This dissertation evaluates the relationship between five team knowledge building processes (i.e., information exchange, knowledge sharing, option generation, evaluation of alternatives, and regulation), the external representations constructed by a team during a performance episode, and performance outcomes in a problem solving task. In a broad range of domains such as the military, and healthcare, team-based work structures used to solve complex problems; however, the bulk of research on teamwork to date has dealt with behavioral coordination in routine tasks. This leaves a gap in the theory available for developing interventions to support collaborative problem solving, or knowledge-based performance, in teams. Sixty nine three person teams participated in a strategic planning simulation using a collaborative map. Content analysis was applied to team communications and the external representations team members created using the collaborative tool. Regression and multi-way frequency analyses were used to test hypotheses about the relationship between the amount and sequence of team process behaviors respectively and team performance outcomes. Additionally, the moderating effects of external representation quality were evaluated. All five team knowledge building processes were significantly related to outcomes, but only one (i.e., knowledge sharing) in the simple, positive, and linear way hypothesized. Information exchange was negatively related to outcomes after controlling for the amount of acknowledgements team members made. Option generation and evaluation interacted to predict outcomes such that higher levels of evaluation were more beneficial to teams with higher levels of option generation. Regulation processes exhibited a negative curvilinear relationship with outcomes such that high and low performing teams engaged in less regulation than did moderately performing teams. External representation quality moderated a composite team knowledge building process variable such that better external representations were more beneficial for teams with poorer quality processes than for teams with high quality process. Additionally, there were significant differences in the sequence of team knowledge building processes between high and low performing teams as well as between groups based on high and low levels of external representation quality. The team knowledge building process framework is useful for understanding complex collaborative problem solving. However, these processes predict performance outcomes in complex and inter-related ways. Further implications for theories of team performance and applications for training, designing performance support tools, and team performance measurement are discussed.

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Objectives: The objectives of this research were to describe the interactions (formal and informal) in which macrocognitive functions occur and their location on a pediatric intensive care unit (PICU); describe challenges and facilitators of macrocognition using three constructs of space syntax (openness, connectivity, and visibility); and analyze the health care built environment (HCBE) using those constructs to explicate influences on macrocognition. Background: In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple health care settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, “Macrocognition in the Health Care Built Environment” (m-HCBE) addresses this relationship. Methods: A focused ethnographic study was conducted, including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data. Results: Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs). Conclusions: Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help to advance the m-HCBE theory for improving physical space by designing new spaces or refining existing spaces, or for adapting IPT practices to maximize formal and informal SMI opportunities; this lays the groundwork for future research to improve safety and quality for patient and family care.