Editorial
Interprofessional and Interdisciplinary Collaboration: Moving Forward
Policy, Politics, & Nursing Practice 14(3–4) 115–116 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1527154414533616 ppn.sagepub.com
Sally S. Cohen, PhD, RN, FAAN
Over the past few years, there has been increasing emphasis on the importance of interprofessional collaboration in practice, research, and health policy. It has become de rigueur among government and private funders to require such partnerships in applications from potential grantees. Examples of organizational efforts to enhance interprofessional education abound. In 2009, six national organizations representing schools of dentistry, medicine, nursing, osteopathic medicine, pharmacy, and public health “formed a collaborative to promote and encourage constituent efforts that would advance substantive interprofessional learning experiences to help prepare future clinicians for team-based care of patients” (Interprofessional Collaborative Practice [ICP], 2011, p. 1). Their work culminated in a national conference and a report on core competencies for interprofessional collaborative practice (ICP, 2011). In 2012, the Center for Applied Research in Philadelphia, in conjunction with the Robert Wood Johnson Foundation, convened a meeting of 12 nurse and physician leaders “to seek a consensus document on interprofessional collaboration.” Although they were unable to reach consensus, they identified “lessons learned” for next steps. This included that “interprofessional collaboration is already occurring on the ground—the problem is at the organizational level” (Jablow, 2013, p. 1). The federal government’s support for interprofessional practice and education collaboration resulted in a Health Resources and Services Administration grant of more than $4 million to the University of Minnesota to run the National Coordinating Center for Interprofessional Education and Collaborative Practice. Four foundations—the Robert Wood Johnson Foundation, the Josiah Macy Jr. Foundation, the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation—gave a total of $8.6 million over 4 years for the Center. Another example of foundation support for interprofessional education was in 2013, when the Josiah Macy Jr. Foundation convened a group of national experts to discuss how to “align” interprofessional education with changes in health care delivery (Cox & Naylor, 2013).
Mary Naylor, PhD, RN, FAAN (University of Pennsylvania) and Malcolm Cox, MD (U.S. Department of Veterans Affairs) co-chaired the conference. In her opening remarks, Naylor charged the attendees with taking the issues of interprofessional education and health care redesign “to the next level.” She referred to the ‘“marriage that needs to happen between teambased care and education,’” which currently are “two disparate entities” (Cox & Naylor, 2013, p. 128). These conferences, grants, and reports suggest the challenges and progress in convening clinicians and national organizations to reach consensus on interprofessional collaboration and education. From another perspective, foundations, academic health centers, and government entities have shown growing interest in interdisciplinarity, which is distinct from interprofessionalism. Interdisciplinarity includes the ways that experts in different disciplines might interact as they study societal issues and problems for which no single discipline can provide solutions. Because society and knowledge are ever changing, interdisciplinarity is dynamic, with moving boundaries. Nonetheless, a “taxonomy of interdisciplinarity” exists and it behooves clinicians, academicians, researchers, and policy experts to be mindful of this taxonomy when discussing interdisciplinary health care, research, or health policy projects. The three major typologies of interdisciplinarity are multidisciplinarity, interdisciplinarity, and transdisciplinarity. Multidisciplinarity sequences or juxtaposes different disciplines in analyzing issues. Interdisciplinarity entails integration, linking, or blending of ideas and concepts from different disciplines. Lastly, transdisciplinarity refers to a shared overarching framework that “transcends the narrow scope of disciplinary worldviews” (Klein, 2010, p. 24). The major point here is to appreciate that when working with individuals from different disciplines, collaboration might take the form of any one or a combination of these three typologies. Moreover, people may use the term “interdisciplinary” but be closer in meaning to multidisciplinary or transdisciplinary. Furthermore, the definition of a discipline might vary among the participants of the collaboration. It might refer to different
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clinical specializations (i.e., orthopedics, cardiology, psychiatry, or endocrinology). It can also refer to the social sciences and other fields such as law, history, public administration, nursing, or medicine, which are all part of health policy research and practice, depending on the issue and approach. Therefore, it is important that when engaging in collaborations with experts from different disciplines, that the participants share the same notion of the type of interdisciplinarity at play. And, that they be clear as to the distinctions they might be making between interprofessional and interdisciplinary collaboration. Where do we go from here? One thought is to require all players or participants in interprofessional or interdisciplinary collaboration to identify their goals and perspectives on the project. This could facilitate teamwork and efficiency. Another idea is to have an open conversation before engaging in the work at hand, to discuss the differences among interprofessional and interdisciplinary collaboration, and to seek mutual understanding about the group’s approach. Lastly, it is also important that faculty teaching health policy introduce these themes to students, especially those at doctoral levels. In so doing, we might develop a new cadre of health policy scholars who have an appreciation for these nuances and use them as a starting point, not afterthought, for their work. This would apply regardless of whether scholars focus on health care practice, educating professionals, or research in health policy or practice. This is especially important as the boundaries among issues, disciplines, and professions blur.
One goal of clarifying and defining terms at the outset of a project is to improve our ability to analyze and discuss these issues. Perhaps that will lead to new types of interdisciplinary and interprofessional relationships with our colleagues as we strive to improve health care systems and population outcomes for all. Sally S. Cohen, PhD, RN, FAAN Deputy Editor, PPNP References Cox, M., & Naylor, M. (2013, June). Transforming patient care: Aligning interprofessional education with clinical practice redesign. In Highlights from the conference discussion (p. 128). Atlanta, GA: USA. Proceedings of a Conference sponsored by the Josiah Macy Jr. Foundation. Retrieved from http://macyfoundation.org/docs/macy_ pubs/JMF_TransformingPatientCare_Jan2013Conference_ fin_Web.pdf. Interprofessional Collaborative Practice. (2011). Core competencies for interprofessional practice. Retrieved from http:// www.aacn.nche.edu/education-resources/ipecreport.pdf. Jablow, P. (2013). How to foster interprofessional collaboration between physicians and nurses? Incorporating lessons learned in pursuing a consensus. Retrieved from http://www. rwjf.org/en/research-publications/find-rwjf-research/2013/ 01/how-to-foster-interprofessional-collaboration-betweenphysicians.html. Klein, J. T. (2010). A taxonomy of interdisciplinarity. In R. Frodeman, J. T. Klein, & C. Mitcham (Eds.), The Oxford handbook of interdisciplinarity (pp. 15–30). New York, NY: Oxford University Press.
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Interprofessional and Interdisciplinary Collaboration: Moving Forward
Policy, Politics, & Nursing Practice 14(3–4) 115–116 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1527154414533616 ppn.sagepub.com
Sally S. Cohen, PhD, RN, FAAN
Over the past few years, there has been increasing emphasis on the importance of interprofessional collaboration in practice, research, and health policy. It has become de rigueur among government and private funders to require such partnerships in applications from potential grantees. Examples of organizational efforts to enhance interprofessional education abound. In 2009, six national organizations representing schools of dentistry, medicine, nursing, osteopathic medicine, pharmacy, and public health “formed a collaborative to promote and encourage constituent efforts that would advance substantive interprofessional learning experiences to help prepare future clinicians for team-based care of patients” (Interprofessional Collaborative Practice [ICP], 2011, p. 1). Their work culminated in a national conference and a report on core competencies for interprofessional collaborative practice (ICP, 2011). In 2012, the Center for Applied Research in Philadelphia, in conjunction with the Robert Wood Johnson Foundation, convened a meeting of 12 nurse and physician leaders “to seek a consensus document on interprofessional collaboration.” Although they were unable to reach consensus, they identified “lessons learned” for next steps. This included that “interprofessional collaboration is already occurring on the ground—the problem is at the organizational level” (Jablow, 2013, p. 1). The federal government’s support for interprofessional practice and education collaboration resulted in a Health Resources and Services Administration grant of more than $4 million to the University of Minnesota to run the National Coordinating Center for Interprofessional Education and Collaborative Practice. Four foundations—the Robert Wood Johnson Foundation, the Josiah Macy Jr. Foundation, the Gordon and Betty Moore Foundation, and The John A. Hartford Foundation—gave a total of $8.6 million over 4 years for the Center. Another example of foundation support for interprofessional education was in 2013, when the Josiah Macy Jr. Foundation convened a group of national experts to discuss how to “align” interprofessional education with changes in health care delivery (Cox & Naylor, 2013).
Mary Naylor, PhD, RN, FAAN (University of Pennsylvania) and Malcolm Cox, MD (U.S. Department of Veterans Affairs) co-chaired the conference. In her opening remarks, Naylor charged the attendees with taking the issues of interprofessional education and health care redesign “to the next level.” She referred to the ‘“marriage that needs to happen between teambased care and education,’” which currently are “two disparate entities” (Cox & Naylor, 2013, p. 128). These conferences, grants, and reports suggest the challenges and progress in convening clinicians and national organizations to reach consensus on interprofessional collaboration and education. From another perspective, foundations, academic health centers, and government entities have shown growing interest in interdisciplinarity, which is distinct from interprofessionalism. Interdisciplinarity includes the ways that experts in different disciplines might interact as they study societal issues and problems for which no single discipline can provide solutions. Because society and knowledge are ever changing, interdisciplinarity is dynamic, with moving boundaries. Nonetheless, a “taxonomy of interdisciplinarity” exists and it behooves clinicians, academicians, researchers, and policy experts to be mindful of this taxonomy when discussing interdisciplinary health care, research, or health policy projects. The three major typologies of interdisciplinarity are multidisciplinarity, interdisciplinarity, and transdisciplinarity. Multidisciplinarity sequences or juxtaposes different disciplines in analyzing issues. Interdisciplinarity entails integration, linking, or blending of ideas and concepts from different disciplines. Lastly, transdisciplinarity refers to a shared overarching framework that “transcends the narrow scope of disciplinary worldviews” (Klein, 2010, p. 24). The major point here is to appreciate that when working with individuals from different disciplines, collaboration might take the form of any one or a combination of these three typologies. Moreover, people may use the term “interdisciplinary” but be closer in meaning to multidisciplinary or transdisciplinary. Furthermore, the definition of a discipline might vary among the participants of the collaboration. It might refer to different
Downloaded from ppn.sagepub.com by guest on June 7, 2015
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clinical specializations (i.e., orthopedics, cardiology, psychiatry, or endocrinology). It can also refer to the social sciences and other fields such as law, history, public administration, nursing, or medicine, which are all part of health policy research and practice, depending on the issue and approach. Therefore, it is important that when engaging in collaborations with experts from different disciplines, that the participants share the same notion of the type of interdisciplinarity at play. And, that they be clear as to the distinctions they might be making between interprofessional and interdisciplinary collaboration. Where do we go from here? One thought is to require all players or participants in interprofessional or interdisciplinary collaboration to identify their goals and perspectives on the project. This could facilitate teamwork and efficiency. Another idea is to have an open conversation before engaging in the work at hand, to discuss the differences among interprofessional and interdisciplinary collaboration, and to seek mutual understanding about the group’s approach. Lastly, it is also important that faculty teaching health policy introduce these themes to students, especially those at doctoral levels. In so doing, we might develop a new cadre of health policy scholars who have an appreciation for these nuances and use them as a starting point, not afterthought, for their work. This would apply regardless of whether scholars focus on health care practice, educating professionals, or research in health policy or practice. This is especially important as the boundaries among issues, disciplines, and professions blur.
One goal of clarifying and defining terms at the outset of a project is to improve our ability to analyze and discuss these issues. Perhaps that will lead to new types of interdisciplinary and interprofessional relationships with our colleagues as we strive to improve health care systems and population outcomes for all. Sally S. Cohen, PhD, RN, FAAN Deputy Editor, PPNP References Cox, M., & Naylor, M. (2013, June). Transforming patient care: Aligning interprofessional education with clinical practice redesign. In Highlights from the conference discussion (p. 128). Atlanta, GA: USA. Proceedings of a Conference sponsored by the Josiah Macy Jr. Foundation. Retrieved from http://macyfoundation.org/docs/macy_ pubs/JMF_TransformingPatientCare_Jan2013Conference_ fin_Web.pdf. Interprofessional Collaborative Practice. (2011). Core competencies for interprofessional practice. Retrieved from http:// www.aacn.nche.edu/education-resources/ipecreport.pdf. Jablow, P. (2013). How to foster interprofessional collaboration between physicians and nurses? Incorporating lessons learned in pursuing a consensus. Retrieved from http://www. rwjf.org/en/research-publications/find-rwjf-research/2013/ 01/how-to-foster-interprofessional-collaboration-betweenphysicians.html. Klein, J. T. (2010). A taxonomy of interdisciplinarity. In R. Frodeman, J. T. Klein, & C. Mitcham (Eds.), The Oxford handbook of interdisciplinarity (pp. 15–30). New York, NY: Oxford University Press.
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