1. Military Teamwork

2. The Plan A Fair comparison??? Military Teams ANZCA Teamwork Curricula
EMAC
Military Teamwork Curricula
AMAC
Questionnaire/Interpretation
The Big Five
Current areas of interest
Resilience training/markers

3. A Fair Comparison?
‘Team performance cannot be understood independently of the team’s organizational, work, and task environment’.
Tannenbaum, S.I., Beard, R.L. & Salas, E. (1992). Team building and its influence on team effectiveness: an examination of conceptual and empirical developments. In K. Kelley (ed.), Issues, Theory, and Research in Industrial/Organizational Psychology. Amsterdam: Elsevier Science Publishers B.V.

4. Military Teams Organisational structure (the paradox of rank)
Just in case versus Always on
Training versus Real work
Constancy of teams
Duress of environment
Selection criteria

5. EMAC Manual
“Effective management of emergencies, particularly in aviation, is now recognised to hinge on the behavioural aspects of leadership and the interaction with a team. There is growing recognition that the surgical and anaesthetic staff in an operating room similarly work as a team, particularly during emergencies. EMAC focuses on the role of the anaesthetist as the leader of this team.”
Brian Robinson
Feb 2001
Introduction to First Edition

6. ANZCA EMAC ‘Teamwork’ Curricula
2010 Instructor’s Manual
“Teamwork” 17
Learning outcome
“Declaring a crisis and calling for help, with effective leadership, teamwork, and communication.”
Goals of course HF background reading
“Teamwork, communication and error recognition and management are a big part of the human factors experience”
“Team”7 ( in teamwork context)
“Develop skills in working in a team”-
“Co-ordinate management priorities and effective team behaviours Allow team to allocate roles and consider preparatory actions”
“…however emphasis placed on the team approach to major trauma”
Incidence = 24
USED AS A VERB, ADVERB, NOUN learning outcomes x2
learning point
Teamwork exercise (No one does this –time Mx)
Learning outcome X2
“Declaring a crisis and calling for help, with effective leadership, teamwork, and communication.”
Debriefing point X3
discussion point X5
Goals of course HF background reading

7. Military‘Teamwork’ Curricula
ADF Advanced Medical Assistant Course TMP Page 107 of 443
Version 1.4 dated 01 Jul 2008 Printed copy is uncontrolled
2. Team Work
LWD 0-2 Leadership
• Teamwork refers to the environment of trust, support, interdependence and group effort that each leader must create and sustain.
• Teamwork is fundamental to any environment as it provides crucial speed and initiative. Some tasks are best done on an individual basis although the team may prompt and encourage that individual.

8. • The advantages of working as a team include:
- harnessing the talents of individuals members and gaining synergy in group effort allowing the sharing of limited resources
-the ability to respond quickly to contingencies as they arise
- the ability to complete complex tasks that cannot be completed on an individual basis
- greater social satisfaction for team members through sense of belonging and learning new skills
- the ability to provide support to individual members
• Tensions within a team may also arise. The supervisor is to ensure these problems are resolved to ensure the team remains focused and achieves its goals.
• The team structure is vital for ease of
communication and decision making. Two key considerations are taken into account:
- Identify the team goals
- The second consideration involves focus on the following:
􀂃 clear roles and responsibilities
􀂃 effective communication
􀂃 performance feedback
􀂃 objective judgement
This will allow the leaders to recognise the various talents in team members and harness these to assist the team to operate most effectively.

9. FANZCA/ADF Comparison
FANZCA REGISTRAR
ADVANCED MILITARY MEDIC (SEN/ PARAMEDIC)
Five years
14 weeks (90-100)
12 Modules
(2013 EMAC Compulsory)
CARDIAC- ASTHMA- ANAPHYLAXIS- TRAUMA- UNCONSCIOUS
5-10 Simulations per Individual /5 years (2/52 Access +/- Individual needs assessment , Registrar tutorial, EMAC)
Average 35 times Team- Roles- Roles assessment (No churn)
Curriculum HF
Technical PROTOCOLS
Technical PROTOCOLS
Clinical care- Admin- Teamwork- Leadership (2IC)

10. Teamwork Questionnaire
1. In an operational war fighting military context, what do you understand by the term ‘teamwork’ and/or alternatively how would you define teamwork?
WARFIGHTING
HEALTH CARE
Dynamic process to achieve varying aspects
A strategy
Achieving a common goal
Highly influenced by a hierarchy of structured seniority. (Command)
Structured differently to conventional teamwork behaviour
People working together to achieve tasks in a safe and calm manner.
People looking out for each other.
Individual can work together with others to form a cohort to achieve any and all challenges. (with disregard to ones wellbeing )
Collection of personnel who are operating in a chain of command to execute a pre determined objective

11. Teamwork Questionnaire
2. What generic individual and/or collective group skills are essential for a military war fighting team to function at a very high level?
WARFIGHTING
HEALTH CARE
Decision making
Group decision making
All fighters trained equally
Equality equals effectiveness (mission body)
Command leadership
Socialisation irrelevant to decision making process
Teamwork, courage, determination, knowledge, communication, honour, loyalty.
Good communication, teamwork, Leadership, discipline, initiative, BONDING essential.
Leadership, competence, effective communication, situational awareness.
Courage.

12. Teamwork Questionnaire
3. What teamwork skills should be acquired or enhanced as a result of team training?
WARFIGHTING
HEALTH CARE
Acceptance of authority.
Looking out for team members, providing support when required.
Mateship trust loyalty, communication skills.
Communication.
Interoperability.

13. Teamwork Questionnaire
4. What individual skills should be acquired or enhanced by team training?
WARFIGHTING
HEALTH CARE
Discipline
Honour, confidence, communication, loyalty, integrity, honesty, courage.
Importance of communication.
Importance of individual contribution to team objectives.

14. Teamwork Questionnaire
5. What do you understand by the term ‘team leadership’?
WARFIGHTING
HEALTH CARE
Influence on others to achieve the set goal
Inspire the team to act
Intelligence
Charisma
Previous demonstration
A group or body of people with no definitive leader role,
Every member contributes and affirms a position therefore every member is classed as a leader. (Singapore Army)
Everyone is able to contribute an input for an outcome.
No power vacuum or struggle, there is no one person in charge.
A collective with a clear goal.
Leadership desirable from all team members. (Caveat: Only one command.)
Team led by persons

15. Teamwork Questionnaire
6. Anaesthetists learn non technical skills. One tool to teach these is the Anaesthetists’ Non Technical Skills (ANTS) system. These skills are defined as the cognitive, social and personal resource skills that complement technical skills. In the ANTS system these elements are comprised of
Coordinating activities with team members
Exchanging information
Using authority and assertiveness
Assessing capabilities, and
Supporting others.
Flin R. et al Anaesthetists’ non technical skills. British Journal Anaesthesia. 2010;105 (1):
How do you perceive military team training to be any different? For the military which features are absent or dissimilar to the teamwork behaviours listed? 
WARFIGHTING
HEALTH CARE
Ability to lead
Getting the best out of each individual
Promote the teams positives, not the faults
Similar
Non judgemental decisions.
Use of authority is key.

16. Teamwork Questionnaire
Another list of perceived core competencies for teamwork are
Mutual performance monitoring
Back up behaviours
Adaptability
Active leadership (described as creating a climate that encourages the other competencies and shapes the mental model of their teams), and
Team orientation
Day D V et al, Leadership capacity in teams. The Leadership Quarterly. 2004; 15:
How do you perceive military team training to be any different? For the military which features are absent or dissimilar to the teamwork behaviours listed?
WARFIGHTING
HEALTH CARE
Train in all- Lead in the important
Active leadership most influential
Senior complete all tasks
Exceeding personal and team limitations
Perfect match to military
Similar- Mutual performance monitoring may pose issues for subordinates.

17. Teamwork Questionnaire
8. In what general ways do you perceive military war fighting teams are required to be different to high reliability industry civilian teams? (high reliability industry examples = Nuclear power generation, commercial aviation)
WARFIGHTING
HEALTH CARE
Practice hands off leadership to develop skills
Practice hands on leadership to maintain direction
Total command in extremes of war -fighting
Guardians of their country.
Soldier first- speciality second.
Command has absolute authority.
Acceptance of ever present risk of death.

18. Interpretation Groups become teams through disciplined action
Real teams are deeply committed to their purpose, goals, and approach.
‘High performance’ Team members are also highly committed to one another.
THE WISDOM OF TEAMS: Creating the High Performance Organization
Jon Katzenbach ,Douglas Smith
Harper Business 2000
Global Learning Communities Publications Vol.3 Issue 5

19. The Big Five!
Team leadership (direct and coordinate, assess, assign, motivate, establish a positive atmosphere, develop team KSAs )
Mutual performance monitoring (develop common understandings to accurately monitor team mate performance)
Back up behaviour (ability to shift workload among members to achieve balance)
Adaptability/Flexibility (adjust strategies reallocation resources, or team repertoire)
Team/ Collective orientation (belief in the importance of team goal’s over individual member’s goals)
C S Burke, E Salas, K Wilson-Donnelly, et al. Qual Saf Health Care : i96-i104
For over 30 years, military-sponsored research has advanced the state-of-the science by defining the essential components of teamwork (Salas et al)
Jeffrey M. Beaubien, Ph.D., David P. Baker, Ph.D., Amy K. Holtzman, M.A HOW MILITARY RESEARCH CAN IMPROVE TEAM TRAINING EFFECTIVENESS IN OTHER HIGH-RISK INDUSTRIE Proceedings of the 45th Annual Conference of the International Military Testing Association – 2003.

20. Resilience
‘Extreme environments involve exceptional risk and pose the greatest need for resilience.’
Christopher P. Nemeth Resilience Engineering: The Birth of a Notion Chapter p 7. Ashgate
Individuals
Skomorovsky A Sudom K ‘Role of Hardiness in Psychological Well being of CF Officer Candidates’ Military Medicine176, 1:
Small teams/Systems
Resilience repertoire
Poorly understood. (Skills, behaviours, attitudes)
Furniss. D. et al Reliability Engineering and System Safety 96 (2011) 2-10
PTSD/Adaption 17 programs (US)
Bowles et al ‘Military Organisation s and Programs Contributing to Resilience Building’ Military Medicine 176, 6:
Australian – ‘battleSMART’ Self regulation and Resilience training.

21. HMAS CANBERRA