Evaluating teamwork among medical staff: How to measure and compare aspects of the team mental models of doctors and nurses.

Shared perceptions of a task among those responsible for its completion are important for achieving successful outcomes. This study proposes a framework for eliciting various aspects of team members' "mental models" (TMMs) of complex medical tasks. The intention is to provide 'proof of concept' for a methodology to measure similarities and differences between team members' perceptions of selected attributes of the task. Applying our framework in a gynecology ward, we use cognitive interviewing and concept mapping to reveal differences between the TMMs of doctor and nurse teams. These group differences are found to reflect limited awareness of the other group's level of involvement, workload, responsibilities and contributions to quality of care. We argue that such differences may lead to frustration, conflict, poor teamwork and risks to patient safety; but once identified, and subject to certain limitations, the differences could be used to develop interventions that will enhance teamwork.