Impact of group structure and process on multidisciplinary evidence-based guideline development: an observational study

被引:51
作者
Pagliari, C [1 ]
Grimshaw, J [1 ]
机构
[1] Univ Aberdeen, Hlth Serv Res Unit, Aberdeen, Scotland
关键词
evidence-based medicine; group processes; guideline development; practice guidelines;
D O I
10.1046/j.1365-2753.2002.00333.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Rationale, aims and objectives This paper presents selected results from a study investigating the impact of small group processes on the development of clinical practice guidelines by multidisciplinary panels. Observations of one panel developing a guideline for primary care over several months are reported here. Methods Non-participant observation with content analy-sis of transcripts aided by field notes. Results Bales's interaction process analysis was used to categorize interactions in terms of their task-oriented or socioemotional qualities. This revealed a well-functioning, task-oriented group characterized by predominantly positive social behaviours. However, a breakdown of dialogue by speaker indicated a marked effect of professional role and status on the level of contribution to group discussions. This, and marked changes in panel composition across meetings, has implications for the multidisciplinarity of decision-making in such groups and hence for the acceptance and implementation of their outputs. Conclusions These findings are likely to generalize to other health care settings in view of the growing emphasis on multidisciplinary decision-making and the clear status hierarchies inherent within the medical and allied fields.
引用
收藏
页码:145 / 153
页数:9
相关论文
共 24 条
[1]  
ALLEN VL, 1971, J EXPT SOCIAL PSYCHO, V4, P31
[2]   OPINIONS AND SOCIAL PRESSURE [J].
ASCH, SE .
SCIENTIFIC AMERICAN, 1955, 193 (05) :31-35
[3]  
Asch SE., 1951, Groups, leadership, and men, P177
[4]  
Bales R, 1950, INTERACTION PROCESS
[5]   Development and application of a generic methodology to assess the quality of clinical guidelines [J].
Cluzeau, FA ;
Littlejohns, P ;
Grimshaw, JM ;
Feder, G ;
Moran, SE .
INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, 1999, 11 (01) :21-28
[6]  
COULTER I, 1995, HEALTH SERV RES, V30, P577
[7]  
*DEP HLTH, 1998, 1 CLASS SERV
[8]   STATUS, EXPECTATIONS, AND BEHAVIOR - A META-ANALYTIC REVIEW AND TEST OF THE THEORY [J].
DRISKELL, JE ;
MULLEN, B .
PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN, 1990, 16 (03) :541-553
[9]  
EAGLY AH, 1983, AM PSYCHOL, V38, P971
[10]   SEX-DIFFERENCES IN CONFORMITY - STATUS AND GENDER-ROLE INTERPRETATIONS [J].
EAGLY, AH ;
CHRVALA, C .
PSYCHOLOGY OF WOMEN QUARTERLY, 1986, 10 (03) :203-220