Development and validation of the primary care team dynamics survey

Health Serv Res. 2015 Jun;50(3):897-921. doi: 10.1111/1475-6773.12257. Epub 2014 Nov 25.


Objective: To develop and validate a survey instrument designed to measure team dynamics in primary care.

Data sources/study setting: We studied 1,080 physician and nonphysician health care professionals working at 18 primary care practices participating in a learning collaborative aimed at improving team-based care.

Study design: We developed a conceptual model and administered a cross-sectional survey addressing team dynamics, and we assessed reliability and discriminant validity of survey factors and the overall survey's goodness-of-fit using structural equation modeling.

Data collection: We administered the survey between September 2012 and March 2013.

Principal findings: Overall response rate was 68 percent (732 respondents). Results support a seven-factor model of team dynamics, suggesting that conditions for team effectiveness, shared understanding, and three supportive processes are associated with acting and feeling like a team and, in turn, perceived team effectiveness. This model demonstrated adequate fit (goodness-of-fit index: 0.91), scale reliability (Cronbach's alphas: 0.71-0.91), and discriminant validity (average factor correlations: 0.49).

Conclusions: It is possible to measure primary care team dynamics reliably using a 29-item survey. This survey may be used in ambulatory settings to study teamwork and explore the effect of efforts to improve team-based care. Future studies should demonstrate the importance of team dynamics for markers of team effectiveness (e.g., work satisfaction, care quality, clinical outcomes).

Keywords: Survey; primary care; team dynamics; team effectiveness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Communication
  • Cross-Sectional Studies
  • Female
  • Group Processes*
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team / organization & administration*
  • Primary Health Care / organization & administration*
  • Psychometrics
  • Racial Groups
  • Reproducibility of Results