A Conceptual Framework of How Meeting Mindsets Shape and Are Shaped by Leader–Follower Interactions in Meetings

In this conceptual paper, we define a person's meeting mindset as the individual belief that meetings represent opportunities to realize goals falling into one of three categories: personal, relational, and collective. We propose that in alignment with their respective meeting mindsets, managers use specific leadership claiming behaviors in team meetings and express these behaviors in alignment with the meeting setting (virtual or face-to-face) and their prior experiences with their employees. Employees’ responses, however, are also influenced by their meeting mindsets, the meeting setting, and prior experiences with their managers. The interplay between managers’ leadership claiming behavior and their employees’ responses shapes leader–follower relations. Embedded in the team context, the emerging leader–follower relations impact the meaning of meetings. We outline match/mismatch combinations of manager–employee meeting mindsets and discuss the influence that a manager and employee can have on each other's meeting mindset through their behavior in a meeting. Plain Language Summary Have you ever had the experience of entering a team meeting and quickly realizing that your idea of how the meeting conversation should be approached did not align with your boss's understanding of the meeting purpose? This is indeed a common experience in meetings between managers and their employees. While we understand much about the communication dynamics that occur in meetings, we know less about what motivates people to communicate in certain ways in meetings. In this conceptual paper, we classify people's understanding of meetings as being driven by one of three purposes: [1] to strategically position and promote themselves (which reflects a personal meeting mindset), [2] to shape collaborations and to ensure reciprocation (which reflects a relational meeting mindset), or [3] to strengthen the team identity and increase the willingness to go the extra mile for the team (which reflects a collective meeting mindset). Meeting mindsets shape how people enact their leader or follower role in meetings—that is, how a manager exhibits leadership and how employees react. However, managers’ and employees’ meeting mindsets may not necessarily match, which can trigger tensions and may ultimately change the way in which managers or employees define the meaning of meetings. Our research helps managers to comprehend the reasoning behind their own and other people's meeting behavior and may promote reflection on one's leadership approach, particularly in a team meeting context. It can also help employees to grasp the power they can have in terms of actively shaping their managers’ meeting mindsets.

Adaptation of Geriatric Interprofessional Education from In-Person to Virtual Simulation

We modified an in-person simulation-enhanced interprofessional education model as necessitated by COVID-19 restrictions to a fully virtual education experience. Online prework remained unchanged but adjustments were made related to previously in-person activities. Diverging from the in-person training we held live virtual poster sessions with learner-presenter interaction. In preparation for their role in the team meeting simulation, learners were moved into preassigned profession-specific breakout rooms for a live virtual huddle with facilitators. Next, learners were moved to preassigned interprofessional breakout rooms where they began the simulated team meeting. After initial discussion, a standardized patient joined the breakout room to present the patient/caregiver perspective. The event ends with a virtual reflective debrief focused on interprofessional collaborative competencies.

P-P50 Analysis of the efficiency of the hepatobiliary multidisciplinary team meeting to identify quality improvement strategies

Background The multidisciplinary team meeting is the mainstay of management of patients with hepatopancreatobiliary (HPB) cancer and is considered the gold standard of care. Disadvantages of these meetings include large numbers of patients to be discussed covering multiple super-specialities over a short time span. This can lead to decision fatigue amongst clinicians. Logistical factors such as information technology and presence of clinicians with relevant expertise may also hamper the progress of the meeting. The aim of this study was to analyse the efficiency of our HPB MDT with a view to identifying multi-factorial quality improvement interventions. Methods 13 weeks of prospectively generated multidisciplinary team meeting outcomes were analysed from our departments weekly 150-minute long MDT meeting between 01/06/21 and 24/08/21. Patient demographics and pathology were noted. The number of overall discussions in each meeting were recorded. Number of patients in each sub-category (1. Regional pancreatic cancer service, 2. Hepatocellular carcinoma or liver adenoma, 3. pancreatic cystic neoplasms, 4. Gallbladder cancer and cholangiocarcinoma, 5. Pancreatic neuroendocrine tumours and 6. Other) were recorded. The number of patients without a recorded outcome was collated and reasons for no outcome being generated were categorised. Results 174/ 869 patients (20 %) did not receive an outcome from the meeting and were carried forward to the next week. Of the patients carried forward to the next week; 33/177 (18.6%) had no available histopathology following biopsies. Of these 33 patients, 23 did not have post-operative histopathology yet available for discussion. 82/177 (46 %) patients did not have the relevant investigations performed or available to move the discussion forward. These investigations were wide ranging and included radiological and endoscopic interventions. Of these, 19 patients (2 % over-all) had not had images sent across from a peripheral centre. 3 patients required both histology and radiology for further discussion. 59/869 (6%) of patients were not discussed due to time constraints. This equated to an average of 4 patients per meeting. Conclusions This study demonstrates the breadth and depth of a general HPB MDT. Strategies are required to simplify the MDT process to allow for time for discussion of the most complex patients, in particular those requiring surgery. Multifactorial reasons for a lack of MDT outcome at any single meeting have been found in this study. This signifies that a more robust triage process involving multiple specialities needs to be considered. Logistical factors also need to be in place allowing for transfer of relevant images from peripheral units. Histopathology reporting takes time and appropriate expectations for the availability of these results needs to be in place. The next step in this study is to identify and implement effective quality improvement strategies to improve outcome rates and allow more time for complex case discussions.

Geriatric Interprofessional Education: In-Person Simulation

Our in-person geriatric interprofessional training model is layered with scaffolds of active learning, tabletop team meeting simulation, assessment of older adult community members at risk for falls, and reflective feedback. The first step addresses knowledge acquisition via online didactic content. The second step reinforces the knowledge gained in the online didactics through in-person posters and interactive skills practice, followed by a profession-specific huddle to communicate patient assessment findings. The third step is an interprofessional team meeting simulation based on a case study of a complex geriatric patient. The fourth step is performing a supervised assessment on an older adult. The assessment incorporates the assessment tools practiced during the poster/skills session and team skills learned in the didactics and simulation. This is followed by the design of an interprofessional team-developed patient-centered plan of care. The event ends with a reflective debrief focused on interprofessional collaborative competencies.