More than a century of group-related research has shown that under some circumstances, groups perform better than the sum of their individual members, whereas under other circumstances, they perform worse. Baumeister et al. explain that group performance can be improved not only through a shared identity, but also more important through the differentiation of selves. This means that group members have individual roles and identify themselves within their respective roles.
The theoretical framework of Baumeister and colleagues is largely in line with empirical evidence on performance in the corporate sector. One may wonder, however, whether their framework can be applied to teamwork in general. As a consequence, Baumeister et al. encouraged commentaries with further evidence or alternate theories. I will discuss an example that is rather different from previous considerations, making the first analogy between Baumeister et al.'s framework and group effort within resuscitation teams.
At first glance, the possibility for individuality might be rather limited during resuscitation, where the right actions must be performed quickly, leaving no room for discussion. Therefore, a resuscitation might appear directive, with a team leader determining what actions are to be carried out, and in what order, to come up with decisions that might be life-saving for the patient. Nevertheless, I will transfer the framework of Baumeister et al. to resuscitation teamwork. This transfer might prove relevant because optimal teamwork is a well-known necessity in resuscitation teams (American Heart Association 2011).
Based on many years of experience in resuscitation, guidelines have been developed to optimize resuscitation teamwork (American Heart Association 2011; Field et al. Reference Field, Hazinski, Sayre, Chameides, Schexnayder, Hemphill, Samson, Kattwinkel, Berg, Bhanji, Cave, Jauch, Kudenchuk, Neumar, Peberdy, Perlman, Sinz, Travers, Berg, Billi, Eigel, Hickey, Kleinman, Link, Morrison, O'Connor, Shuster, Callaway, Cucchiara, Ferguson, Rea and Vanden Hoek2010; Nolan et al. Reference Nolan, Soar, Zideman, Biarent, Bossaert, Deakin, Kosterg, Wyllieh and Böttigeri2010; Sayre et al. Reference Sayre, O'Connor, Atkins, Billi, Callaway, Shuster, Eigel, Montgomery, Hickey, Jacobs, Nadkarni, Morley, Semenko and Hazinski2010). What all of these guidelines have in common is that a resuscitation team consists of several team members and a team leader. The team leader is responsible for assigning particular roles to each team member. She or he also has to make sure that all team members know their exact tasks. Consequently, the team leader oversees the resuscitation. That ensures the leader can coordinate the resuscitation and recognize where problems arise and if further support is needed. On the other hand, each team member has a specialized role: For example, two team members alternate in delivering chest compressions, one team member secures the airway and provides ventilation, another team member provides intravenous injections, and so forth. All team members are familiar with all tasks during resuscitation. Nevertheless, some team members carry out some tasks better than others – for example, some are more skilled in delivering chest compressions, others are more skilled in securing the airway, and so forth.
There is an interesting parallel between Baumeister et al.'s framework on group performance and resuscitation teamwork. The three components – specialization, moral responsibility, and efficiency – appear in resuscitation teams as well. Turning to specialization first, each team member has a particular role, for example, the strongest members might perform chest compressions, so they will concentrate on this aspect. Similarly, a high degree of moral responsibility can be assumed. One can expect that members of a resuscitation team feel morally responsible to do their best. Social loafing is hardly possible in a resuscitation situation. For example, if a team member has to perform chest compressions, avoidance would have the immediate consequence of making resuscitation impossible. A failure to perform one's role would also be noticed by the team leader, so the team leader could intervene. Finally, the efficiency criterion is met. For example, if the team leader detects weak points, she or he can give advice on what to do better or reassign tasks. Another aspect of the efficiency criterion is that guidelines fostering this team structure are based on empirical evidence on how to resuscitate in the most effective way. These guidelines are under continuous re-evaluation (Field et al. Reference Field, Hazinski, Sayre, Chameides, Schexnayder, Hemphill, Samson, Kattwinkel, Berg, Bhanji, Cave, Jauch, Kudenchuk, Neumar, Peberdy, Perlman, Sinz, Travers, Berg, Billi, Eigel, Hickey, Kleinman, Link, Morrison, O'Connor, Shuster, Callaway, Cucchiara, Ferguson, Rea and Vanden Hoek2010; Nolan et al. Reference Nolan, Soar, Zideman, Biarent, Bossaert, Deakin, Kosterg, Wyllieh and Böttigeri2010; Sayre et al. Reference Sayre, O'Connor, Atkins, Billi, Callaway, Shuster, Eigel, Montgomery, Hickey, Jacobs, Nadkarni, Morley, Semenko and Hazinski2010).
Now one might wonder whether an analogy between the framework of Baumeister and colleagues and a resuscitation team can be made. Is individuality of team members really limited in a resuscitation team? Obviously, the creative freedom of a team member during resuscitation is limited; for example, the team member responsible for chest compressions must perform them in the established way and rhythm known to produce optimal results. She or he must avoid unusual, creative types of compressions. Nevertheless, the team member knows his or her individual role and has acquired special knowledge in this role. Another question is whether the role of the team leader in resuscitation teams is as directive as it appears. According to current resuscitation guidelines, the role of the team leader actually encourages viewpoints from all team members. The team leader coordinates the start of a resuscitation in a directive way by assigning tasks and overseeing the resuscitation's progress, but she or he actively encourages all team members to express their viewpoints during the resuscitation (American Heart Association 2011). According to Baumeister and colleagues, who refer to the laboratory study of Lorinkova et al. (Reference Lorinkova, Pearsall and Sims2013), directive leadership was associated with better performance at the start but worse outcomes in the long run. Lorinkova et al. attribute those worse outcomes to ignoring the views of other team members. When making a transfer to current resuscitation guidelines, however, the team leader behaves in the optimal way, being directive at the start and incorporating team members' viewpoints as the resuscitation is underway. An example of this practice is provided in the AHA training video (American Heart Association 2011). Consequently, we can draw an analogy between Baumeister et al.'s framework and resuscitation teamwork. This is particularly interesting because resuscitation is a special situation in which everyone acts under high stress levels.
I was surprised that the framework can be generalized to teamwork in resuscitation teams. In the future, I would like to see it tested in other situations of the health sector. Doing so may ultimately help improve teamwork more broadly.
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More than a century of group-related research has shown that under some circumstances, groups perform better than the sum of their individual members, whereas under other circumstances, they perform worse. Baumeister et al. explain that group performance can be improved not only through a shared identity, but also more important through the differentiation of selves. This means that group members have individual roles and identify themselves within their respective roles.
The theoretical framework of Baumeister and colleagues is largely in line with empirical evidence on performance in the corporate sector. One may wonder, however, whether their framework can be applied to teamwork in general. As a consequence, Baumeister et al. encouraged commentaries with further evidence or alternate theories. I will discuss an example that is rather different from previous considerations, making the first analogy between Baumeister et al.'s framework and group effort within resuscitation teams.
At first glance, the possibility for individuality might be rather limited during resuscitation, where the right actions must be performed quickly, leaving no room for discussion. Therefore, a resuscitation might appear directive, with a team leader determining what actions are to be carried out, and in what order, to come up with decisions that might be life-saving for the patient. Nevertheless, I will transfer the framework of Baumeister et al. to resuscitation teamwork. This transfer might prove relevant because optimal teamwork is a well-known necessity in resuscitation teams (American Heart Association 2011).
Based on many years of experience in resuscitation, guidelines have been developed to optimize resuscitation teamwork (American Heart Association 2011; Field et al. Reference Field, Hazinski, Sayre, Chameides, Schexnayder, Hemphill, Samson, Kattwinkel, Berg, Bhanji, Cave, Jauch, Kudenchuk, Neumar, Peberdy, Perlman, Sinz, Travers, Berg, Billi, Eigel, Hickey, Kleinman, Link, Morrison, O'Connor, Shuster, Callaway, Cucchiara, Ferguson, Rea and Vanden Hoek2010; Nolan et al. Reference Nolan, Soar, Zideman, Biarent, Bossaert, Deakin, Kosterg, Wyllieh and Böttigeri2010; Sayre et al. Reference Sayre, O'Connor, Atkins, Billi, Callaway, Shuster, Eigel, Montgomery, Hickey, Jacobs, Nadkarni, Morley, Semenko and Hazinski2010). What all of these guidelines have in common is that a resuscitation team consists of several team members and a team leader. The team leader is responsible for assigning particular roles to each team member. She or he also has to make sure that all team members know their exact tasks. Consequently, the team leader oversees the resuscitation. That ensures the leader can coordinate the resuscitation and recognize where problems arise and if further support is needed. On the other hand, each team member has a specialized role: For example, two team members alternate in delivering chest compressions, one team member secures the airway and provides ventilation, another team member provides intravenous injections, and so forth. All team members are familiar with all tasks during resuscitation. Nevertheless, some team members carry out some tasks better than others – for example, some are more skilled in delivering chest compressions, others are more skilled in securing the airway, and so forth.
There is an interesting parallel between Baumeister et al.'s framework on group performance and resuscitation teamwork. The three components – specialization, moral responsibility, and efficiency – appear in resuscitation teams as well. Turning to specialization first, each team member has a particular role, for example, the strongest members might perform chest compressions, so they will concentrate on this aspect. Similarly, a high degree of moral responsibility can be assumed. One can expect that members of a resuscitation team feel morally responsible to do their best. Social loafing is hardly possible in a resuscitation situation. For example, if a team member has to perform chest compressions, avoidance would have the immediate consequence of making resuscitation impossible. A failure to perform one's role would also be noticed by the team leader, so the team leader could intervene. Finally, the efficiency criterion is met. For example, if the team leader detects weak points, she or he can give advice on what to do better or reassign tasks. Another aspect of the efficiency criterion is that guidelines fostering this team structure are based on empirical evidence on how to resuscitate in the most effective way. These guidelines are under continuous re-evaluation (Field et al. Reference Field, Hazinski, Sayre, Chameides, Schexnayder, Hemphill, Samson, Kattwinkel, Berg, Bhanji, Cave, Jauch, Kudenchuk, Neumar, Peberdy, Perlman, Sinz, Travers, Berg, Billi, Eigel, Hickey, Kleinman, Link, Morrison, O'Connor, Shuster, Callaway, Cucchiara, Ferguson, Rea and Vanden Hoek2010; Nolan et al. Reference Nolan, Soar, Zideman, Biarent, Bossaert, Deakin, Kosterg, Wyllieh and Böttigeri2010; Sayre et al. Reference Sayre, O'Connor, Atkins, Billi, Callaway, Shuster, Eigel, Montgomery, Hickey, Jacobs, Nadkarni, Morley, Semenko and Hazinski2010).
Now one might wonder whether an analogy between the framework of Baumeister and colleagues and a resuscitation team can be made. Is individuality of team members really limited in a resuscitation team? Obviously, the creative freedom of a team member during resuscitation is limited; for example, the team member responsible for chest compressions must perform them in the established way and rhythm known to produce optimal results. She or he must avoid unusual, creative types of compressions. Nevertheless, the team member knows his or her individual role and has acquired special knowledge in this role. Another question is whether the role of the team leader in resuscitation teams is as directive as it appears. According to current resuscitation guidelines, the role of the team leader actually encourages viewpoints from all team members. The team leader coordinates the start of a resuscitation in a directive way by assigning tasks and overseeing the resuscitation's progress, but she or he actively encourages all team members to express their viewpoints during the resuscitation (American Heart Association 2011). According to Baumeister and colleagues, who refer to the laboratory study of Lorinkova et al. (Reference Lorinkova, Pearsall and Sims2013), directive leadership was associated with better performance at the start but worse outcomes in the long run. Lorinkova et al. attribute those worse outcomes to ignoring the views of other team members. When making a transfer to current resuscitation guidelines, however, the team leader behaves in the optimal way, being directive at the start and incorporating team members' viewpoints as the resuscitation is underway. An example of this practice is provided in the AHA training video (American Heart Association 2011). Consequently, we can draw an analogy between Baumeister et al.'s framework and resuscitation teamwork. This is particularly interesting because resuscitation is a special situation in which everyone acts under high stress levels.
I was surprised that the framework can be generalized to teamwork in resuscitation teams. In the future, I would like to see it tested in other situations of the health sector. Doing so may ultimately help improve teamwork more broadly.
ACKNOWLEDGMENT
The author thanks Catherine Jones for proofreading the manuscript.