Title: Stages of team building
Course: Health Management, Ethics and Research - Ethiopia (Full)

Stages of team building

Team building usually refers to the process of selecting and creating a team within a community. To improve the performance of any health teams that you are keen to develop it is helpful to use the structured four-stage team building model described below.

Forming

The first stage in team development is the forming stage. During this stage your health team members get to know each other and find out which behaviours will be acceptable to the rest of the group members. Members establish initial rules and ways of working with each other. This exercise helps the team to create trust among team members.

Storming

During the storming stage, team members are encouraged to participate and engage with the issues and decisions that are key to the success of the community health team in achieving its goals. This is the stage when health team members may challenge, disagree with, and question one another. This stage can be uncomfortable for some members, but it is an important stage in tackling problems.

Norming

At this stage the team comes to an agreement on its purpose and plans. Members are clear what their roles and responsibilities are and how they fit into the team. The team has a sense of identity and tries to work together. By the time the team reaches this stage they know how to work with each other.

Performing

Group structure, norms and behaviour are understood and accepted. Members know how to work with each other and can effectively handle disagreements and misunderstandings. Differences have minimised and members have dealt with them. The group is now focused on accomplishing its purpose.

Look at Table 4.1 to see a detailed checklist of what to do at each stage of team building.

Table 4.1 Stages of team building

Stage of team building | Member issues | Team tasks | Team behaviour
Forming | Who are these people? | Identify member skills, talents, behavioural preferences | Develop trust
How do you relate to them and they to you? | Establish base level expectations and operating ground rules | Bonding
Are you in or out? | Establish common goals Establish roles | Greater bonding
Storming | Who's in control here? | Develop communication skills | Expressing different ideas, feelings and opinions
How will the rules really work ? | Test ground rules | Responding to leadership and followership
Are you up or down ? | Clarify roles, goals and resources in and outside the team Power and control issues | Becoming dependent on each other
Norming | How are we doing? | Utilise the ground rules and hold people accountable | Checking with members to assure understanding
Are we all clear about what we each bring to the team? | Continue to clarify goals | Clarifying, gatekeeping, encouraging participation and honesty
Are we able to work effectively with each other? | Processes for decision making and problem solving | Comfortable with differences of opinion or style
Performing | I know my value to this team | Achieve tasks efficiently | Use each other as sounding boards
We need each others' expertise | Exercise effective communication, problem solving and decision making skill | Rotate leadership and fellowship
We are a cohesive group | Give and receive performance and personal feedback effectively Share power and control | Demonstrate caring collaboration and independence

adapted from Tuckman, B.W and Jensen, M.A (1977) Stages of small group development revisited. Group Org. Studies 2; pp 419–27

Case Study 4.2 Four stages of team building

You are assigned to a rural village and as part of your work you are planning to establish a health team who can work with you to achieve the goal of improving the health of everybody in the community. You have already identified the members of your health team and need to start building your team. You want to apply the four stages of team building so that you will have an effective team.

As a Health Extension Practitioner selecting and creating this team within your community, what are the steps that you would follow to build a strong team?

Show answer

First, form a team by identifying community members who are well informed about health issues. They are interested in participating in the community health work, and are willing to become volunteers (the forming stage). After you have identified them, try to build trust and set ground rules and common goals for why you are coming together. Secondly, in the storming step, you may want to call a meeting and let everyone express their ideas, feelings and opinions. Do not worry if you find that people hold different views at this stage. Thirdly, in the norming stage, every team member should try to understand each other, as they go about decision making about health issues in the community. Fourthly, during the performing stage, the team should be able to go about the required work and demonstrate collaboration and independence.