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Research ArticleResearch

Teams of rural physicians matter

Testing a framework of team effectiveness

Eliseo Orrantia, Theresa Kline and Lindsay Nutbrown
Canadian Family Physician April 2022; 68 (4) 280-287; DOI: https://doi.org/10.46747/cfp.6804280
Eliseo Orrantia
Rural generalist in Marathon, Ont, and Associate Professor at the Northern Ontario School of Medicine in Thunder Bay.
MD MSc FCFP FRRMS
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  • For correspondence: eorrantia@mfht.org
Theresa Kline
Professor Emeritus at the University of Calgary in Alberta.
PhD
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Lindsay Nutbrown
Research assistant at Marathon Family Health Team.
RKin DOMP
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  • Figure 1.
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    Figure 1.

    Framework for teamwork effectiveness in rural physician teams

  • Figure 2.
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    Figure 2.

    Path correlation matrix of team-model variables using physician-rated team performance: The ICC path value from team climate to team performance is not significant in the presence of a mediator (team efficacy).

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    Figure 3.

    Path correlation matrix of team-model variables using external observer–rated team performance: The ICC path value from team climate to team performance is not significant in the presence of a mediator (team efficacy).

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    Table 1.

    Individual-level variable data descriptive statistics: Variables were measured using a 5-point Likert scale.

    INDIVIDUAL PHYSICIAN VARIABLES (N=70)MEAN (SD)CRONBACH α
    Rural practice preparedness3.27 (0.82).73
    Career opportunities3.68 (0.87).66
    Working conditions3.62 (0.63).85
    Community integration3.70 (0.68).79
    Partner support (single item)4.14 (0.88)NA
    Intentions to stay3.96 (1.00).94
    Organizational commitment3.66 (0.75).87
    • NA—not applicable.

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    Table 2.

    Team-level variable data descriptive statistics: Variables were measured using a 5-point Likert scale.

    PHYSICIAN TEAM VARIABLES (N=26)MEAN (SD)CRONBACH αAVERAGE ICC
    Decision making3.96 (0.74).930.46
    Communication3.81 (0.85).930.60
    Conflict resolution3.92 (0.71).960.51
    Team efficacy4.02 (0.60).910.35
    Team performance (physician rated)3.55 (0.44).890.51
    Team climate3.90 (0.74)NANA
    • ICC—intraclass correlation coefficient, NA—not applicable.

    • View popup
    Table 3.

    Team-level variable data descriptive statistics with external observer data: Variables were measured using a 5-point Likert scale.

    TEAM AND EXTERNAL OBSERVER VARIABLESMEAN (SD)
    Decision making4.10 (0.68)
    Communication3.89 (0.88)
    Conflict resolution4.05 (0.63)
    Team efficacy4.17 (0.49)
    Team performance (external observer rated)3.52 (0.75)
    Team climate4.01 (0.70)
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    Table 4.

    Zero-order correlation matrix of team-model variables using physician-rated team performance

    VARIABLETEAM CLIMATETEAM EFFICACYTEAM PERFORMANCE
    Team climateNANANA
    Team efficacy0.774NANA
    Team performance0.5540.858NA
    • NA—not applicable.

    • View popup
    Table 5.

    Zero-order correlation matrix of team-model variables using external observer–rated team performance

    VARIABLETEAM CLIMATETEAM EFFICACYTEAM PERFORMANCE
    Team climateNANANA
    Team efficacy0.829NANA
    Team performance0.5650.844NA
    • NA—not applicable.

    • View popup
    Table 6.

    GEE parameter estimates predicting intentions to stay and corresponding zero-order correlations: N=70.

    HYPOTHESIS TEST
    PARAMETERb VALUESTANDARD ERRORWald Embedded ImageP valueZERO-ORDER CORRELATION
    Team efficacy0.1100.15090.535.4640.30*
    Rural practice preparedness0.2060.10523.839.0500.38*
    Career opportunities0.5700.092537.983<.0010.43*
    Community integration0.1890.11082.925.0870.56*
    Working conditions0.1070.16200.438.5080.49*
    • GEE—generalized estimating equation.

    • ↵* Statistically significant at P<.01.

    • View popup
    Table 7.

    GEE parameter estimates predicting intentions to stay and corresponding zero-order correlations: N=59.

    HYPOTHESIS TEST
    PARAMETERb VALUESTANDARD ERRORWald Embedded ImageP valueZERO-ORDER CORRELATION
    Team efficacy0.0530.11580.208.6490.36†
    Rural practice preparedness0.1910.11422.785.0950.38†
    Career opportunities0.3100.074717.271<.0010.33*
    Community integration0.5220.107623.546<.0010.51†
    Working conditions0.1920.14721.699.1920.48†
    Partner support0.1940.11163.024.0820.25*
    • GEE—generalized estimating equation.

    • ↵* Statistically significant at P<.05.

    • ↵† Statistically significant at P<.01.

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Canadian Family Physician: 68 (4)
Canadian Family Physician
Vol. 68, Issue 4
1 Apr 2022
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Teams of rural physicians matter
Eliseo Orrantia, Theresa Kline, Lindsay Nutbrown
Canadian Family Physician Apr 2022, 68 (4) 280-287; DOI: 10.46747/cfp.6804280

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Eliseo Orrantia, Theresa Kline, Lindsay Nutbrown
Canadian Family Physician Apr 2022, 68 (4) 280-287; DOI: 10.46747/cfp.6804280
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