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Variables associated with perceived work role performance among mental healthcare professionals: The importance of team dynamics

Marie-Josée Fleury, Guy Grenier, Jean-Marie Bamvita, Marie-Pierre Markon, François Chiocchio


Rationale, aims, and objectives: Team effectiveness is associated not only with team design, but also with team dynamics such as work role performance. This study aimed to: (1) identify variables associated with perceived work role performance in a sample of 315 mental health professionals and (2) assess the contributions of team members and team characteristics; organizational and territorial context; team emergent states and team processes.

Method: Mental health professionals from 4 health service networks in Quebec, Canada, completed a self-administered questionnaire consisting of standardized scales. Based on a conceptual framework adapted from the Input-Mediator-Output-Input (IMOI) model, independent variables were organized according to: (1) characteristics of team members and their teams, (2) organizational and territorial context, (3) team emergent states and (4) team processes. Their respective contributions to perceived work role performance were tested using a hierarchical regression analysis.

Results: Perceived work role performance was associated with younger age (characteristics of team members and their team), familiarity between co-workers (Team emergent states) and belief in interprofessional collaboration, knowledge-sharing, team interdependence and team support (Team processes). Most variation in work role performance was explained by Team emergent states, followed by Team processes.

Conclusion: This study tested a large number of variables associated with perceived work role performance in mental healthcare based on a comprehensive and innovative, theory-driven framework. The inclusion of mental health professionals from several types of teams representing mental health networks in different geographical areas added value to the study. The results confirm the need for managers to optimize team emergent states and team processes in order to improve work role performance. Initiatives such as training in teamwork and clinical guidelines are recommended.


Clinical outcomes, evaluation, health policy, health services research, interprofessional collaboration, multi-disciplinary clinical teams, person-centered healthcare, practical reasoning, team dynamics, territorial and organizational contexts

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Tapp, H., Phillips, S.E., Waxman, D., Alexander, M., Brown, R. & Hall, M. (2012). Multidisciplinary team approach to improved chronic care management for diabetic patients in an urban safety net ambulatory care clinic. Journal of the American Board of Family Medicine 25 (2) 245-246.

Wagner, E.H. (2000). The role of patient care teams in chronic disease management. British Medical Journal 320 (7234) 569-572.

Mickan, S.M. & Rodger, S.A. (2005). Effective health care teams: a model of six characteristics developed from shared perceptions. Journal of Interprofessional Care 19 (4) 358-370.

Hogan, M. (2014). Mental health reform under policy mainstreaming: needed, but uncertain. Epidemiology and Psychiatric Sciences 23 (1) 11-16.

Nicaise, P., Dubois, V. & Lorant, V. (2014). Mental health care delivery system reform in Belgium: the challenge of achieving deinstitutionalisation whilst addressing fragmentation of care at the same time. Health Policy 115 (2-3) 120-127.

Thiebaut, G.C., Farand, L. & Fleury, M.J. (2014). Policies and mental health action plans in OECD: lessons for Quebec?. Sante Mentale Au Quebec 39 (1) 65-84.

Xyrichis, A. & Ream, E. (2008). Teamwork: a concept analysis. Journal of Advanced Nursing 61 (2) 232-241.

Mickan, S.M. (2005). Evaluating the effectiveness of health care teams. Australian Health Review 29 (2) 211-217.

Oandasan, I., Baker, G.R., Barker, K., Bosco, C., Damour, D., Jones, L., Kimpton, S., Lemieux-Charles, L., Nashmith, L., San Martin, Rodriguez, L., Tepper, J. & Way, D. (2006) Teamwork in Healthcare: Promoting effective teamwork in healtcare in Canada. Ottawa: Canadian Health Services Research Foundation.

Quaschning, K., Korner, M. & Wirtz, M. (2013). Analyzing the effects of shared decision-making, empathy and team interaction on patient satisfaction and treatment acceptance in medical rehabilitation using a structural equation modeling approach. Patient Education and Counseling 91 (2) 167-175.

Kilpatrick, K., Lavoie-Tremblay, M., Ritchie, J.A. & Lamothe, L. (2011). Advanced practice nursing, health care teams, and perceptions of team effectiveness. The Health Care Manager 30 (3) 215-226.

Manser, T. (2009). Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica 53 (2) 143-151.

Clements, D., Dault, M. & Priest, A. (2007). Effective teamwork in healthcare: research and reality. Healthcare Papers 7, Spec No:26-34.

Deneckere, S., Robyns, N., Vanhaecht, K., Euwema, M., Panella, M., Lodewijckx, C., Leigheb, F., Sermeus, W. & EQCP-studygroup. (2011). Indicators for follow-up of multidisciplinary teamwork in care processes: results of an international expert panel. Evaluation & Health Professions 34 (3) 258-277.

Wholey, D.R., Zhu, X., Knoke, D., Shah, P., Zellmer-Bruhn, M. & Witheridge, T.F. (2012). The teamwork in assertive community treatment (TACT) scale: development and validation. Psychiatric Services 63 (11) 1108-1117.

Mowbray, C.T., Holter, M.C., Teage, G.B. & Byhee, D. (2003). Fidelity criteria: development, measurement, and validation. American Journal of Evaluation 24 (3) 315-340.

Kozlowski, S.W.J. & Ilgen, D.R. (2006). Enhancing the effectiveness of work goups and teams. Psychological Science in the Public Interest 7 (3) 77-124.

Xyrichis, A. & Ream, E. (2008). Teamwork: a concept analysis. Journal of Advanced Nursing 61 (2) 232-241.

Griffin, M.A., Neal, A. & Parker, S.K. (2007). A new model of work role performance: Positive behavior in uncertain and interdependent contexts. Academy of Management Journal 50 (2) 327-347.

Ilgen, D.R. & Pulakos, E.D. (1999). The Changing Nature of Performance: Implications for Staffing, Motivation, and Development. Frontiers of Industrial and Organizational Psychology. San Fransisco: Jossey-Bass.

Goh, T.T., Eccles, M.P. & Steen, N. (2009). Factors predicting team climate, and its relationship with quality of care in general practice. BMC Health Services Research 9, 138.

Lemieux-Charles, L. & McGuire, W.L. (2006). What do we know about health care team effectiveness? A review of the literature. Medical Care Research and Review 63 (3) 263-300.

Körner, M., Bütof, S., Müller, C., Zimmermann, L., Becker, S. & Bengel, J. (2015). Interprofessional teamwork and team interventions in chronic care: A systematic review. Journal of Interprofessional Care 30 (1) 15-28.

Reeves, S., Lewin, S., Espin, S. & Zwarenstein, M. (2011). Interprofessional teamwork for health and social care. Oxford: Wiley-Blackwell.

Ilgen, D.R., Hollenbeck, J.R., Johnson, M. & Jundt, D. (2005). Teams in organizations: From input-process-output models to IMOI models. Annual Review of Psychology 56, 517-543.

Mathieu, J., Maynard, M.T., Rapp, T. & Gilson, L. (2008). Team effectiveness 1997-2007: A review of recent advancements and a glimpse into the future. Journal of Management 34 (3) 410-476.

Webber, S.S. & Donahue, L.M. (2001). Impact of highly and less job-related diversity on work group cohesion and performance: a meta-analysis. Journal of Management 27 (2) 141-162.

Vinokur-Kaplan, D. (1995). Treatment teams that work (and those that don't): An application of Hackman's group effectiveness model to interdisciplinary teams in psychiatric hospitals. Journal of Applied Behavioral Science 31 (3) 303-327.

Xyrichis, A. & Lowton, K. (2008). What fosters or prevents interprofessional teamworking in primary and community care? A literature review. International Journal of Nursing Studies 45 (1) 140-153.

Bower, P., Campbell, S., Bojke, C. & Sibbald, B. (2003). Team structure, team climate and the quality of care in primary care: an observational study. Quality & Safety in Health Care 12 (4) 273-279.

Borrill, C., West, M., Shapiro, D. & Rees, A. (2000). Team working and effectiveness in health care. British Journal of Healthcare Management 6 (8) 364-371.

Shortell, S.M., Marsteller, J.A., Lin, M., Pearson, M.L., Wu, S.Y., Mendel, P., Cretin, S. & Rosen, M. (2004). The role of perceived team effectiveness in improving chronic illness care. Medical Care 42 (11) 1040-1048.

Poulton, B. & West, M. (1999). The determinants of effectiveness in primary health care teams. Journal of Interprofessional Care 13 (1) 7-18.

Kozlowski, S.W.J. & Bell, B.S. (2003). Work groups and teams in organizations. In: Handbook of psychology (Vol 12): Industrial and Organizational Psychology. W Borman, D Ilgen, R Klimoski, (eds.), pp. 333-375. New York: Wiley-Blackwell.

Davenport, D.L., Henderson, W.G., Mosca, C.L., Khuri, S.F. & Mentzer, R.M., Jr. (2007). Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. Journal of the American College of Surgeons 205 (6) 778-784.

Kirkman, B.L., Rosen, B., Tesluk, P.E. & Gibson, C.B. (2006). Enhancing the transfer of computer-assisted training proficiency in geographically distributed teams. Journal of Applied Psychology 91 (3) 706-716.

Chiocchio, F., Forgues, D., Paradis, D. & Iordanova, I. (2011). Teamwork in integrated design projects: Understanding the effects of trust, conflict, and collaboration on performance. Project Management Journal 42 (6) 78-91.

Chiocchio, F., Grenier, S., O’Neill, T.A., Savaria, K. & Willms, J.D. (2012). The effects of collaboration on performance: A multilevel validation in project teams. International Journal of Project Organisation and Management 4 (1) 1-37.

Sicotte, C., D’Amour, D. & Moreault, M-P. (2002). Interdisciplinary collaboration within Quebec community health care centres. Social Science and Medicine 55 (6) 991-1003.

Campion, M.A., Medsker, G.J. & Higgs, A.C. (1993). Relations between work group characteristics and effectiveness: Implications for designing effective work groups. Personnel Psychology 46 (4) 823-847.

Janz, B.D., Colquitt, J.A. & Noe, R.A. (1997). Knowledge worker team effectiveness: The role of autonomy, interdependence, team development, and contextual support variables. Personnel Psychology 50 (4) 877-904.

Rossi, M.E. (2008). The development and validation of the comprehensive team interdependence scale. College of Arts and Sciences: University of South Florida.

Jehn, K.A. & Mannix, E.A. (2001). The dynamic nature of conflict: A longitudinal study of intragroup conflict and group performance. Academy of Management Journal 44 (2) 238-251.

De Dreu, C.K. & Weingart, L.R. (2003). Task versus relationship conflict, team performance, and team member satisfaction: a meta-analysis. Journal of Applied Psychology 88 (4) 741-749.

Quigley, N.R., Tesluk, P.E., Locke, E.A. & Bartol, K.M. (2007). A multilevel investigation of the motivational mechanisms underlying knowledge sharing and performance. Organization Science 18 (1) 71-88.

Dyer, J.H. & Nobeoka, K. (2000). Creating and managing a high-performance knowledge-sharing network: the Toyota case. Strategic Management Journal 21 (3) 345-367.

Konradt, U., Otte, K.P., Schippers, M.C. & Steenfatt, C. (2016). Reflexivity in Teams: A Review and New Perspectives. Journal of Psychology 150 (2) 153-174.

Williams, H.M., Parker, S.K. & Turner, N. (2010). Proactively performing teams: The role of work design, transformational leadership, and team composition. Journal of Occupational and Organizational Psychology 83 (2) 301-324.

Ram, P., Grol, R., Van den Hombergh, P., Rethans, J.J., van der Vleuten, C. & Aretz, K. (1998). Structure and process: the relationship between practice management and actual clinical performance in general practice. Family Practice 15 (4) 354-362.

Donabedian, A. (2000). Evaluating physician competence. Bulletin of the World Health Organization 78 (6) 857-860.

Geneau, R., Lehoux, P., Pineault, R. & Lamarche, P. (2008). Understanding the work of general practitioners: a social science perspective on the context of medical decision making in primary care. BMC Family Practice 9, 12.

Perlow, L.A., Gittel, J.H. & Berdahl, J.L. (2004). Contextualizing patterns of work group interaction: Toward a nested theory of structuration. Organization Science 15 (5) 520-536.

Smith, K.G., Smith, K.A., Olian, J.D., Sims, H.P., O'Bannon, D.P. & Scully, J.A. (1994). Top management team demography and process: The role of social integration and communication. Administrative Science Quality 39 (3) 412-438.

Ancona, D.A. & Caldwell, D.F. (1992). Demography and design: Predictors of new product team performance. Organization Science 3 (3) 321-341.

MSSS. (2005). Plan d'action en santé mentale 2005-2010: La force des liens. Quebec: Ministère de la santé et des services sociaux.

MSSS. (2005). Projet de Loi 83. Loi modifiant la Loi sur les services de santé et les services sociaux et d'autres disposistions législatives. Québec: Ministère de la Santé et des Services Sociaux.

Commonwealth of Australia. (2009). Fourth National Mental Health Plan- An agenda for collaborative government action in mental health 2009-2004: Commonwealth of Australia.

Department of Health. (2011). No health without mental health: A cross-government mental health outcomes strategy of all ages. England: National Health Service.

Thornicroft, G. & Tansella, M. (2002). Balancing community-based and hospital-based mental health care. World Psychiatry 1 (2) 84-90.

Choi, B.C. & Pak, A.W. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness. Clinical & Investigative Medicine 29 (6) 351-364.

Molyneux, J. (2001). Interprofessional teamworking: what makes teams work well? Journal of Interprofessional Care 15 (1) 29-35.

Chiocchio, F., Lebel, P., Therriault, P-Y., Boucher, A., Hass, C., Rabbat, F-X. & Bouchard, J-F. (2012). Stress and Performance in Health Care Project Teams. Newtown Square, PA: Project Management Institute.

van der Feltz-Cornelis, C.M. (2011). Ten years of integrated care for mental disorders in the Netherlands. International Journal of Integrated Care 11 (Special Edition) e015.

Killumets, E., D'Innocenzo, L., Maynard, M.T. & Mathieu, J.E. (2015). A Multilevel Examination of the Impact of Team Interpersonal Processes. Small Group Research 46 (2) 227-259.

Courtenay, M., Nancarrow, S. & Dawson, D. (2013). Interprofessional teamwork in the trauma setting: a scoping review. Human Resources for Health 11, 57.

Körner, M., Lippenberger, C., Becker, S., Reichler, L., Müller, C., Zimmermann, L., Rundel, M. & Baumeister, H. (2016). Knowledge integration, teamwork and performance in health care. Journal of Health Organization Management 30 (2) 227-243.

Upshur, C. & Weinreb, L. (2008). A survey of primary care provider attitudes and behaviors regarding treatment of adult depression: what changes after a collaborative care intervention? Primary Care Companion to the Journal of Clinical Psychiatry 10 (3) 182-186.

van Rijswijk, E., van Hout, H., van de Lisdonk, E., Zitman, F. & van Weel, C. (2009). Barriers in recognising, diagnosing and managing depressive and anxiety disorders as experienced by Family Physicians; a focus group study. BMC Family Practice 10, 52.

Kates, N., Mazowita, G., Lemire, F., Jayabarathan, A., Bland, R., Selby, P., Isomura, T., Craven, M., Gervais, M. & Audet, D. (2011). The evolution of collaborative mental health care in Canada: A shared vision for the future. Canadian Journal of Psychiatry 56 (5) 1-10.

Chiocchio, F. (2012). Indicateurs pertinents à la collaboration dans le milieu de la santé - Cadre conceptuel et inventaire de mesures. Universit de Montral: Qubec, Canada.

Tesluk, P., Mathieu, J.E., Zaccaro, S.J. & Marks, M. (1997). Task and aggregation issues in the analysis and assessment of team performance. In: Team Performance Assessment and Measurement: Theory, Methods, and Applications. Brannick, M.T., Prince, C. & Salas, E. (eds.), pp. 197-224. Marwah, New Jersey: Erlbaum.

Lin, C.C. & Peng, T.K. (2010). From Organizational Citizenship Behaviour to Team Performance: The Mediation of Group Cohesion and Collective Efficacy. Management and Organization Review 6 (1) 55-75.

Podsakoff, P.M., MacKenzie, S.B., Lee, J-Y. & Podsakoff, N.P. (2003). Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology 88 (5) 879-903.

Costa, A.C. (2003). Work team trust and effectiveness. Personnel Review 32 (5) 605-622.

Bosch, M., Faber, M.J., Cruijsberg, J., Voerman, G.E., Leatherman, S., Grol, R.P., Hulscher, M. & Wensing, M. (2009). Review Article: Effectiveness of patient care teams and the role of clinical expertise and coordination: a literature review. Medical Care Research and Review 66 (6) 5S-35S.

Salas, E., DiazGranados, D., Weaver, S.J. & King, H. (2008). Does team training work? Principles for health care. Academic Emergency Medicine 15 (11) 1002-1009.

Buljac-Samardzic, M., Dekker-van Doorn, C.M., van Wijngaarden, J.D. & van Wijk, K.P. (2010). Interventions to improve team effectiveness: a systematic review. Health Policy 94 (3) 183-195.

Klein, C., DiazGranados, D., Salas, E., Le, H., Burke, C.S., Lyons, R. & Goodwin, G.F. (2009). Does team building work? Small Group Research 40 (2) 181-222.

Simons, T.L. & Peterson, R.S. (2000). Task conflict and relationship conflict in top management teams: the pivotal role of intragroup trust. Journal of Applied Psychology 85 (1) 102-111.

Allen, N.J. & Meyer, J.P. (1990). The measurement and antecedents of affective, continuance and normative commitment to the organization. Journal of Occupational and Organizational Psychology 63 (1) 1-18.

Spector, P.E. (1985). Measurement of human service staff satisfaction: Development of the Job Satisfaction Survey. American Journal of Community Psychology 13 (6) 693-713.

Maynard, M.T. (2007). The impact of experience and familiarity: An examination in project teams. Doctoral Dissertations: University of Connecticut.

Bock, G-W., Zmud, R.W., Kim, Y-G. & Lee, J-N. (2005). Behavioral intention formation in knowledge sharing: Examining the roles of extrinsic motivators, social-psychological forces, and organizational climate. MIS Quarterly 29 (1) 87-111.

Spreitzer, G.M. (1996). Social structural characteristics of psychological empowerment. Academy of Management Journal 39 (2) 483-504.

De Dreu, C.K.W. (2007). Cooperative outcome interdependence, task reflexivity, and team effectiveness: a motivated information processing perspective. Journal of Applied Psychology 92 (3) 628-638.



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