Interprofessional Team Performance in Pediatric Settings: Analyzing Reflections from QI-Trained Medical Students

University of Nebraska Medical Center

Background: The aim of this study was to analyze reflections on interprofessional team performance from medical students who received quality improvement (QI) training and consider implications for identifying the facilitators of and barriers to effective team-based care in pediatric settings. Methods: Survey evaluations and narrative reflections were completed by third-year students (M3s) at a single U.S. allopathic medical school during their pediatric clerkship after receiving training in TeamSTEPPS® and Institute for Healthcare Improvement (IHI) Open School, two programs that support QI in healthcare. Descriptive statistical and inductive thematic analyses were conducted on the resulting 183 narratives, along with the development of a valence rating system. Results: Inductive thematic analysis generated 40 themes that were grouped under the five TeamSTEPPS® skill domains into thematic maps. The most common themes were patient care, rounding style, and intra-team communications. 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. The narrative findings were summarized in an evidence-informed figure that highlighted qualities of high and low-performing teams. 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 on improving patient care delivery. The evidence-informed figure detailing elements of interprofessional team performance can be used as a framework to inform future QI studies and current team-based, interprofessional care in pediatrics.