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Quality of leadership in multidisciplinary cancer tumor boards: development and evaluation of a leadership assessment instrument (ATLAS)

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Abstract

Background

High-quality leadership and chairing skills are vital for good performance in multidisciplinary tumor boards (MTBs), but no instruments currently exist for assessing and improving these skills.

Objective

To construct and validate a robust instrument for assessment of MTB leading and chairing skills.

Design and setting

We developed an observational MTB leadership assessment instrument (ATLAS). ATLAS includes 12 domains that assess the leadership and chairing skills of the MTB chairperson. ATLAS has gone through a rigorous process of refinement and content validation prior to use to assess the MTB lead by two urological surgeons (blinded to each other) in 7 real-live (n = 286 cases) and 10 video-recorded (n = 131 cases) MTBs.

Outcome measures and statistical analysis

ATLAS domains were analyzed via descriptive statistics. Instrument content was evaluated for validity using the content validation index (CVI). Intraclass correlation coefficients (ICCs) were used to assess inter-observer reliability.

Results

Instrument refining resulted in ATLAS including the following 12 domains: time management, communication, encouraging contribution, ability to summarize, ensuring all patients have treatment plan, case prioritization, keeping meeting focused, facilitate discussion, conflict management, leadership, creating good working atmosphere, and recruitment for clinical trials. CVI was acceptable and inter-rater agreement adequate to high for all domains. Agreement was somewhat higher in real-time MTBs compared to video ratings. Concurrent validation evidence was derived via positive and significant correlations between ATLAS and an established validated brief MTB leadership assessment scale.

Conclusion

ATLAS is an observational assessment instrument that can be reliably used for assessing leadership and chairing skills in cancer MTBs (both live and video-recorded). The ability to assess and feedback on team leader performance provides the ground for promotion of good practice and continuing professional development of tumor board leaders.

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References

  1. Department of Health. The NHS Cancer Plan. A plan for investment. A plan for reform. London 2000

  2. Department of Health. Manual for Cancer Services. 2004

  3. Chan WF, Cheung PS, Epstein RJ, Mak J (2006) Multidisciplinary approach to the management of breast cancer in Hong Kong. World J Surg 30(12):2095–2100

    Article  PubMed  Google Scholar 

  4. McAvoy B (2003) Optimising cancer care in Australia. Aust Fam Physician 32(5):369–372

    PubMed  Google Scholar 

  5. Taylor C, Munro AJ, Glynne-Jones R et al (2010) Multidisciplinary team working in cancer: what is the evidence? BMJ 340:c951

    Article  PubMed  Google Scholar 

  6. Wright FC, Lookhong N, Urbach D, Davis D, McLeod RS, Gagliardi AR (2009) Multidisciplinary cancer conferences: identifying opportunities to promote implementation. Ann Surg Oncol 16(10):2731–2737

    Article  PubMed  CAS  Google Scholar 

  7. Croke JM, El-Sayed S (2012) Multidisciplinary management of cancer patients: chasing a shadow or real value? An overview of the literature. Curr Oncol 19(4):e232–e238

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Lamb BW, Brown KF, Nagpal K, Vincent C, Green JS, Sevdalis N (2011) Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol 18(8):2116–2125

    Article  PubMed  Google Scholar 

  9. Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS (2012) Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13,722 women. BMJ 344:e2718

    Article  PubMed  PubMed Central  Google Scholar 

  10. Stephens MR, Lewis WG, Brewster AE et al (2006) Multidisciplinary team management is associated with improved outcomes after surgery for esophageal cancer. Dis Esophagus 19(3):164–171

    Article  PubMed  CAS  Google Scholar 

  11. Lamb BW, Wong HW, Vincent C, Green JS, Sevdalis N (2011) Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an observational assessment tool. BMJ Qual Saf 20(10):849–856

    Article  PubMed  Google Scholar 

  12. Harris J, Taylor C, Sevdalis N, Jalil R, Green JS (2016) Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT). Int J Qual Health Care 28(3):332–338

    Article  PubMed  PubMed Central  Google Scholar 

  13. Chemers MM (2008) Leadership effectiveness: an integrative review. Blackwell Handbook of Social Psychology: Group Processes: Blackwell Publishers Ltd; 2008. pp 376–399

  14. Taylor C, Ramirez AJ (2009) Multidisciplinary team members’ views about MDTworking: results from a survey commissioned by the National Cancer Action Team: National Cancer Action Team, London. http://ncat.nhs.uk/our-work/ensuring-better-treatment/multi-disciplinary-team-development-tab-inaction. Accessed 3 July 2017

  15. The National Cancer Action Team: the Characteristics of an effective multidisciplinary team (MDT) (2010). http://ncat.nhs.uk/our-work/ensuring-better-treatment/multi-disciplinary-team-development-tab-inaction. Accessed 3 July 2017

  16. Tobin M, Edwards JL (2002) Are psychiatrists equipped for management roles in mental health services? Aust N Z J Psychiatry 36(1):4–8

    Article  PubMed  Google Scholar 

  17. Hogg M, Vaughan G (2008) Social psychology, 5th edn. Pearson Education Limited, Essesx

    Google Scholar 

  18. Netemeyer RG, Bearden WO, Sharma S (2003) Scaling procedures: issues and applications. Sage, Thousand Oaks

    Book  Google Scholar 

  19. Lynn MR (1986) Determination and quantification of content validity. Nurs Res 35(6):382–385

    Article  PubMed  CAS  Google Scholar 

  20. DeVon HA, Block ME, Moyle-Wright P et al (2007) A psychometric toolbox for testing validity and reliability. J Nurs scholarsh 39(2):155–164

    Article  PubMed  Google Scholar 

  21. Polit DF, Beck CT (2006) The content validity index: are you sure you know what’s being reported? Critique and recommendations. Res Nurs Health 29(5):489–497

    Article  PubMed  Google Scholar 

  22. Korndorffer JR Jr, Kasten SJ, Downing SM (2010) A call for the utilization of consensus standards in the surgical education literature. Am J Surg 199(1):99–104

    Article  PubMed  Google Scholar 

  23. Bartko JJ (1966) The intraclass correlation coefficient as a measure of reliability. Psychol Rep 19(1):3–11

    Article  PubMed  CAS  Google Scholar 

  24. McGraw KO, Wong SP (1996) Forming inferences about some intraclass correlations coefficients (vol 1, pg 30, 1996). Psychol Methods 1(4):390

    Article  Google Scholar 

  25. Bland JM, Altman DG (1997) Cronbach’s alpha. Bmj 314(7080):572

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Fleissig A, Jenkins V, Catt S, Fallowfield L (2006) Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol 7(11):935–943

    Article  PubMed  Google Scholar 

  27. Ruhstaller T, Roe H, Thurlimann B, Nicoll JJ (2006) The multidisciplinary meeting: an indispensable aid to communication between different specialities. Eur J Cancer 42(15):2459–2462

    Article  PubMed  Google Scholar 

  28. McGlynn B, White L, Smith K et al (2014) A service evaluation describing a nurse-led prostate cancer service in NHS, Ayrshire and Arran. Int Urol Nurs 8(3):166–180

    Article  Google Scholar 

  29. Lamb BW, Sevdalis N, Mostafid H, Vincent C, Green JS (2011) Quality improvement in multidisciplinary cancer teams: an investigation of teamwork and clinical decision-making and cross-validation of assessments. Ann Surg Oncol 18(13):3535–3543

    Article  PubMed  CAS  Google Scholar 

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Funding

The study was funded by the National Institute for Health Research (NIHR), UK, via the Imperial Center for Patient Safety and Service Quality (www.cpssq.org), and the Barts Health NHS Trust R&D Department. Sevdalis was supported by the National Institute for NIHR Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. Sevdalis is a member of King’s Improvement Science, which is part of the NIHR CLAHRC South London and comprises a specialist team of improvement scientists and senior researchers based at King’s College London. Its work is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), Guy’s and St Thomas’ Charity, the Maudsley Charity, and the Health Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

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Correspondence to Rozh Jalil.

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Conflict of interest

Sevdalis is the Director of London Safety & Training Solutions Ltd., which provides team skills training and advice on a consultancy basis in hospitals and training programs in the UK and internationally. The other authors have no conflicts of interest to report.

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Jalil, R., Soukup, T., Akhter, W. et al. Quality of leadership in multidisciplinary cancer tumor boards: development and evaluation of a leadership assessment instrument (ATLAS). World J Urol 36, 1031–1038 (2018). https://doi.org/10.1007/s00345-018-2255-1

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  • DOI: https://doi.org/10.1007/s00345-018-2255-1

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