Perceived influence of power distance, psychological safety, and team cohesion on team effectiveness

J Interprof Care. 2020 Jan-Feb;34(1):20-26. doi: 10.1080/13561820.2019.1633290. Epub 2019 Aug 5.


Interprofessional education needs a stronger theoretical basis informed by the challenges facing collaboration across professions. This study explores the impact of power distance (perception of role hierarchy), on team effectiveness as mediated by team cohesion and psychological safety (believe one can speak up without the fear of negative consequences). Furthermore, it tests for differences between medical and nursing students in these concepts. Final-year medical and nursing students completed a paper survey on study constructs at the end of a three-session, 6-h interprofessional critical care simulation activity. Two hundred and forty-three (76% response rate) retrospective surveys found the relationship between power distance and perceived team effectiveness was mediated by perceptions of team cohesion and psychological safety, suggesting these concepts influence desired interprofessional collaboration. There were no differences between medical and nursing students on study variables. While interprofessional training typically focuses on general attitudes toward interprofessional collaboration and on the acquisition and demonstration of knowledge and skills, these findings suggest important team concepts underlying effective collaboration may include perceptions of psychological safety and power distance. These concepts can be key drivers of cohesion and effectiveness during interprofessional simulation exercises and may be targets for future interventions.

Keywords: Interprofessional education; power distance; psychological safety; surveys; team culture; team dynamics.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cooperative Behavior
  • Education, Medical / organization & administration
  • Education, Nursing / organization & administration
  • Female
  • Group Processes*
  • Humans
  • Interprofessional Relations*
  • Male
  • Patient Care Team / organization & administration*
  • Patient Care Team / standards
  • Perception
  • Power, Psychological
  • Retrospective Studies
  • Safety
  • Simulation Training / organization & administration
  • Students, Medical / psychology*
  • Students, Nursing / psychology*