The importance of teamwork in healthcare is becoming increasingly apparent (Hall and Weaver 2001). The growing complexity of patient care and the surge in comorbidities have resulted in an increase in medical specializations (i.e. among medical doctors, nurses, psychologists, etc.) (Hall and Weaver 2001; Hall 2005). To overcome specialty fragmentation, multidisciplinary healthcare teams have become the solution, characterized by strong collaborations between different medical specialties (e.g. general practitioners, surgeons) and health professions (e.g. medical doctors, nurses) (Hall and Weaver 2001). Effective teamwork has been found to be beneficial for a variety of additional reasons, such as increased work-engagement (Montgomery et al. 2015), lower burn-out risk, higher performance and fewer medical errors (Rosen et al. 2018). However, it is important to note that effective teamwork becomes more challenging with the rise in specializations, as different medical specializations have distinct interests, technical jargon and educational backgrounds (Hall 2005).
Evidence on medical doctors’ teamwork skills shows they are usually not considered team workers, but rather solo performers and independent decision-makers (Gabbard 1985; Reuben et al. 2004; Whitehead 2007). They have a tradition of working independently and are trained to take full responsibility as medical experts (Gabbard 1985; Reuben et al. 2004; Whitehead 2007; Saba et al. 2012). Nevertheless, former studies indicate differences in gender (Anderson and Sleap 2004; Walkiewicz et al. 2018) and medical specialties (Reuben et al. 2004). For instance, women are usually better team workers compared to men, while men generally score higher on leadership (Anderson and Sleap 2004; Walkiewicz et al. 2018). Additionally, certain medical specialties have a longer tradition of teamwork (Reuben et al. 2004) or require higher levels of empathy (Chen et al. 2007), which is an important characteristic of teamwork (Hojat et al. 2015). For example, medical students who prefer general practice or person-centered specialties (e.g. psychiatry) usually have higher empathy scores than those who prefer technique-oriented specialties (e.g. clinical biologist) (Chen et al. 2007).
To ensure high-quality healthcare, teamwork has been increasingly identified and incorporated into curricula for medical education (Chakraborti et al. 2008). The Canadian Medical Educational Directives for Specialists (CanMEDS) developed an outcomes-based framework for medical education that identifies seven core competencies for medical doctors, including the Collaborator (Frank et al. 2015). The Collaborator is described as someone who works ‘effectively with other health care professionals to provide safe, high-quality, patient-centred care’ (Frank et al. 2015, 18). Belgium, Denmark, Australia and New Zealand are among the countries that have adopted this framework as a guideline for medical education curricula (Ringsted et al. 2006; KU Leuven 2021).
Despite this progress, medical education is still marked by strong competitiveness (e.g. numerus clausus) and a focus on individual achievements and outcompeting peers (Coulehan and Williams 2001; Saba et al. 2012; Yates 2012; Chandrashekar and Mohan 2019; Colebatch et al. 2019). Evidence has indicated that medical students perceive healthcare as an individual responsibility rather than a collective one (Horsburgh et al. 2006). In addition, Walkiewicz et al. (2018) showed that medical students scored higher on action-oriented team roles (i.e. concerned with immediate tasks) and thinking-oriented roles (i.e. creative or analytical thinkers) than on the team worker role (Walkiewicz et al. 2018), which CanMEDS refers to as the Collaborator (Frank and Danoff 2007). Furthermore, multiple studies have found that empathy scores decreased throughout medical education (Chen et al. 2007; Newton et al. 2008; Hojat et al. 2009; Lim et al. 2013). These findings contradict with the increasing importance of interprofessional collaboration and multidisciplinary teamwork in modern healthcare (Saba et al. 2012; Chandrashekar and Mohan 2019).
There is also still much uncertainty on medical students’ perceptions with regard to their own professional team roles. We have been able to identify only one study by Walkiewicz et al. (2018), but the generalizability of their findings was problematic due to the relatively small sample size. Nonetheless, examining perceptions has great value as studies have shown that people who have positive perceptions about teamwork tend to be more committed to it (Mendo-Lázaro et al. 2017; Puente-Palacios and De Souza 2018). Furthermore, perceptions and beliefs mainly result from past experiences, which means that providing positive experiences (i.e. on teamwork) may improve people’s commitment towards teamwork in the future (Puente-Palacios and De Souza 2018).
The aim of this study is to examine self-perceptions of medical students on their professional team role, with a focus on teamwork. In addition, we have assessed differences according to gender and future specialty (i.e. general practice, person-centered specialty or technique-oriented specialty). Based on the literature, we expected overall higher scores for action-oriented and thinking-oriented roles versus team worker roles (Walkiewicz et al. 2018); and higher scores for team worker roles in female students (Anderson and Sleap 2004; Walkiewicz et al. 2018) and in those who will later opt for a training as general practitioner or a person-oriented specialty (Chen et al. 2007).