This article was originally published on September 10, 2010.
Despite the growing recognition of the importance of interdisciplinary teams in solving the world's most important biomedical problems, few scientists have had the opportunity for formal training to develop teamwork skills. The National Institutes of Health , through its Clinical and Translational Science Awards  (CTSA), has begun to provide institutions with the funding they need to develop team science training programs.
In October 2009, the Stanford University CTSA  launched its first-ever team science training program. Ten teams and about 70 people participated in the workshop. The experience of designing, executing, and evaluating the program has taught us a great deal about how to make this type of training work. We expect that other institutions are considering and/or developing their own team training programs; we have written this article describing our experience at Stanford with the hope that it will provide other institutions with helpful tips and guidelines.
Hannah Valantine , professor of cardiology and senior associate dean for diversity and leadership at the Stanford School of Medicine, spearheaded the team science training program. She enlisted the help of Margaret Neale , a professor of organizational behavior at the Stanford Graduate School of Business . Neale is a nationally recognized expert on team dynamics and a seasoned trainer of teams. Neale proposed a 4-day agenda that would provide scientific research teams with the opportunity to learn about the principles of team dynamics and how to apply them to their own teams.
We anticipated that most team leaders would be reluctant to pull their whole groups away from their work for several days, so we attended department faculty meetings and gave 5- to 10-minute presentations about why we were offering the program, what the program would include, and how it would improve team functioning. After we visited all the departments, we advertised the program by e-mail; within 2 weeks, 12 teams had signed up. We turned away two teams to keep the number of participants manageable.
Team leaders registered by filling out a short online form that asked them to list the name and contact information of each team member. In hindsight, it would have been helpful to ask for additional information, such as the team members' titles and roles within the group and a brief explanation of what the team hoped to gain from attending the program. Such information would have helped us tailor the content of the program to the needs of the participants and to evaluate its success.
The 10 teams that enrolled in the program brought between two and 15 members. The teams varied widely in their composition and scientific focus.
John Boothroyd , a professor of microbiology and immunology, brought his whole 15-member laboratory, which focuses on Toxoplasma biology and pathogenesis. Team leader Michaela Kiernan , a senior scientist and health psychologist who studies the effectiveness of interventions for weight management and physical activity, attended with her postdoc and two research assistants.
Several clinical teams also participated. David Rosenthal , a professor of pediatric cardiology and director of the pediatric heart failure program at Lucile Packard Children's Hospital, brought his clinical research team. Rosenthal's research focuses on improving the care of children with heart failure. His team was comprised of other clinical faculty, a research coordinator, and a nurse practitioner.
This was Neale's first time working with scientific research teams. Her approach was highly experiential: At the beginning of each day, participants engaged in an interactive team exercise. This was followed by a brief lecture and discussion about the exercise and what it demonstrated.
The program occurred in four sessions (3 hours each) on consecutive days during a single week.
As participants arrived on the first day, we invited them to sit anywhere in the room. On each seat was a handout with detailed information about a murder mystery. We asked the participants to form teams with other participants and work together to solve the mystery. We didn't tell the participants, but the handouts weren't all the same; to solve the mystery, participants had to gather information from people around the room with different versions of the handout. Most of our participants failed because they had naturally gravitated toward the people sitting near them -- members of their own current research teams.
When the exercise was over, Neale presented findings from experimental studies demonstrating the importance of team diversity -- factors that included gender, ethnicity, age, educational background, type of training received, and level of experience. Neale explained how diversity can help a team come up with more creative solutions to problems. Participants spent the last portion of the day discussing and reflecting upon the importance of team diversity to achieving successful outcomes.
A common problem in teams is that not all team members contribute equally; some team members hold back while others dominate discussions. To explore this problem and how to remedy it, Neale led the participants through an exercise called "Lost in the Desert." Participants were asked to rank a list of items (e.g., water bottle, knife, compass) according to how important they would be to somebody trying to survive for several days alone in the desert. Participants completed the exercise by themselves first and then completed it again within assigned teams. Afterward, they were asked to compare their group scores with the individual scores achieved by each team member.
In several cases, teams ended up scoring worse on the exercise than their best individual team member had scored. When this happens, Neale said, it signifies that the team did not fully leverage the expertise it had at its disposal. Neale offered a simple solution: before jumping into a new task, it's worth taking the time to ask each team member about their past experience or expertise that is relevant to the task at hand.
The third day of our program focused on negotiation, and participants were randomly grouped into teams of three people each. Each team member was assigned to represent the interests of a different fictitious research company. The task was to allocate a set amount of research dollars among the three parties. It was clear from the information given about the companies that some of them were more powerful than others. After several timed discussions, teams had to publicly report to the rest of the group how much money they had decided to give each company.
Neale used the exercise to lead into a discussion about how power and relationships affect negotiation outcomes. This was followed by lively discussion about how power affects relationships in scientific settings.
The last day of our program attempted to pull together the content from the previous days through a long exercise called "The Big Picture." Each participant was assigned a role to play, such as senior manager, manager, worker, or customer. Workers were grouped into small teams, each led by a manager. The goal of the faux company was to create a larger-than-life version of a famous painting while operating under time and budget constraints. Each of the teams was responsible for producing a piece of the painting, and by the end of the exercise all of the pieces had to fit together to create "The Big Picture" and satisfy the customers.
All in all, the final product was a success. But due to time constraints, there was only a very short discussion following this exercise. If we were to repeat "The Big Picture," we would add more time for discussion, especially because this exercise has the potential to illustrate so many different lessons about successful teamwork.
Shortly after the program, we performed an anonymous online survey of the program participants. We learned that the majority (85%) of our participants found the program interesting and helpful. One anonymous postdoc said, "I have a better understanding now for how a good team functions and the importance of each person's role. I appreciate more the difficulties my boss faces (after having had to play a similar role in 'The Big Picture' exercise.)." A faculty member wrote on the survey, "This program led me to reflect more upon my own team's composition in respect to diversity and to consider rotating certain members accordingly." Most of our survey respondents (82%) said they would recommend the program to somebody else.
Participants also offered useful criticisms. Several felt the exercises were too long and would have preferred more time devoted to lecture and discussion instead. Another suggestion, made by several participants, was that the exercises should have been more tailored to the real-life situations commonly faced by scientific research teams, rather than being generic.
To see if our program had any long-term effects, we interviewed some of our team leaders 6 months later. Lorene Nelson , chief of epidemiology, told us, "We definitely learned a few useful things, like that conflict can be good. We tend to be a very harmonious team, and we realized the importance of assigning one person to play the role of devil's advocate to help our thinking processes." But Nelson also reported that her team was disappointed that certain practical topics, such as time management and delegation, were not covered by the program. She suggested that we advertise the program differently so that potential participants would better understand the skills the program targets.
During our follow-up interview, Boothroyd, who brought his entire lab group to the program, said that "a big draw of the program for me was the opportunity to bring your entire team and have them all go through the same experience together. But the way the program was set up, there was a lot of mixing up of team members, which did not leverage the existing teams that were there."
Boothroyd also brought up another common criticism: that the program should have built in more time for teams to reflect on what they learned. Although several teams ended up doing this on their own, we plan to add more structured time in future programs for teams to reflect upon what they learned and come up with concrete ways to improve their functioning.
The most important lesson we learned was the need to tailor the program for the scientific environment. This isn't easy to do because most of what's known about formal team training has been learned in other contexts, such as business. For next time, we hope to do more research on our teams ahead of time to tailor it to the scientists' needs. Instead of allowing teams to sign up voluntarily, we plan to ask each department to nominate one to two teams. This will allow us to spend more time before the program understanding the unique situations and needs of each of our teams. We may also consider holding focus groups with potential participants to come up with tailored case examples and exercises.
Another lesson was the importance of ongoing training. Team principles need to be practiced and reinforced periodically. One way to achieve this would be to create a year-long course in which a smaller number of teams would participate monthly. In addition, we are considering adding coaching to the program, either by hiring professional coaches or by training some of our faculty to act as coaches. These coaches would attend actual team meetings to help solve team problems as they arise.
Choosing the right instructor is pivotal to program success. Margaret Neale proved to be an excellent choice not only because of her experience in this area but also because she's an academic herself and was able to establish herself as credible to our naturally skeptical audience. Many of our participants told us that they liked hearing about actual research done on teams, most of which they had never been exposed to before.
We know that no team science training program will succeed if the reward structures for teamwork in science stay the same. If we don't change the culture of academia so that teamwork is rewarded, scientists are unlikely to take team science training seriously. In our next version of the program, we hope to kick off our first session by having senior leaders at the medical school discuss how Stanford rewards and recognizes team science.
Overall, we are satisfied with the progress we made this past year in implementing the program. We are excited about rolling out another version in the near future, and we look forward to seeing what new progress other institutions make as the interest in team science continues to grow.
Photos courtesy of Stanford School of Medicine.
Daisy Grewal is an academic research and program manager at the Stanford Center for Clinical and Translational Education and Research at the Stanford School of Medicine.