Interprofessional Team Performance in Pediatric Settings: Analyzing Reflections of Quality Improvement (QI)-Trained...

Background and objective Navigating interprofessional team dynamics is essential for high-quality patient care in pediatric settings. This study involved medical students on a pediatric clerkship who explored the characteristics of high- and low-performing clinical teams by considering drivers and barriers to effective team performance. By analyzing these reflections, the study aimed to identify key facilitators and barriers to effective team-based care. Methods Survey evaluations and narrative reflections were completed by third-year students (M3s) at a single US allopathic medical school during their pediatric clerkship after receiving training in TeamSTEPPS® and Institute for Healthcare Improvement (IHI) Open School, two programs that support quality improvement (QI) in healthcare. Descriptive statistical and inductive thematic analyses were conducted on the resulting 183 narratives. A valence rating system was employed to quantify narrative responses as positive/attractive or negative/aversive, with a Cronbach alpha of 0.958 between two independent reviewers. Results Inductive thematic analysis generated 40 themes that we grouped under the five TeamSTEPPS® skill domains (situation monitoring, communication, leadership, team structure, mutual support) into thematic conceptual models. High-performing teams demonstrated open communication, role clarity, shared understanding, and organized task delegation. Low-performing teams displayed a lack of information exchange, uncertain team roles, unhealthy power dynamics, and disorganized task delegation. Conclusions After instruction in QI methods, pediatric clerkship students identified consistent drivers of and barriers to effective team performance. The themes within the narrative reflections can provide insights into improving patient care delivery, specifically around situation monitoring, communication, and team structure.