INNOVATION FUND Technology and AI in Healthcare Implementation and Integration SHOWCASE 2019

Teams of Rural Physicians and Why They Matter: Testing a Theoretical Framework of Team Effectiveness that Predicts Outcomes of Performance, Commitment, and Intentions to Stay

Implementation & Integration

Eliseo Orrantia


Northern Ontario School of Medicine


NOA-18-010 This study of many of the rural physicians in Northern Ontario, that identify as practicing in physician teams, supports our theoretical framework of Physician Team Effectiveness. The model now allows us to develop interventions targeted at physician team decision making, communication and conflict resolution to attempt to impact their linked, important outcomes of team performance and commitment of members to their team.


NOA-18-010 Physician group practices have been encouraged in Ontario through alternative payment plans to improve health human resources. Effective team functioning has been found to have links to important outcomes of performance and workplace attitudes, but groups of physicians have yet to be studied for their teamwork. This project examined rural physician teams and was designed to assess the important organizational outcomes of performance, commitment, and intentions to stay through the lens of team effectiveness. A total of 26 physician teams, made up of 70 members from rural Northern Ontario communities supported by the Rural Northern Physician Group Agreement (RNPGA) payment plan, participated in the study. In addition, 25 external observers in supervisory positions evaluated teams on their workplace performance. Survey data was analyzed by Structural Equation Modeling. The variable Team Climate, composed of decision making, communication and conflict resolution measures, positively predicted Team Efficacy, which in turn positively predicted Team Performance. This fully mediated set of relationships held whether Team Performance was rated by the physicians themselves, or by the external observers. Team Efficacy positively predicted Team Performance, Team Commitment, and Intentions to Stay. However, Team Efficacy did not predict Intentions to Stay above and beyond several variables cited in the extant literature on physician retention. The findings provide support for initiatives that attempt to enhance effectiveness in rural physician teams, by influencing team decision making, communication and conflict resolution, to improve team performance and physician attitudes towards team commitment.

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