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The examination of culture in pediatric cardiac care is particularly important for several key reasons: first, it represents high-stakes medicine, second, there are multiple stakeholders requiring collaboration between cardiologists, surgeons, anaesthesiologists, perfusionists, nursing staff, and allied health care professionals, and finally, both the patient and the family are intimately involved in the care pathway. This review article investigates some of the critical components to building an effective culture, drawing upon similarities in other disciplines, thereby fostering high performance multidisciplinary teams in congenital cardiology care. Strategies to change culture such as Kotter\u2019s model of change are also discussed. High performance teams share one common vital characteristic: <jats:italic>psychological safety<\/jats:italic> for team members to speak their minds, thereby fostering an open culture, in which creativity can flourish to facilitate major breakthroughs. 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