Anna T. Mayo – Carnegie Mellon University
Anne-Sophie Sabbatucci – Indiana University
Rossella Rocchino – Technical University Munich
Article link: https://doi.org/10.1177/00018392221096451
- How did the idea for this study actually emerge and evolve?
This origin of this work traces back to my graduate school advisor, Anita Woolley, who had given a few talks to the fellows at the hospital that became the field site. When questions about a potential collaboration surfaced, Anita generously offered me the “in” and I jumped at the chance to be a part of studying teams in a field setting. I had no experience behind the scenes in healthcare, but the chance to understand teams that have real impact on people’s lives was compelling to me.
I thought I was getting ready to study teams that were relatively bounded, if short-lived, and early conversations with the hospital had been related to measuring collective intelligence in a field setting. When I got into the setting to conduct a couple of days of observation, I realized how much more dynamic these teams were than the ones I had been reading about and studying up to that point. It became clear that qualitative work was the place to start. And as I iterated between data collection, analysis, and consulting the literature, the puzzle of how some of these groups with shifting membership came to actually look like a team began to capture my attention.
- Your paper relies primarily on observations, so on your notes of those observations. How did you manage watching, listening, and notetaking in such a likely fast-paced environment? What were the challenges? How did your technique evolve?
One of the biggest challenges was getting familiar with the medicalese that participants used. A primary part of the inpatient teams’ work that I was observing was what they called “family-centered rounds.” This describes the period, each day and for each patient, when the physicians would go to a patient’s bedside to meet with the patient’s family (and nurse) to discuss the patient’s case and make a care plan. The presence of the family in particular meant the physicians would speak in lay terms – great for a newcomer like me! However, as the research revealed, many teams did not do this, so I had to pick up on a range of medical terms I otherwise never would have known. Especially early on, I used rare quiet moments to ask for explanations of terms or of what had just happened, and I did my own research after observation periods so that I could follow the conversations and later ask informed questions in interviews. By the end of the study an attending physician I was observing joked that I might be able to pass a medical school exam – far from it, but understanding some basics meant I could unpack the more compelling social processes at play. It was also a challenge to know who was who; again, early on I did a lot of asking, “who was that?” after fleeting hallway conversations.
I also tried to keep in mind great advice I got before starting the project. Anita Woolley suggested that I imagine going through the hospital with huge sheets of fly paper trying to get everything I could to stick. I took that to heart, developing strategies for getting as much as possible recorded, like having my own short hand for taking notes. I ended up with a bin of filled notebooks—more notes than I ever anticipated having. Being able to return to and analyze rich data was key for me. One other piece of advice that stuck with me came from Sara Kiesler, who emphasized paying attention to what I was *not* seeing or hearing. This helped me notice the people who often weren’t present, which underscored much of the theory I developed.
- How did you start coding the data (e.g., type of codes, tools you used, number of teams), and why did you do it this way? How did your coding evolve? What did you see at first, and how did that change in time? We noticed you did not start coding using gerunds; why?
My coding started from the beginning and was a highly iterative process. As soon as I had observed and interviewed two teams I was looking for comparisons within/across them. As I gathered more data I started putting together a variety of spreadsheets and figures to try to make sense of what I was seeing while staying organized. With yet more data, I turned to the software Nvivo; there I started with open codes, with my focus directed in part based on the memos I had been writing and the comparisons I had been making, and I eventually grouped those codes into themes. The reviewers challenged me in the first review, though, pointing out a need to develop more construct clarity. At that point, I was able to see how I could leverage what was already out there rather than reinventing the wheel, and I leaned on existing constructs, such as Marks, Mathieu, and Zaccaro’s (2001) team processes. I also have a reviewer to thank for the suggestion to code using gerunds. That came at the same time, between the first and second submission, which was a turning point for me. These changes, sparked by the reviewers, helped me to move from trying to write a variance story to instead taking a more process-oriented view of what was happening.
- Did you have ASQ in mind already before the paper was concluded? How did this affect your writing style and the formulation of each section?
I don’t think I had a specific journal in mind when I started to write for my dissertation, but by the time the draft was taking shape I do remember considering submitting to ASQ. I really admire the journal and the work that has been published there, and I thought (hoped) there might be a fit with what I was doing. After defending, I turned to writing explicitly with a submission to ASQ in mind. Improving my writing is an ongoing effort for me, but I’m sure I’ve learned a lot about writing from reading well-written work. So, I found myself turning to papers, particularly those published in ASQ, that were influential for my own thinking and that I found to be useful models. Then, at a certain point, I found that I had to find the structure that made sense to me for this work.
- When did you start drafting the paper? How did the drafts shift between different rounds of reviews? What aspects were received well or challenged by reviewers, and how did you feel about this process?
Drafting a paper started with getting my dissertation document together. The piece I initially submitted was fairly close to what was in my dissertation, tailored to what I thought might make sense at ASQ. The review process was fantastic. The editor allowed the time I needed to go back to the data in a couple of revisions. And the reviewers and the editor challenged me immensely, but at the same time were quite constructive. I mentioned earlier their challenges around construct clarity and the opportunity to take a temporal lens and code with gerunds; something eventually clicked as I went back to the data that after getting that first set of reviews. From the first to the second submission, I rewrote almost everything. I started to believe I was tapping into the data in a way that did justice to it, and I moved from a fairly linear, variance-focused story to unpacking temporal patterns in a much more fine-grained way. I was able to think about the interplay of constructs such as internal and external coordination. There’s still a variance story embedded in the article to some extent, but the process story became the main story in my mind. I continued to revise in subsequent rounds after that, but the biggest leap for me was that first revision. In the end, I am extremely grateful for the tough, but fair and constructive, reviews I received that set me down that path. I firmly believe the process helped me to get more out of the data. It was a great example, in my opinion, of how productive the review process can be.
- What did you most love about this research? What major challenges did you face during this work, and how did you overcome them?
This one is easy – the thing I loved most was the people. I collected these data before the pandemic. Perhaps since then the world at large has a different appreciation for healthcare workers, but this project is what opened my eyes to their dedication and caring. I have immense respect for all of the healthcare professions represented in this study (and those that didn’t make it in). I’m so grateful that the participants in this study let me into their world.
A lot of the challenges I faced had to do with delays (e.g., in getting through IRB and HIPPA hoops to get access to patient data), but the people I was getting to know and the importance of the work they were doing made it easier to have patience.
- What challenges and advantages did you encounter in conducting inductive research as a single author? Did you interact with other researchers during the process? Any suggestions for Ph.D. students in the same position?
I’m sure that part of my interest in studying teams stems from the fact that I really enjoy working with others, which made this a hard process at times. That said, I had the luxury of this being a part of my dissertation, which means I had amazing support around me as this project developed. I talked with just about anyone who would listen and presented the work at a variety of conferences and workshops. I learned so much from others during this process. My advice to PhD students in a similar position would be to not hesitate in asking others for feedback!
- How does this article fit in with your broader research trajectory? Are you working on projects extending this paper’s findings or leveraging the same data/context?
This project influenced my broader research program in at least a couple of ways. First, it sparked an interest in the more-dynamic teams that don’t fit the traditional definitions of a team. I’m seeing more and more of these team-like structures in organizations and have enjoyed engaging in research that aims to understand what can be done to support teamwork in such settings. Second, this was a chance for me to dip my toe into the context of healthcare, and it set me on a path of dedicating a greater portion of my research to the study of healthcare teams and understanding the intersection between healthcare and organization science. With healthcare representing roughly 20% of the US GDP, understanding organizational issues in healthcare seems worth it on its own, but as noted already, I see connections to other industries that are also employing more-dynamic teams. Working in interdisciplinary settings and finding where phenomenon do and don’t cross over has pushed my thinking forward and has been fun.
In this particular context of inpatient teams, I have a working paper with Anita Woolley and a few physicians that reports on a follow-up field experiment – hopefully there will be more to come on that in time!
Anne-Sophie is a Ph.D. student at the Kelley School of Business at Indiana University. Her dissertation involves, among other things, qualitative research on Iraq’s emerging entrepreneurial ecosystem. Her research broadly focuses on understanding entrepreneurship as emancipation and as a process for social change.
Rossella is a Ph.D. Candidate of the Business School at Technical University Munich (TUM) in Germany. I conduct research at the intersection of entrepreneurship, societal impact, and communities at different levels of analysis. She is currently studying community-based enterprises in rural Italy and their governance forms.