TY - JOUR
T1 - Team dynamics and clinician’s experience influence decision-making during Upper-GI multidisciplinary team meetings
T2 - A multiple case study
AU - Luijten, J. C. H. B. M.
AU - Westerman, M. J.
AU - Nieuwenhuijzen, G. A. P.
AU - Walraven, J. E. W.
AU - Sosef, M. N.
AU - Beerepoot, L. V.
AU - van Hillegersberg, R.
AU - Muller, K.
AU - Hoekstra, R.
AU - Bergman, J. J. G. H. M.
AU - Siersema, P. D.
AU - van Laarhoven, H. W. M.
AU - Rosman, C.
AU - Brom, L.
AU - Vissers, P. A. J.
AU - Verhoeven, R. H. A.
N1 - Funding Information: Author PS received research support or funding from EndoStim, Pentax, Norgine, Motus GI and The Enose company and is a member of the Advisory Board of Motus GIE. Author HL is a consultant or adviser in BMS, Lilly, MSD, Nordic Pharma, Servier, and received research funding and/or medication supply from Bayer, BMS, Celgene, Janssen, Lilly, Nordic Pharma, Philips, Roche, Servier. Author RV: received research grants from Roche and Bristol-Myers Squibb. Funding Information: This study was part of a mixed methods multiple case study investigating the underlying causes of variabilities in hospital practice in the curative treatment of esophagogastric cancer, known as the VARIATE project (outlined in ). The present study focused on identifying facilitators and barriers influencing CDM during MDTM, as well as factors potentially explaining variability in hospital practice. This study was funded by the Dutch Cancer Society (Project No. 10895). Publisher Copyright: Copyright © 2022 Luijten, Westerman, Nieuwenhuijzen, Walraven, Sosef, Beerepoot, van Hillegersberg, Muller, Hoekstra, Bergman, Siersema, van Laarhoven, Rosman, Brom, Vissers and Verhoeven.
PY - 2022/10/18
Y1 - 2022/10/18
N2 - Background: The probability of undergoing treatment with curative intent for esophagogastric cancer has been shown to vary considerately between hospitals of diagnosis. Little is known about the factors that attribute to this variation. Since clinical decision making (CDM) partially takes place during an MDTM, the aim of this qualitative study was to assess clinician’s perspectives regarding facilitators and barriers associated with CDM during MDTM, and second, to identify factors associated with CDM during an MDTM that may potentially explain differences in hospital practice. Methods: A multiple case study design was conducted. The thematic content analysis of this qualitative study, focused on 16 MDTM observations, 30 semi-structured interviews with clinicians and seven focus groups with clinicians to complement the collected data. Interviews were transcribed ad verbatim and coded. Results: Factors regarding team dynamics that were raised as aspects attributing to CDM were clinician’s personal characteristics such as ambition and the intention to be innovative. Clinician’s convictions regarding a certain treatment and its outcomes and previous experiences with treatment outcomes, and team dynamics within the MDTM influenced CDM. In addition, a continuum was illustrated. At one end of the continuum, teams tended to be more conservative, following the guidelines more strictly, versus the opposite in which hospitals tended towards a more invasive approach maximizing the probability of curation. Conclusion: This study contributes to the awareness that variation in team dynamics influences CDM during an MDTM.
AB - Background: The probability of undergoing treatment with curative intent for esophagogastric cancer has been shown to vary considerately between hospitals of diagnosis. Little is known about the factors that attribute to this variation. Since clinical decision making (CDM) partially takes place during an MDTM, the aim of this qualitative study was to assess clinician’s perspectives regarding facilitators and barriers associated with CDM during MDTM, and second, to identify factors associated with CDM during an MDTM that may potentially explain differences in hospital practice. Methods: A multiple case study design was conducted. The thematic content analysis of this qualitative study, focused on 16 MDTM observations, 30 semi-structured interviews with clinicians and seven focus groups with clinicians to complement the collected data. Interviews were transcribed ad verbatim and coded. Results: Factors regarding team dynamics that were raised as aspects attributing to CDM were clinician’s personal characteristics such as ambition and the intention to be innovative. Clinician’s convictions regarding a certain treatment and its outcomes and previous experiences with treatment outcomes, and team dynamics within the MDTM influenced CDM. In addition, a continuum was illustrated. At one end of the continuum, teams tended to be more conservative, following the guidelines more strictly, versus the opposite in which hospitals tended towards a more invasive approach maximizing the probability of curation. Conclusion: This study contributes to the awareness that variation in team dynamics influences CDM during an MDTM.
KW - clinicians
KW - experience
KW - multidisciplinary team meeting (MDT)
KW - team dynamics
KW - upper-GI cancer
UR - http://www.scopus.com/inward/record.url?scp=85140987932&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fonc.2022.1003506
DO - https://doi.org/10.3389/fonc.2022.1003506
M3 - Article
C2 - 36330470
SN - 2234-943X
VL - 12
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1003506
ER -