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Becoming a Team

Morse, Christopher B.

doi: 10.1097/ACM.0b013e3181a4253f
Other Features: Teaching and Learning Moments

Mr. Morse is a second-year medicine student, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; (

Teamwork is fast becoming an important component of health care quality and safety improvement, but do current initiatives in health professions education address this emerging paradigm early enough? My own experience during the first year of medical school is one example of incorporating teamwork early into the medical curriculum.

During my first week of medical school, my classmates and I each became members of a Learning Team. Every team comprises six students who work together until graduation. One of our first tasks was to agree on core values to establish common goals and commitments. We then drafted operating principles to set rules of behavior during team meetings and to allow for mutual accountability. Working through these tasks at the onset was an important component to our later success.

As the year progressed, our Learning Team became more than just a requirement of the curriculum. We participated in small-group discussions, completed projects, and took exams together. Under such high stakes, our team could draw on our collective knowledge and excel. Sometimes, these situations would also reveal the gaps in our still-developing communication skills. Working together, we grew to appreciate and depend on the strengths and weaknesses of each team member.

But working as a team was not easy. We all came to the table educated, opinionated, and accustomed to being correct. Naturally, we had many disagreements. But these were learning opportunities that we worked through. A highlight of the year was a team analysis project for which we observed a clinical team at our teaching hospital, assessing their strengths and weaknesses and comparing their team to our team. We found that, similar to our experience, they struggled with core aspects of teamwork, such as communication and accountability. As part of the project's conclusion, we prescribed changes for their team that had helped us.

My Learning Team experience was a surprisingly influential part of my first year of training. In a few months, I will begin my clerkship rotations and work with many different clinical teams. The lessons I have taken away from my Learning Team experience will help me become an important member of each team, improve my interactions with faculty and staff, and enhance my educational experience.

Integrating teamwork into medicine is undeniably more challenging than in other industries. Clinical teams are complex and change frequently. Health care professionals train in separate disciplines, and specialization creates fragmentation within hospitals and ambulatory practices. But these aspects that make medicine so unique cannot be used as an excuse not to try.

Medicine can be resistant to change, but incorporating teamwork early into the medical curriculum can overcome this. Change that starts with students will radiate outward as they graduate and share their experiences. I have often heard people compare physician training to running a marathon. World-class marathon runners begin running as children, running faster and farther each year. Similarly, I believe that the best physicians will be those who work well in a team because they have been doing so from the beginning of their education and know of no other way.

Christopher B. Morse

© 2009 Association of American Medical Colleges