinka, what are some reasons that people may avoid leadership? (2)
A
- feel like leaders are disliked
- waiting to see who else might want to step up
24
Q
according to Suter, what are 2 core competencies for effective collaboration practice?
A
- role understanding & appreciation of other roles
- and communiciation
25
according to Suter, what is included under the competency of "role understanding & appreciation of other roles" (2)
- recognizing the value & expertise of other professionals for pt care
- realization that no single discipline can meet all of a pt's needs drives a desire to collaborate
26
according to Suter, challenges surrounding how to work as an IPC team most centre around...
- lack of understanding of IP roles & responsibilities
27
according to Suter, overlap in the scope of certain professionals may cause individuals to become... (2)
- more protective of things in their scope
- show resistance to collaboration
28
according to Suter, role blurring creates...
- risk for conflict and burnout
29
according to Suter, role blurring requires ______ to resolve (3)
- strong leadership
- defining clear boundaries
- demarcating individual contributions
30
according to Suter, focusing on _____ can help reduce IPC conflicts
- a pt's needs
31
according to Suter, IPC teams should strike a balance between ... (2)
- interdependence
- and professional autonomy
32
according to Suter, diverse professional cultures can reinforce...
- a professional differentiation --> can make it hard to work together (think of each profession as a clique)
33
according to Suter, diverse professional cultures can reinforce...
- a professional differentiation --> can make it hard to work together (think of each profession as a clique)
34
according to Suter, the core competency of communication includes....
- formal &
- informal communication
35
according to Suter, the core competency of communication includes....
- formal &
- informal communication
36
according to Suter, communication is the key to.. (2)
- collaborative pt centered care
- care coordination
37
according to Suter, what can occur as a result of poor role communication?
- role confusion
38
according to Suter, what is important with communication in IPC teams?
- avoid using professional jargon
39
according to Suter, what is a key way to improve communication on IPC teams?
- team rounds
40
according to Suter, what are valuable traits of good communication
- building trusting relationships
- having a desire for continiuous learning and reflection
41
according to Suter, teams should reach a consensus on _____, and present a ____ when communicating w pts and families
- reach a consensus on the care process
- present a unified opinion
42
what key concepts are identified in Varpio's article? (2)
- knotworking
- followship
43
according to Varpio, knotworking is defined as...
- a rapidly pushing, distributed, and partially improvised orchestration of collaborative performance between otherwise loosely connected actors and activity systems
44
according to Varpio, followership is described as...
- the concept that both leaders & followers are recognized as agents w power in collaborative teams
45
describe leadership r/t Varpio's article
- given the complexity of IPC, it is unrealistics to expect a team to unfailingly follow a single predetermined leader
- leadership should be distributed across a team, w individual professions taking the lead when their expertise is needed
46
according to Varpio, what theory is affiliated w the concept of knotworking
cultural historic activity theory (CHAT)
47
describe CHAT according to Varpio
- CHAT-informed research supports socially, materially, and historically informed analyses of human activities involved in IPC practices
- it allows scholars to study how tensions, contraindications, and alignments exist within individual activity systems and between these activitity systems
- framework which helps to understand and analyse the relationship between the human mind (what people think and feel) and activity (what people do)
48
according to Varpio, we should visualize knotworking as...
- the contributions from each member involved in pt care weaving together to form a theoretical know
49
according to Varpio, what is the most difficult element of knotworking
- sharing control --> can destabilize hierarchies/tradition
50
according to Varpio, successful knotworking relies on.. (3)
- collaborators understanding each other quickly
- coordinating efforts seamlessly
- sharing control of situations fluidly
51
according to Varpio, team activities in knotworking involve 3 different dimensions:
1. social-spatial
2. temporal
3. moral-ideological
52
describe the social-spatial dimension of team activities according to Varpio
- focuses on the relationships between individuals at a certain point in time
- the social-spatial relationships on any given ward change according to the types of people there & the challenges they collectively face
ex. nurse to pt, nurse to nurse, IPC
53
describe the temporal dimension of team activities according to Varpio
- focuses on the successive steps required to achieve a pt care goal
54
describe the moral-ideological dimension of team activities according to Varpio (2)
- focuses on the relationship of power, control, responsibility, and trust
- examines team leadership across time
55
according to Varpio, collaboration occurs over.... why?
- mutliple shifts and over widely distributed spaces
ex. ER --> ward --> OR
- bc IPC teams are constantly having members leaving/joining (ex. people quitting, diff shifts)
56
according to Varpio, knotworking establishes ...
- that there is no single team leader
57
according to Varpio, followership is the concept that ...
- both leaders & followers are recognizing as agents w power in collaborative teams
- followers should influence the leadership progress and vice versa
58
according to Varpio, followers in followership should not be .. rasther they should ...
- submissive or passive
- should influence, guide, and purposefully engage in team interactions
59
according to Varpio, responsibilities and actions in an IPC team are _______ with followership
- balanced between leaders & followers
60
according to Varpio, followership skills enable individuals to..
- work w the leader to advance the goals, vision, and behaviors essential for both work unit & organizational success
61
according to Varpio, with followership leaders should be able to...
- easily flex into follower positions
62
what key concepts are found in the WRHA article on Role Clarification (2)
- role clarification involves being able to describe one's own professional role, as well as the roles of other HCP
- role clarification helps avoid duplication & gaps in service
63
according to the WRHA, engaging in role clarification requires HCP to ... (4)
- respect the cultures of their community
- use appropriate knowledge to communicate their roles, knowledge, skills, and attitudes
- consult w others in appropriate ways to access their skills & knowledge
- build interprofessional and professional competencies and roles into service delivery
64
according to the WRHA, what is the outcome of role clarification
- care plans that best meet the needs of the pt, maximize the HCP's time, and distribute the workload more appropriately among team members
65
what key concepts are found in the WRHA article on Collaborative Leadership
collaborative leaderships occurs when:
- HCP work together as team w the pt/family to plan, introduce, and evaluate care & services
- each member of the team shares responsibility for their role in the process toward creating positive healthy outcomes
66
according to the WRHA, leadership roles are assigned based on...
- need for specific expertise at any given point in time
67
according to the WRHA, who may be the leader of the healthcare team
- the pt
68
according to the WRHA, what 2 categories of expertise are required for a leader?
- keeping people on task
- ensuring people work well together
69
according to the WRHA, colla leaderships required each person on the team to ... (5)
- collaborate in shared decision making
- own the responsibility of their part of the chosen process
- contribute to creating a team that works well together
- creating a positive climate for collab practice
- working towards a positive outcome
70
what are essential elements of IP leadership (4)
- leaders: formal & informal
- enviro
- team members: followers/peers
- situation
71
what is the importance of role clarification (9)
- avoid duplication & gaps in services
- utilizes profession specific expertise
- improves team functioning
- may assist in avoiding conflict
- frees up time for HCPs to work to their full scope
- shifts care from provider driven to pt centered, the focus of IP practice
- ensures more effective assessment, planning, implementation, and evaluation of services
- leads to improve pt safety and out comes
- know who to go to for help if completing a skill with no experience
72
what are strategies to promote role clarification (7)
- develop common language
- be familiar w and respect roles of other professionals
- know responsibilities, constraints, and limitations (imp for pt safety) of own professional role
- recognize the need for and complexity of "role blurring"
- recognize existence of professional cultures and labeling/stereotyping
- create practical initiatives to enhance role knowledge
- role blurring can be good
73
what is role blurring?
- occurs when there is a lack of understanding on one's own role or roles of others & their scope of practice
74
role blurring/overlapping may ensure?
- carry over of skills = capability to take on the tasks of which are also within another IPC member's scope
75
when is carry-over of skills beneficial?
- if low staffing
- low availability of other IPC members
76
what are the pros of role blurring (5)
- enhance continuity of care
- allow workloads to be appropriately shared
- aid professional development by helping staff learn new skills
- improve professional knowledge thru shared perspectives
- enhance utilization of limited resources
77
what are the cons of role blurring (5)
- increased chance of conflict (d/t miscommunication, doing a job poorly)
- increased burnout among team members
- increased anxiety and frustration among team members
- ineffective use of limited resources
- negative pt outcomes
78
what is knotworking
- tying and retying together individual threads and expertise from across the IHT to achieve specific outcomes
- there are many team members within the IP team, and knotworking brings attention to the fact, who makes up the team is fluid & continually in flux
79
how does the flux of membership in IP teams complicate effective collaboration?
-
80
success of knotworking depends on... (3), which is most difficult?
- mutual understanding
- seamless coordination of care
- shared control of situation = most difficult
81
describe shared control r/t knotworking
- it requires all professions to consider how power in the team can and should be distributed in effective ways, which may not coincide w traditional expectations
82
why is shared control of situation in knotworking the most difficult (2)
- can shake up tradition/status quo
- destabilizes hierarchies that historically informed pt care activities
- hierarchies are difficult to destabilize
83
describe: collaborative/shared leadership
- practitioners work together as a team w the client and his/her family to assess, plan, implement, and evaluate care and services
- each member of the team shares responsibility and accountability for their role in the process toward creating desired outcomes
84
describe characteristics of classical leadership (7)
- leader established by position in hierarchy
- evaluated by how leader solves problems
- group members expect leader to provider answers/solutions
- leader differs from toher in character, skills, or motivation
- formal communication style
- info retained and controlled as a source of power
- may use secrecy, deception, or payoffs
85
describe characteristics of shared leadership (7)
- leaders identified by quality of interactions
- evaluated by how people work together
- group members take ownership for problems, seek common goal
- leadership based on teachable/learnable attributes of curiosity, empathy, and cooperativeness
- informal communication style w an emphasis on listening
- info freely sought and shared
- relies on democratic process, honesty, and shared ethics
86
what are factors that impact IP leadership (6)
- enviro
- team members (followers/peers)
- power
- communication
- leaders
- situation
87
what are factors that impact IP leadership
- enviro
- team members (followers/peers)
- power
- communication
- leaders
- situation
88
in some instances, 2 or more leaders may be needed. what are the roles of each leader?
- one to keep team members on task as they work towards common goal (task orientation)
- one to connect team members w client and their families = serving as a link among those involved in the care process, helps team members work well together (relationship orientation)
89
with collab leadership, each person on the team should... (6)
- own the responsibility for their part in the process
- contribute to creating a team that works well together
- create positive climate for collab practice
- work towards positive outcome
- collab in shared decision making
- advance interdependent working relationships among all participants
90
describe the characteristics of a formal leadern (4)
- has designated title
- appointed by health care institution
- formal decision-making structure that is imposed by health care facility
- formal leader often provides day-to-day leadership
91
describe the characteristics of informal leadership (6)
- no formal title or authority
- anyone who moves the work of the team forward
- can be more effective than formal leadership in certain circumstances
- referent power
- expert power
- reward power
92
what is refernt power
- lead by example
- inferred by status or personal characteristics
93
what is expert power
- sought out for knowledge and skills
- those w specialized knowledge, info, and skills
94
what is reward power
- may praise & recognize members for job well done
95
what is coercive power
- relates to the ability to distribute positive/negative reinforces
96
how does the in flux of membership of healthcare teams complicate effective collaboration?
- hard to be continuously clarifying roles/working as a team w lots of turnover
97
with collab leadership, it is essential to switch between....
- leader and follower roles
98
IP team members must be keep in mind...
- shared purpose
99
being an effective leader and follower requires...
- team members to take & relinquish power and control over the team as the situation evolves and demands
100
a good follower should... (3)
- avoid groupthink
- challenge the leader's ideas
- think critically about group direction
101
shared decision making is...
- team members lending their knowledge and expertise to contribute to a pt's plan of care
102
shared decision-making isn't...
- appropriate in every situation
- no guarantee that consensus will be reached, decisions may be made by only 1 or 2 members
103
what are examples of where shared decision making is inappropriate (3)
- CPR scenario = someone needs to take charge
- other acute situations which require decisive actions
- diagnostic decision making isn't shared by nurses, but informed byt hem
104
why is IP shared leadership challenging? (7)
- HCPs are trained to critically think about their profession's segment of a complex problem
- leadership training is often provided within the profession
- leading an IP team presents unique challenges
- stress causes HCPs to revert to working the way they were trained to work, and they may lose sight of the team goals/needs
- hierarchical ranks within IP team tied to professional identity
- policies may place restrictions on scope of practice
- legal considerations --> require someone to be in charge
105
define: followership skills
- those who enable individuals to work w the leader to advance the goals, vision, and behaviors essential for both work unit and organizational success
- collaborate, dont compete w leader
106
followership skills are required by....
- all members of IP healthcare team
107
changing roles between..... are necessary to support positive pt outcomes
- leaders and followers
108
who needs to feel a sense of power on IP team?
- both leaders and followers
109
is power static in IP teams?
- no, situations change constantly
110
what are major sources of power in a developed IHT (6)
- commitment
- professional knowledge
- energy
- organizational skills
- tenure
- dedication to improving the team
111
what is an imp source of power in the early phases of team development, but less imp as teams grow?
- personal attributes like charisma
112
what is legitimate power
- by nature of their position wields the power
113
what is the micro lvl
- unit lvl
114
what is the meso lvl
- hospital lvl
115
what is the macro lvl
- system lvl
NURS 4520: IPC
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