Collaboration in healthcare over time

Funding: SSHRC

This research aims to understand why and how collaboration became such an important solution to healthcare problems in Canada and beyond. It also tries to understand how authors write and think about collaboration: the things they see, and those they do not.

Key Insights

  • Authors are rarely explicit about who is a member of the team

  • Over time, increasing use of collective language (e.g. “non-physicians” or “allied health”, contrasted with previous list of all professions in specific context)

  • Collaboration is rarely explicitly defined, but what it entails generally falls into one of the following categories: activities, psychometric properties of individuals, “togetherness”

  • Collaborative ideal in healthcare (defined as the belief that collaboration can improve the healthcare system with limited cost and structural upheaval) is supported by norms of justice and progress

  • The growing belief in collaboration as a solution in healthcare has been met with the development of formal structures that aim to support collaboration at the individual, organizational, and systemic levels.

  • The Interprofessional Education (IPE) tradition has not fully engaged with the issues of power and conflict that plague healthcare and limit interprofessional collaboration.

  • The current paradigm of Interprofessional Education (IPE) is unlikely to yield improvements in collaborative practice, for six key reasons. Another paradigm, which we call education for collaboration, can prove to be a better solution.

  • Much of the literature on nursing and interprofessional collaboration ignores issues of power and hierarchies. Recent literature appears less likely to discuss power.

  • The tension between a logic of substitution and a logic of differentiation can undermine interprofessional education programs

Research still in progress, but the Leslie Dan Faculty of Pharmacy featured Ms. Patti Leake’s MSc research here.

Co-Investigators

Cynthia Whitehead

Heather Boon

 

Students and Research Assistants

Carrie Cartmill

Catherine Giroux

Patricia (Patti) Leake

Daniel Miller

J Cristian Rangel

Mandy Pipher

Sarah Whyte

Articles or Chapters

Paradis E. Forthcoming 2018. Zurückliegende, aktuelle und künftige Diskurse über interprofessionelles (Past, current and future discourses of interprofessional learning, teaching & working). In Ewers M, Paradis E and D Herinek (Eds). Interprofessionell Lernen, Lehren und Arbeiten. BELTZ Juventa Publishers. Buy Book

Paradis E and CR Whitehead. 2018. “Beyond the lamppost—A proposal for a fourth wave of education for collaboration.” Academic Medicine. 93(10):1457–1463 doi: 10.1097/ACM.0000000000002233 Download

Patricia J Leake. 2018. Nursing, power and gender in interprofessional collaboration. MSc Thesis. Leslie Dan Faculty of Pharmacy, University of Toronto. Committee: E Paradis, CR Whitehead, H Boon. Download

Whyte S, Paradis E, Cartmill C, Kuper A, Boon H, Hart C, Razack S, Pipher M, Whitehead CR. December 2017. “Misalignments of purpose and power in an early Canadian interprofessional education initiative.” Advances in Health Sciences Education. 22(5):1123-49. doi:10.1007/s10459-016-9746-x Download

Paradis E, Pipher M, Cartmill C, Rangel JC and CR Whitehead. August 2017. “Articulating the ideal: 50 years of interprofessional collaboration in Medical Education.” Medical Education. 51(8): 861-872. doi: 10.1111/medu.13331 Download

Paradis E and CR Whitehead. 2015. “Louder than words: power and conflict in interprofessional education articles, 19542013.” Medical Education. 49: 399-407. doi: 10.1111/medu.12668 Download

Paradis E and S Reeves. 2013. “Key trends in interprofessional research: a macrosociological analysis, 1970 to 2010.” Journal of Interprofessional Care. 27(2): 113-22. doi: 10.3109/13561820.2012.719943.  Download