Temporal development of high-performance translational teams

Abstract

Successful translation involves the coupled application of knowledge-generating research with product development to advance a device, drug, diagnostic, or evidence-based intervention for clinical adoption to improve human health. Critical to the success of the CTSA consortium, translation can be more effectively accomplished by training approaches that focus on improving team-emergent knowledge skills and attitudes (KSAs) linked to performance. We earlier identified 15 specific evidence-informed, team-emergent competencies that facilitate translational team (TT) performance. Here, we examine the SciTS literature describing developmental, temporal dynamics, and adaptive learning stages of interdisciplinary teams and integrate these with real-world observations on TT maturation pathways. We propose that TTs undergo ordered developmental phases, each representing a learning cycle that we call Formation, Knowledge Generation, and Translation. We identify major activities of each phase linked to development goals. Transition to subsequent phases is associated with a team learning cycle, resulting in adaptations that enabling progression towards clinical translation. We present known antecedents of stage-dependent competencies and rubrics for their assessment. Application of this model will ease assessment, facilitate goal identification and align relevant training interventions to improve performance of TTs in the CTSA context.

Keywords: Translational teams; design for dissemination; development model; shared mental model; transactive memory system.

Figure 1.

The translational team (TT) model. A schematic of the strategic core of a CTSA-type TT. The strategic core includes the personnel involved in the translational research across its lifespan, whose integration and effective interactions are essential for team success. These members include traditional academic roles [such as the principal investigator, early career trainee (e.g., a CTSA-funded KL2 scholar), research scientists] and those in nontraditional roles (knowledge brokers, project managers, and mentors). During the conduct of translational research, the strategic core interfaces with external scientific and professional networks, including scientific societies, professional societies, and clinical research programs. In addition, external stakeholders (patient advocacy groups, industry partners, community groups) also play important roles at various stages of translation. As the TT advances across the phases of the translational spectrum, from preclinical (T0) to clinical and community adoption (T4), the TT generates two major outcomes. Two types of outcomes are knowledge generation and training, characteristics of academic knowledge-generating teams. Another outcome is development of a drug/device/intervention, characteristic of an industry product development team. Reproduced from [14], with permission.

Figure 2.

Learning perspectives on teams. Schematic view of input–process–output (IPO) conceptual model of team productivity. The IPO model suggests that many factors (inputs) influence a team’s activities (processes) that result in outcomes (knowledge generated and products developed). In this manuscript, we view team development from a team-based learning lens, that arises from these activities. Viewing translational teams (TTs) from a learning perspective has an important advantage over sequential IPO development models because learning models identify which team competencies are most important and when application of these skills will have the most impact. This model can be used in the assessment of team progress and provides guidance on stage-relevant, team-focused training for promoting TT performance.

Figure 3.

Stochastic growth of translational teams (TTs). Radar graphs depicting growth of four exemplar teams. Axes represent four research output factors and four team process factors assessed by independent observers in TTs in a CTSA environment. Outcomes are EC, external communication/collaboration; MM, meeting management; TL, transformative leadership; VC, vision and charter; PT, progress in translation; RC, research communication and program growth; RG, research generation; RP, research plan. Data from 2011 are shown in yellow and data from 2013 are shown in purple. Areas of overlap, which represent outcomes that have been maintained or improved in 2013 versus 2011, are shown in magenta. Note that TTs grow in different dimensions and to different extents. Reproduced with permission from [5].

Figure 4.

Disruptive events in translational team (TT) maturation. Inherent in the evolutionary learning model, team outcomes (publications, grants, intellectual property, interventions) do not accumulate in a linear process, but are marked by disruptive events serving as “critical moments” or “transition points.” These external events are shown by vertical arrows. Shown are two such external transition points associated with transition from formation to knowledge generation, and the transition from knowledge generation to transition. Transition points promote adaptive evolution of the TT, stimulating new collective knowledge and, in some cases, causing transition to the next phase of evolution.

Figure 5.

Evolutionary learning model for translational team (TT) maturation. Shown is a schematic model of the phases of TT development with external transition points. The team formation phase conducts activities focusing on enhancing team membership, establishing the basis of inter-team trust and developing a shared mental model. These are fostered by transformational leadership behaviors. As the team develops its hypothesis and acquires resources, it transitions into a knowledge generation phase. KSAs developed by the team in its formation phase support and are refined by activities in the knowledge generation phase. During knowledge generation, the team conducts activities in hypothesis testing, evaluation, and refinement. As the evidence base of effectiveness of the translation is established, the team transitions into the translation phase. KSAs (e.g., transactive memory systems, psychological safety and shared leadership) learned during the knowledge generation phase support activities in translation, including engaging new stakeholders, and purveyors. During translation, complex “Collaborative problem solving” leads to transdisciplinarity.