Interprofessional communication is all the rage these days! No, seriously, if you want to get work done on big problems, it means talking to people outside your hallway. In this episode, you’ll learn some of the structural issues that can get in the way of interprofessional communication. And how to address them, so you can get work done around here.
I was talking recently to a health administrator about communication between different groups in his hospital system. He said,
“Interdepartmental communication has been historically very difficult. There were different incentives that made working together something people didn’t want to do. If your department didn’t make the numbers, you’re in trouble, you’re the one out of a job.”
I’ve done an earlier podcast episode about some personal and interpersonal constraints on interprofessional communication. This administrator’s comments point to some of the structural issues that can get in the way of interprofessional communication. And that’s what this episode is about.
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Most of my experience in interprofessional communication is in the education sector, and most of that in higher ed. Departments within the same academic unit can be quite different. These differences are perhaps made the more frustrating because there are so many assumed similarities. In my experience, it was almost worse when we all thought we had been comparing apples to apples, only to find out later we hadn’t been. Some of this friction had to do with differences in our disciplines. Some of it had to do with institutional structures. So I’m going to talk about both these. Briefly.
Let’s start with the interdisciplinary part. “The health sector” is hardly monolithic, right? It’s huge. There are so many parts to it. even within the same institution, Different departments have different knowledge and experience, and potentially different priorities. So, in addition to all the tricky problems always involved with collaboration, you are also dealing with the equally urgent and complex ‘problem’ of different intra-organizational or disciplinary approaches to whatever issues you are there to address.
I’m going to ask you to try a bit of a thought experiment because I think it may be helpful. imagine that every interprofessional encounter is a kind of cultural encounter. Communicating across professional ‘cultures,’ then, I suggest, involves making visible and being explicit about much of what is usually taken for granted in our corner of the hallway, right? our own disciplines or specializations. Our own specific approaches tend to become invisible to us, so I’m going to start there.
To get better at your own interprofessional communication and collaboration, I am asking you to think about your own professional learning. This includes what you might have come to take for granted in your professional communities… that can make things tricky when interacting with other professional communities. So take a walk back down memory lane for a moment. Think back to your professional program—nursing school, medical school, pharmacy school, public health, veterinary school, you get what I mean. In your professional program, you learned the specialized language of your discipline while you learned medical and scientific information. There were thousands of new terms, which you were expected to use with your peers.
But you learned more than how to speak the language. The term academic socialization refers to the ways postsecondary students are brought into the culture of a discipline through their study, and specifically through discipline-specific language use. Professors Mary Lea and Brian Street, in their explanation of academic socialization, add that:
“Students acquire the ways of talking, writing, thinking, and using literacy that typifies members of a disciplinary or subject area community.”
This new culture of a discipline was intimately tied to your learning, your thinking, your membership in this new professional group, and more. Let’s make this concrete with an example. Let’s take med school. There you learned:
- ways of talkingabout medicine–with your instructors, residents, attendings, and patients
- how to think(and act) like a doctor–in your case studies and clerkships and experiences
- how to readabout medicine–in your lectures and classes
- and how to researchand write about medicine (and in the links I have a classic, very crafty JAMA editorial on medical writing, check it out)
You were socialized into these ways of talking, thinking, reading, and writing. Now, your job depends on it. You are surrounded by people also socialized into it, and whose jobs also depend on it. Regardless of the extent to which you personally identify with the dominant voices or approaches in your discipline, your professional program involved your learning to read, write and think in a discipline- or specialty-specific way.
For a long time.
And you’re still doing it. Every day.
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So if someone from another specialization, discipline, or department disagrees with your group’s way of doing things, it can feel…personal. Because it kinda is.
Methodologists have pointed out that the approach we have been educated with and socialized into can become entwined with our identity. That is, how we do what we do professionally can become part of who we are. We’re kind of attached to it! As a result, we can get personally protective of our disciplinary status quo. This can make for some tense moments when it comes to interprofessional communication, when you’re looking at, talking with, and working with people who have different positions and different disciplinary backgrounds.
So, noticing and being conscious of our disciplinary m.o. is important, but this alone is not enough. We have colleagues with different disciplinary approaches. And we need to work together. In a 2017 article about how researchers can move past historical differences, methodologist Norman Denzin refers to earlier work on fostering dialogue among people who work from different paradigms. Here are 4 of these recommendations that might be helpful:
- openness to critique
- decline in confrontational stances
- avoidance of simplistic representations of others’ paradigms
- more fruitful dialogue among competing paradigms.
Thinking like this may help us appreciate from others’ standpoints the complexity that can underlie differences in approaches. It might help us think twice about our differences when it comes to those apparently straightforward tasks that are involved in an interprofessional communication, such as inventory, scheduling, data gathering, etc. The kinds of things that can slow down progress during interprofessional collaboration when we all think we’re talking apples to apples, and we’re not.
Here are some questions that might spark ideas:
- How do current arrangements challenge communication and collaboration?
- How do current arrangements sustain communication and collaboration?
For example, where and when group meetings are held matters. Some times and locations will make participation easier for some group members than for others.
- What already existing institutional structures could support the kinds of communication and collaboration you’re being asked to do?
For example, are there already existing collaborations that you could piggy-back on, maybe hold meetings at common times or hold one after the other?
Consider what mechanisms are in place, or needed, for ongoing collaboration and support of everyone involved. This kind of information can be helpful in making a case to your organization about better facilitating interprofessional communication. If you’d like more help, contact me at Annemarie at h-cpartners dot com. This has been 10 Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel.