Reflective practice has become a very necessary skill in the health sector. This is to ensure that health professionals learn and improve on their daily practice (Nursing Times,2015). The student intends to reflect upon the role she played in the Action learning set group activity, how communication, change and conflict influenced the decisions and outcome. The student will further analyze the group’s overall performance their presentation using Driscoll cycle of reflections. According to Driscoll (2007), there are three questions to ask when reflecting on one’s practice. These are: What? Which is a description of the incident, So what? Which is an analysis of the incident and Now what? this is the future action plan. According to the Nurses and Midwife council (2015, p.5) ‘’As a nurse or midwife, you owe a duty of confidentiality to all those who are receiving care. This includes making sure that they are informed about their care and that information about them is shared appropriately’’. Therefore, group members’ names would not be mentioned.
What is reflection? O’Carroll and Park (2007) explained reflection as a process of reviewing one’s experiences from practice or an event so as to enable the individual to describe, analyze and evaluate to inform future changes in practice. From this definition, it can be identified that reflection is continuous and the experience we have whether positive or challenging should inform our future learning, that is why it is of great importance to the Nursing and Midwifery Council for us as student nurses to reflect on event at practice (Nursing and Midwifery Council 2017). I worked as part of the Action learning set group which had four members and we had four meetings in the course of planning our presentation. Getting into the Action learning set group was quite easy as we were familiar with each other from the same field of practice. The detail of our first meeting can be referred to (appendix 1).
In every organization, there is a leader who facilitates the affairs of the organization. I exhibited autocratic style of leadership during our Action learning set group meeting. I was not nominated but I took that authoritarian role without considering what other members wanted. Though this impacted on the group positively as I was able to get things done quickly as possible which in other sense helped saved situations and this led to a quick decision making, team members had less sense of empowerment. Creating a WhatsApp group chat to enable the group members communicate their views on the platform, scheduling meetings as well as putting forward what will be discussed in our meetings were some of the ways I exhibited this form of leadership without involving or asking team members opinion. Autocratic leadership is a style of leadership where one person controls the affairs and makes decision in an organization with little or no input from his subordinates (The Economic Time, 2017). Though this type of leadership can save situations as it leads to quick decision making some experts think it can lead to low group members morale (The Economic Time, 2017). According to Mullins (2010), leadership is a relationship through which an individual influence the behavior of other members of a team. A leader should have certain qualities like being proactive, resourceful and above all, have good communication skill (Gopee and Galloway, 2017).Communication is important as it is at the center of who we are as individuals or persons. However, good communication makes a team effective. It is a way information is exchanged between people (World Health Organization, 2009). In order for our proposed group presentation project to be successful, we initially expected each team member to be productive in their assigned tasks. We accomplished this by communicating effectively to each group member regarding our proposed place of meetings, meeting times and what to discuss in every meeting. Ineffective communication could make things fall apart and lead to poor end results, as well as failure to achieve the goals set by the team members (Bach and Grant 2015). Communication is the most significant medium for exchanging information relating to the care and treatment of patient. As nurses, we work in collaboration with patients therefore, effective communication among health professionals enhance effective teamwork and this in tend promote continuity of patient care within the team (Hughes, 2008).
There was miscommunication due to diversity in the team which resulted to conflict. Diversity in a team can affect the team members’ interaction which can in tend affect the performance of individual in the group. It can also be argued that diversity is most effective when persons from different culture contribute their different opinions which can increase the efficiency and overall productivity of the task to be completed (Leonard, Graham and Bonacum, 2004). To comment upon my communication style, there were instances where the way I communication in the group was misunderstood and my listening skills was questioned by members of the team. Listening skills is important in communication as it plays an important part in effective communication. I exhibited poor communication and listening skills during some of our meeting as I kept asking questions which were not relevant to our topic of discussion and kept drawing the group back and could not summarize what other group members had said (Jaques and Salmon, 2007).
One of the key elements in making a good team is good communication (Root, 2017). To be able to work together towards a common goal, team working is very important as effective collaborative practice promote high quality care (Ndoro, 2014). Team work is one of the most productive way of accomplishing complex tasks and mission (Belbin, 2010). Belbin model of team role establishes three categories of roles in the people oriented aspect of role. Using the Belbin model of team role, I saw myself playing the role of a coordinator and team worker in the Action Learning Set group; I focus on the group’s objective and was able to delegate task appropriately to team members by identifying the talent of each team member (Belbin, 2017). However, on reflecting on my role I realized I over delegated task to other team members and did less work which I see as a weakness. Assuming different roles by team members made the team focused on the objectives and task completed effectively (Belbin 2010). However, a common problem with teamwork is social loafing. This can have negative impact on teamwork in a group. Social loafing is the reduction in the effort of individual when people work on collective task (West, Tjosvold and Smith,2005). Though one member was loafing and this affected the progress of the team I was able encouraged him to contribute to the group work so we can achieve a better outcome. I further assisted him to complete part of the task. Poor communication in a team can cause misunderstanding between members and this can lead to conflict (Root, 2017).
Conflicts in organization is considered to have negative effect on team working ability. This intend affect the organization’s productivity and the stability (Barr and Dowding 2012). However, conflict can be healthy for team growth as discussing conflicting views can lead to better solution. It is important to have a conflict resolution skill, as health professionals often experience conflict not only with other members of the multidisciplinary team but with service users (Seren and Ustun 2008). Quality care delivery and safety of patients can be compromised or rendered ineffective when there is conflict among the multidisciplinary team (Kalisch, et al 2009). There was conflict on whose scenario to use, as two members wanted us to use their scenario. Also, there were conflict on how to present this scenario. Some members wanted us to do a role play and others wanted a power point. Suggesting us to vote on whose scenario to use was able to resolved this conflict. Approaches to conflict resolution includes, good leadership and good communication skill (Mckibben, 2017).On reflecting on our group formation, the ALS group was formed by members from the same field of practice. However, we were meant to collaborate with other people from the Child and Adult branch to enhance our inter-professional skill. This also had a negative impact on the team as often times we drifted from the task but I was able to bring the group back onto the task by reminding them of the purpose of the meeting. However, I understand that as nurses, we do not work in isolation but with other professionals therefore, I would like to improve on my inter-professional skills so I can be effective when working with other multidisciplinary team at placement. In conclusion, though the Action learning set faced some challenges during our activities, I felt the motivation in the group was generally good and overall, our performance as a group was good and we were able to achieve our goal. However, as a nurse, I have learnt the importance of communicating and working effectively in a team, as this promote good patient quality care. Therefore, I need to work on my communication skill, manage my time properly and be able to improve on my inter-professional skill. In addition, good communication enhances collaboration, promotes teamwork and help prevent errors (Hughes, 2008). For detail of my personal development plan, refer to (appendix 4).
REFERENCES
Bach, S and Grant, A .(2015) Communication and Interpersonal skill in Nursing 3rd edition. London: SAGE/Learning Matters.Barr, J. and Dowding, L. (2012) Leadership in Healthcare.2nd edn. London: Sage Publication.Belbin M., R.,(2017).
Belbin’s Team Role: How understanding team roles can improve team performance. Available at: http://www.mindtools.com/pages/article/newLDR83.htm (Accessed:2 December 2017).
Belbin, M.,R. (2010) Team roles at work, 2nd edition, Oxford: Elsevier Ltd.Driscoll, J. (2007) Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals. 2nd edn. Edinburgh: Bailliere Tindall Elsevier.Root G., N., III (2017) How communication Affect Teamwork. Available at: http://smallbusiness.chron.com/communication-affect-teamwork-11199.html (Accessed: 14 November 2017).
Gopee, N. and Galloway, J.,(2017) Leadership and management in healthcare. 3rd edn. London: Sage.Hughes, R. ed., (2008) Patient safety and quality: An evidence-based handbook for nurses (Vol. 3). Rockville, MD: Agency for Healthcare Research and Quality.Jaques, D. and Salmon, G.,(2007).
Learning in groups: A handbook for face-to-face and online environments. Routledge. Kalisch, B., Weaver, S. and Salas, E. (2009) ‘What does Nursing Teamwork Look Like? A Qualitative Study’, Journal of Nursing Care Quality, 24(4), pp.298–307.
Leonard, M., Graham, S. and Bonacum, D., (2004). The human factor: the critical importance of effective teamwork and communication in providing safe care. Quality and Safety in Health Care, -13(suppl 1), pp.i85-i90.McKibben, L 2017, ‘Conflict management: importance and implications’, British Journal Of Nursing, 26, 2, pp. 100-103, CINAHL Plus with Full Text, EBSCOhost, viewed 28 November 2017.
Ndoro, S., (2014). Effective multidisciplinary working: the key to high-quality care. British Journal of Nursing, 23(13),pp. 724-727.Nursing Times 215 Using Reflective practice in frontline Nursing. Available at: https://www.nursingtimes.net/home/courses/using-reflective-practice-in-frontline-nursing/5045779.article Accessed: 1 October, 12 October, 21The Nursing and Midwifery Council (2017) Revalidation. Available at: http://revalidation.nmc.org.uk(Accessed: 20 October 2017).
Nursing and Midwife College (2015 p. 5) The Code. Available at: https://www.nmc.org.uk/standards/code/ (Assessed 20 October 2017).O’carroll, M.,Park, A., Nicol, M, (2007) Essential Mental Health Nursing Skills. 1st edition, London: Elsevier Health Science.Seren, S. and Ustun, B., (2008). Conflict resolution skills of nursing students in problem-based compared to conventional curricula. Nurse Education Today, 28(4), pp.393-400.
The Economic Time (2017) Definition of Autocratic Leadership. Available at: https://economictimes.indiatimes.com/definition/autocratic-leadership ‘(Accessed 17 October 2017).West, M.A., Tjosvold, D. and Smith, K.G. eds., (2005). The essentials of teamworking: International perspectives. John Wiley & Sons.
World health Organization (2009) Bulletin of the World Health Organization. Available at: http://www.who.int/bulletin/volumes/87/4/08-056713/en/ 87:247-247. doi: 10.2471/BLT.08.056713
Use a model of reflection to reflect as a group on what you have learned from the meeting.Discuss how well you think the meeting went and what you might have done differently (if anything) to improve the experience. Driscoll’s Reflective Cycle 2007What Happened?We were asked to form groups for our Action Learning Set. Since all individuals from the Leadership class went into groups they felt comfortable with, we also formed a group comprising of course mates from the Mental Health group. Not all group members were present during the formation of the ALS group but were asked via written communication (SMS, WhatsApp, Email) if they will like to be part of the group. During this first official meeting, the group members who were not present for the introduction of the unit task were debriefed and the objectives were clarified. Ground rules were also explored.
So what?All members of the group were given an opportunity to present their chosen scenario. During a period, verbal communication became slightly difficult as we would talk over each other. However, we established ground rules to promote better communication, structure and respect for each other’s views. We felt the motivation in the group was generally good. However, it was identified that a group member was exhibiting a ‘social loafing’ attitude. We discussed, as a group, how best to involve each team member in future meetings in order to eliminate ‘social loafing’ and promote teamworking.Future We aim to delegate and share roles/ tasks to avoid social loafing and confusion during communication as well as promote teamworking.
Action Plan:
What are you going to bring forward to the next meeting? Meeting one only: What topic/issue are you going to present in your formative presentation? How do you intend to present the issue? How have you agreed to communicate as a group?How have you agreed to divide up the work? Bring forwardTo discuss and choose presentation topic/ issue.To alternate roles every week.To focus on discussing the leadership of the team. To allow shared leadership.TopicImportance of effective communication and collaborative multidisciplinary (MDT) teamworking to reduce conflict thereby, ensuring a person-centered approach.
Presenting throughRole play Communicate through WhatsApp group, SMS, Emails, meetings. Divide up the workKeep a log of roles in written form.
Clarify these roles on WhatsApp.Group members had the option to select tasks.Some members were delegated tasks.Support was available at all times.APPENDIX 2Action Learning Set Individual Summary Template Date: 21/09/2017 Name: Phyllis AdamsTopic discussed (Brief summary) We discussed our various scenario which highlighted the importance of effective communication and collaborative multidisciplinary (MDT) teamworking to reduce conflict thereby, ensuring a person-centered approach. Reflection:Use a model of reflection to identify what you have learned from the discussion
How well did you contribute as part of the group? Driscoll 2007During the ALS group meeting, I learnt the importance of leadership. I realized that the meeting was chaotic until I stepped in to facilitate the meeting though I exhibited an autocratic style of leadership because I was not chosen but was able to control the meeting quite well.I have also learnt about the importance of resolving conflict without undermining people, so voting to choose whose scenario to work on was a good way I resolved this confusion. I have also learnt that listening is the key to effective communication. That is, if you are unable to listen effectively, messages can be misunderstood and misinterpreted.I created a WhatsApp group chat to help in our communication between group members. During one of our meetings, I played the role of a facilitator and I allocated time slot for members to brainstorm with their scenario. I suggested we vote on the scenario to use for our presentation as there was a bit of conflict on whose scenario to use. I also delegated task for team members.Action PlanWhat do you need to do to change or improve? How will you achieve this (include resources you will need to access? How will you know if you have achieved your objective? What is the time scale? I need to improve on my communication skill, that is my listening skill and how I speak. my words were misunderstood.I will research and read more on how to communication effectively. I will also ask my team members to assess me on my listening skill by asking me to summarize what we discuss at every meeting and also ask for clarification if my communication is not clear.Group members evaluating me in the next 3 meetings.
PERSONAL DEVELOPMENT PLAN
ObjectivesWhat do I want to be able to do or do better?ActionsWhat methods will I use to achieve my learning objectives
Target date
Time frame
I would like to improve on my inter-professional skills so I can be effective when working with other multidisciplinary team at placement and will achieve that with the help of my mentor during my next placement.
Would work in collaboration with the multidisciplinary team which include; Doctors, occupational therapist, support worker etc. During my placement. March, end of Placement 2AI need to work on my listening skill to improve on my communication skill.I will achieve this with the help of my mentor in my next placement during my first PAD meeting. I will ask my mentor to assess my listening skill by asking me to give a summary of what we discussed during our meeting.I will research and read books on how to communicate effectively. March, End of placement 2AI also need to work on my time management as I reported to some of our meetings late.I will achieve this by informing my mentor about my development plan and ask he monitor the time I report to work.Set my priorities right. By the end of placement 2A