Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams

Edmondson, Amy C.

doi:10.1111/1467-6486.00386

Cited by 1,635Team Dynamics and PerformanceOrganizational Learning and LeadershipInnovative Education and Learning Practices

Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams

Edmondson, Amy C.·2003·Journal of Management Studies

DOI 10.1111/1467-6486.00386

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Abstract

ABSTRACT This paper examines learning in interdisciplinary action teams. Research on team effectiveness has focused primarily on single‐discipline teams engaged in routine production tasks and, less often, on interdisciplinary teams engaged in discussion and management rather than action. The resulting models do not explain differences in learning in interdisciplinary action teams. Members of these teams must coordinate action in uncertain, fast‐paced situations, and the extent to which they are comfortable speaking up with observations, questions, and concerns may critically influence team outcomes. To explore what leaders of action teams do to promote speaking up and other proactive coordination behaviours – as well as how organizational context may affect these team processes and outcomes – I analysed qualitative and quantitative data from 16 operating room teams learning to use a new technology for cardiac surgery. Team leader coaching, ease of speaking up, and boundary spanning were associated with successful technology implementation. The most effective leaders helped teams learn by communicating a motivating rationale for change and by minimizing concerns about power and status differences to promote speaking up in the service of learning.

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Sustainability is likely to be more successful when placed in an organizational culture that values EBP and has leadership that facilitates team participation and psychological safety.
“Sustainability is likely to be more successful when placed in an organizational culture that values EBP and has leadership that facilitates team participation and psychological safety (Edmondson 2003a; b).”
From Advancing a Conceptual Model of Evidence-Based Practice Implementation in Public Service Sectors (2011) · cites this paper as Edmondson 2003b
A study of surgical teams found variations in membership stability but no association between stability and 'implementation success'.
“A study of surgical teams found variations in membership stability but no association between stability and “implementation success” (i.e., composite measure based on number of uses of new technique, proportion of uses, and changes in use) [48, 49].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [48]
Psychological safety and ease of speaking up were associated with implementation success.
“Edmondson and colleagues found that psychological safety and ease of speaking up (i.e., interpersonal climate that allows members to share questions and concerns) were associated with implementation success [48, 49].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [48]
Inter-team communication, specifically speaking up and learning from other teams (boundary spanning), was identified as a critical part of team learning processes associated with successful implementation.
“Inter-team communication, specifically speaking up and learning from other teams (i.e., boundary spanning), was identified as a critical part of team learning processes associated with successful implementation [48].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [48]
Psychological safety was closely related to learning behavior within the team, including speaking up with questions and concerns.
“Psychological safety was closely related to learning behavior within the team, including speaking up with questions and concerns [48, 49].”
From Teamwork and implementation of innovations in healthcare and human service settings: a systematic review (2024) · cites this paper as [48]

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Authors: Edmondson, A. C.
Affiliations: Harvard University (US)
Corresponding author: Edmondson, Amy C.
ORCID: Edmondson, Amy C.
Venue: Journal of Management Studies
Publisher: Wiley
Published: 2003-08-04
Volume: 40
Issue: 6
Pages: 1419-1452
ISSN: 0022-2380 (ISSN-L)
1467-6486
DOI: 10.1111/1467-6486.00386
OpenAlex: W1993517542
Cited by: 1,635
References: 59
Citations by year: 2026: 54 · 2025: 77 · 2024: 80 · 2023: 74 · 2022: 107 · 2021: 115 · 2020: 118 · 2019: 81 · 2018: 100 · 2017: 102 · 2016: 96 · 2015: 94 · 2014: 89 · 2013: 90 · 2012: 80
FWCI: 22.88
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Management Studies (publishedVersion)
Topics: Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Organizational Learning and Leadership
Social Sciences › Human Factors and Ergonomics › Innovative Education and Learning Practices
Keywords: speaking up, team leadership, team learning, surgical workforce, boundary spanning, organizational context, team effectiveness

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Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams

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