The collaborative health care team: The role of individual and group expertise

Background: Increasing costs of health care and rapid knowledge growth have led to collaboration among health care professionals to share knowledge an d skills. Purposes: To characterize the qualitative nature of team interaction and it s relation to training health professionals, drawing on theoretical and ana lytical frameworks from the sociocognitive sciences. Methods: Activities in a primary care unit were monitored using observation al field notes, hospital documents, and audio recordings of interviews and clinical interactions. Results: The demarcation of responsibilities and roles of personnel within the team became fuzzy in practice. Continuous care was provided by primary care providers and specialized care by intermittent consultants. The nature of individual expertise required was a function of the patient problem and the interaction goal. These team characteristics contributed to the reduct ion of unnecessary and redundant interactions. Conclusions: Distributed responsibilities allow the team to process massive amounts of patient information, reducing the cognitive load on individuals . The uniqueness of individual professional expertise as it contributes to the accomplishment of team goals is highlighted, suggesting emphasis on con ceptual competence in the development of individual professional education programs. Teaching and Learning in Medicine, 12(3), 117-132. Copyright (C) 2000 by Lawrence Erlbaum Associates, Inc.