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Team communication is considered a key factor for team performance. Importantly, voicing concerns and suggestions regarding work-related topics—also termed speaking up—represents an essential part of team communication. Particularly in action teams in high-reliability organizations such as healthcare, military, or aviation, voice is crucial for error prevention. Although research on voice has become more important recently, there are inconsistencies in the literature. This includes methodological issues, such as how voice should be measured in different team contexts, and conceptual issues, such as uncertainty regarding the role of the voice recipient. We tried to address these issues of voice research in action teams in the current literature review. We identified 26 quantitative empirical studies that measured voice as a distinct construct. Results showed that only two-thirds of the articles provided a definition for voice. Voice was assessed via behavioral observation or via self-report. Behavioral observation includes two main approaches (i.e., event-focused and language-focused) that are methodologically consistent. In contrast, studies using self-reports showed significant methodological inconsistencies regarding measurement instruments (i.e., self-constructed single items versus validated scales). The contents of instruments that assessed voice via self-report varied considerably. The recipient of voice was poorly operationalized (i.e., discrepancy between definitions and measurements). In sum, our findings provide a comprehensive overview of how voice is treated in action teams. There seems to be no common understanding of what constitutes voice in action teams, which is associated with several conceptual as well as methodological issues. This suggests that a stronger consensus is needed to improve validity and comparability of research findings.

Although identifying cues indicating a problem represents a crucial aspect of team adaptation, little is known about the conditions under which team members do this correctly. To address this issue, the current study focused on the motivational basis of cue identification by investigating interactive effects of members' regulatory focus, their contribution redundancy, and the team performance context. Participants working in 105 three-person teams were asked to identify problem cues in a signal detection task. Utilizing a 2 (regulatory focus: promotion vs. prevention) x 2 (performance context: status quo vs. loss) x 2 (contribution redundancy: low vs. high) mixed analysis of variance (ANOVA) design with contribution redundancy as a within-participants factor, we obtained the predicted three-way interaction: In the status quo condition, prevention-focused, but not promotion-focused, team members were less accurate in identifying problem cues when their contributions were redundant. Our findings contribute to a better understanding of the motivational basis of team adaptation.

Objective: This field study aimed at examining the role of anesthesia teams' adaptive coordination in managing changing situational demands, such as in nonroutine events (NREs). Background: Medical teams' ability to adapt their teamwork (e.g., their coordination activities) to changing situational demands is crucial to team performance and, thus, to patient safety. Whereas the majority of previous studies on the matter have focused on critical but rare events, it has recently been pointed out that the effective management of NREs is a key challenge to medical teams. Hence this study investigated the relationship between coordination activities, NRE occurrence, and team performance. Method: We videotaped 22 anesthesia teams during standard anesthesia induction and recorded data from the vital signs monitor and the ventilator. Coordination was coded by a trained observer using a structured observation system. NREs were recorded by an experienced staff anesthesiologist using all three video streams. Checklist-based team performance assessment was also performed by an experienced staff anesthesiologist. Results: We found that anesthesia teams adapt their coordination activities to changing situational demands. In particular, the increased occurrence of NREs caused an increase in the time the teams spent on task management. A stronger increase in the teams' task management (i.e., more adaptive coordination) was related to their performance. Conclusion: Our results emphasize the importance of adaptive coordination in managing NREs effectively. Application: This study provides valuable information for developing novel team training programs in health care that focus on adaptation to changing task requirements, for example, when faced with NREs.