Response to "Living up to Our Expectations: Do We Need to Go Back to Go Forward?"

Submitted by Guest on November 3, 2011 - 12:03pm

Blog post by InspireNet Leadership Council member, Lesley Bainbridge

This is a response to blog post Living up to Our Expectations: Do We Need to Go Back to Go Forward? written by David Byres and Marion Briggs.

It’s taken me a while to craft a response to Living up to Our Expectations: Do We Need to Go Back to Go Forward? And in reading this blog again I’ve decided to respond to several key components but not to all. I live and breathe interprofessional education and collaboration each and every day and am privileged to do so. I believe in it because I have lived it – when working with the frail elderly for 5 years I experienced the ultimate in team based care and collaboration. I know it works and is way more satisfying than going it alone at best or living through tension daily at worst. I also know from my current academic life that evidence and not just personal experience is necessary. But there are papers galore now that speak to the evidence and so my response to this blog is from my experience, my reading, my research and my beliefs.

I agree with Marion and David that we do probably expect people to collaborate – after all, it’s really just good manners isn’t it? Well no, it’s actually more complicated than that and we most often don’t make our expectations clear or explicit. If we did, and I think Marion and David do allude to this, we would support people to meet all of our expectations including collaboration. The trouble with collaboration is that we still don’t really understand it well and so it’s often hard to know how to support people to collaborate. I think that we need to rethink the concept of collaboration and then to figure out how we teach it.

I want to put the “I” back in team. My colleague Dr. Glenn Regehr has challenged me to rethink collaboration in such a way that we start to think about how we as individuals collaborate and then how we teach or train individuals to develop their own collaborative network in order to best work with patients and families to meet their goals and needs. We can’t control the behaviour of others but we can, for the main part, control how we behave. So how do we conceptualize social capital, for example, how do we build it and how do we burn it? In the busy and stressed workplace how do we learn how to share the ebb and flow of workload and to willingly seek ways to help and to ask for help that is willingly given? How do we learn how to pay attention to the words we use – that art of framing or rhetoric? How do we negotiate priorities? How do we resolve conflict readily – co-creating Stephen Covey’s “third option”? How do we understand and accept different perspectives? How do we earn and demonstrate respect?

All of this represents another level of collaboration that we haven’t paid much attention to. Yes, health care is about relationships and we need to understand these complex components of collaboration in order to build and sustain relationships in healthy and fulfilling ways that enable us to give our best to our organizations and our patients. Yes we do have a national competency framework for interprofessional collaboration and in many ways it is working to enable a common language and understanding nationally. But it is an evolving document, one that will eventually need to consider these other frames of reference for collaboration. It speaks somewhat superficially to making judgements, moving beyond pure competency language but we have some distance to go before we understand what happens when we make judgements and how that influences collaboration.

We are making progress on the interprofessional education side, both for students and practitioners, but until we know more about the best timing, the most effective amount, appropriate assessment models for collaboration and what we are really aiming for we can’t really know that we are doing all the right things. We can reinforce stereotyping in a heartbeat if we get the timing and the messaging wrong. So, no we can’t go back but we can learn lessons from the past and apply them to the future. There is a sea change afoot – I believe the future will be collaborative!

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Lesley Bainbridge, BSR(PT), MEd, PhD
Director, Interprofessional Education, Faculty of Medicine
Associate Principal, College of Health Disciplines
University of British Columbia

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