Many of you are asked to take a leadership role in leading a team, whether it’s for research, administration, or even clinical. It is easy to feel unprepared for these roles, and there are many pitfalls waiting to sabotage your group’s teaming culture. The ALiEM Faculty Incubator has created a series of 10 case-based teaming problems to provide you with evidence-based advice and solutions for tackling some of the more common problems encountered in our professional team experiences.

Case 7

Your simulation educators group has been creating new cases, but it’s all a giant mess. Everyone has different cases in different formats, and each educator has a bunch of cases on their hard drives. They can’t find a way to sort all the cases and prevent redundancy.

What strategies can you use to create more cohesiveness in your group?

The problem this group faces is that they are not a team: there is no shared vision or common purpose, no teamwork culture, no collaboration, and no established communication methods.12

Achieve Cohesiveness

This group needs to come together and form a team, which requires a whole group meeting. Six things need to happen at this meeting:

  1. The leader should empathetically explain that things are not working as they are and engage group members in a discussion as to why. Empathy is one of the pillars of teaming culture and starting with this will help establish the trust needed to avoid future team dysfunction.34
  2. All models of team development involve a forming stage that involves answering the questions “Why am I here?” and “Who are you?” These are the curiosity and passion pillars of teaming.3,5–7
  3. Push the team members for a specific commitment. Each member should reaffirm their overall commitment to the project, define what they can contribute, and express their interests and passions. Allowing each member to feel heard creates trust and an atmosphere of respect and empathy.4
  4. Create a common purpose and a shared vision with an objective that is clear and measurable. These should lead to the final product.8,9 A compelling vision that involves input from all members of the team inspires everyone and orients them to the end goal10 and creates ownership of the team’s final product by each member.11
  5. Set deadlines and create a culture of accountability. Establishing specific deadlines with associated consequences helps prevent team failure and creates mutual accountability. In true collaboration, all are responsible for the final product, not just individual parts.12
  6. Plan for regular communication. Face to face is best, though electronic versions of face-to-face also work (e.g. Skype, Zoom, or Slack).13 Ensure occasional informal “check-ins” as needed in between regular meetings.

Case Conclusion

You realize the need to get everyone on the same page! You call an emergency meeting and follow the above 6 steps. You agree on your end goal (library of simulation cases) and tease out some of the specifics including the intended audience and number of cases. The team also establishes ground rules for communication, case standardization, and data storage.


  1. 1.
    Chamberlin S, Kumar M. Building Effective Teams. Chair Academy. Published 2014. Accessed September 12, 2018.
  2. 2.
    Katzenbach JR, Smith DK. The Discipline of Teams. Harvard Business Review. Published July 1, 2005. Accessed September 12, 2018.
  3. 3.
    Edmonson AC. The Three Pillars of a Teaming Culture. Harvard Business Review. Published December 17, 2013. Accessed September 12, 2018.
  4. 4.
    Conquer Team Dysfunction. The Source for Organizational Health. Published 2014. Accessed September 12, 2018.
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    Noble D, Kirzl J. Objective Metrics for Evaluation of Collaborating Teams. In: Washington, D.C.; 2003.
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    Kumar S, Deshmukh V, Adhish V. Building and leading teams. Indian J Community Med. 2014;39(4):208-213.
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    Stokols D, Misra S, Moser R, Hall K, Taylor B. The ecology of team science: understanding contextual influences on transdisciplinary collaboration. Am J Prev Med. 2008;35(2 Suppl):S96-115.
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    Kerr N, Tindale R. Group performance and decision making. Annu Rev Psychol. 2004;55:623-655.
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    Haas M, Mortensen M. The Secrets of Great Teamwork. Harvard Business Review. Published June 1, 2016. Accessed September 12, 2018.
  11. 11.
    Tiffan B. The art of team leadership. Physician Exec. 2011;37(2):78-80.
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    Arnold N, Ducate L. Collaboration or Cooperation? Analyzing Group Dynamics and Revision Processes in Wikis. CALICO Journal. 2012;29(3):431.
  13. 13.
    Pentland A. The Hard Science of Teamwork. Harvard Business Review. Published March 20, 2012. Accessed September 13, 2018.

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Assistant Clerkship Director Louisiana State University Emergency Medicine Residency
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