Chain Reaction

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Learning Objectives

As a result of participating in this activity, learners will:

1. Organize their team to provide optimal efficiency for this task.
2. Assemble a collaborative solution to a challenge.
3. Evaluate and implement team strategies to complete a design in domino pieces that meets a given set of parameters.

Description

1. Assemble students into teams of 5-6 using some method to ensure diversity/interprofessionalism on each team. Each team is to complete two tasks in sequence to complete this activity.
2. Teams are provided a generous supply of domino pieces and are given a set of parameters by which they must abide during the building of their structure. These can be printed out in advance or can be projected where they can be clearly seen by all team members. There should be approximately the same number of components to this task as there are team members. (Example of a component: Construct a run of dominoes that splits into two separate legs of at least twenty dominoes each.) These can be explicitly sequential, or may simply be one component that must be present in the solution.
3. The team must collaboratively work together to complete all of the required components and set them up such that by pushing the first domino, all components will ultimately fall over.
4. Teams whose creations fall down during the assembly will need to begin again. Any sections remaining standing are unaffected. All team members must participate in this activity, although tasks may be reassigned or the team may elect to change its overall response to the challenge.

Recommendations

This exercise may be used by one team at a time, playing against an urgency, such as time.

Size

Small Group, Medium Group

Equipment

Minimal Equipment - Domino or domino-like pieces; diagrams of patterns to be constructed

Time

One Hour

Modifications

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Lesson

Communication

How team members divide necessary tasks is important, but equally so is how the team responds when an error occurs. Due to the somewhat fragile nature of tasks in this exercise, where each team member is dependent on others, those reactions to failure can become amplified.

Debrief Questions

1. What went well?
2. How did your team divide up the tasks required to complete this challenge? What was your briefing like, if you held one?
3. The possibility of mistakes elevates the need for more frequent check-ins across the team. How often did your team hold huddles?

Clinical Application

In healthcare, if an error occurs, it is not possible to simply stop and start the task over again.

1. How do you think that reality affects providers, given that the consequences could be serious for the patient?
2. What communication strategies are needed when teams discover medical errors made by their own team members?

Bloom's Taxonomy

Analyze/Apply
Evaluate/Create

TeamSTEPPS domain

Communication
Leadership

IPEC Competency

VE 4
RR 1
CC 1, 4, 5 & 7
TT 5 & 11

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Lesson

Mutual Support

We often simply start tasks assuming everyone knows their proper role and their responsibilities. Sometimes that is defined by provider license, but skills/responsibilities may overlap, clouding the expectations of each and all members. Teams must utilize effective communication and support strategies to forestall misunderstanding and team regression.

Debrief Questions

1. Reflect as a team on successes, mistakes and near misses. How did you develop a strategy for avoiding obstacles to success?
2. Identify your immediate reaction when a mistake or near miss occurred. If you could have said anything you wished with impunity, what might that have been?
3. If you were the cause of a mistake or near miss, how did you feel about your performance, your membership on the team, and your perception of what team members thought of you?

Clinical Application

Your patient has a complex medical history, and unknown to you has a number of allergies. In the course of treatment, they become anaphylactic. Team members must now deal with a new/additional crisis with little information.

1. How can team members optimize their own and others’ behaviors?
2. At what point should team members consider a debrief of what happened?
3. How can team members be supportive of one another in this situation?

Bloom's Taxonomy

Analyze/Apply
Evaluate/Create

TeamSTEPPS domain

Communication
Leadership
Mutual Support

IPEC Competency

VE 4, 7 & 8
RR 2, 5 & 6
CC 1, 4-7
TT 8, 9 & 11

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Lesson

Leadership

When things go awry, people often look to others to interpret the issue or suggest a solution. Identified leaders often are called upon either by the team or an authority to explain what happened and to lay out a plan moving forward.

Debrief Questions

Some mistakes happen for totally innocent reasons, exacerbated by stress or pressure. An elbow brushes against something, for example, and unbeknownst to the person, a chain reaction begins.

1. How should leaders deal with mistakes made by team members? What if the same mistake happens more than once?
2. What should leaders be communicating to team members when an error occurs?
3. What responsibility does the leader hold for mistakes?

Clinical Application

Leaders direct the execution of a plan. In healthcare, however, where we utilize a model of situational leadership (the leader being the person most qualified to meet the needs of the patient at that moment), being able to execute the plan may be more than one individual can do.

1. What is the role of consultation on healthcare teams?
2. What is the role of delegation on healthcare teams?
3. What advice would you give to a healthcare team leader about team members making mistakes?

Bloom's Taxonomy

Analyze/Apply
Evaluate/Create

TeamSTEPPS domain

Communication
Situation Monitoring

IPEC Competency

VE 7
RR 2 & 3
CC 1, 4-7
TT 5, 7, 8 & 11

Summary

Even on the highest functioning teams, mistakes can happen that affect the rest of the team members. How teams respond to such challenges can send them plummeting backward toward renegotiating everything they think they know.

Contact

For more information about how to utilize games, low-fidelity simulation, and interactive learning to teach concepts of teamwork and collaboration, contact Better.Teams@rosalindfranklin.edu

Related Tags

collaboration, collaboration process, common goal, communication, conflict, consequence, inexpensive, leadership, low barrier, low resource, mutual support, outcomes, risk, situation monitoring, situational leadership, teams and teamwork