Culture in Multidisciplinary Tumor Conferences: An Exploratory Study of Clinical Decision Making in Two Breast Cancer Centers

Despite a growing body of research into Multidisciplinary Tumor Conferences (MTCs), the specific relationship with organizational and team culture, especially in the context of Breast Cancer Centers (BCCs), is not well understood. Investigating this connection is critical to understanding how cultural norms, attitudes, beliefs, knowledge, and behaviors shape clinical decision-making and multidisciplinary collaboration.

This qualitative study explores the role of organizational and team culture within multidisciplinary tumor conferences in BCCs in Germany via the Grounded Theory Methodology. Analyzing secondary video and interview data from the Patient Participation in Multidisciplinary Tumor Conferences (PINTU) project, we compared two BCCs, each characterized by its own unique pattern of culture.

Nine interrelated cultural dimensions were identified: physical environment, hierarchy, efficiency, conflict and critique, communication patterns, documentation practices, team cohesion, overt patient empathy, and parallelities. Differences between the centers highlighted these dimensions. BCC1 was characterized by steep hierarchy, efficiency, a reserved emotional expression, formal communication, and outsourced documentation. In contrast, BCC2 featured flatter hierarchies, overt empathy, collective documentation, and greater space for informal dialogue.

The marked differences between the two German BCCs highlight culture as a pivotal factor in shaping MTC collaboration. Future research into MTCs would benefit from adopting a cultural lens to enhance understanding of these multidisciplinary settings.