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AAL Newsletter

Overcoming Barriers to Interprofessional Education: Lessons from Interdisciplinary Research

by N. Karl Haden, Ph.D.
Karl Haden

For all the benefits of interprofessionalism in the health sciences—some of which the spring newsletter outlined—progress may be hindered by a number of challenges. Like my previous article, this one draws on research on interdisciplinarity in universities, but focusing here on barriers to collaboration and ways to overcome them. What can we learn from this literature to help advocates of interprofessional education better understand the challenges they face?

This body of research explains, first, that the typical inner workings of disciplines generate inherent barriers. In Siedlok and Hibbert’s words, disciplines develop distinctive ways of “deriving meaning in an area of study” that range from research methodologies, approaches to data generation, and authorship practices to “systems of beliefs and values shared by researchers.”1 These paradigms not only draw boundaries around an intellectual community but establishes its criteria for excellence and defines which types of research questions and methods are valid.2Work outside those sanctioned practices may seem “soft” or marginal to specialists unfamiliar with other disciplines’ standards. These distinctive practices extend to a discipline’s terminology, so that Bridle et al. report “communication has often proven to be a stumbling block in the formation of new collaborations among disciplines,”3with the well-known result of researchers from different fields “speaking different languages” or “talking past each other.”

Since disciplines generally align with university departments, other barriers arise from the distinctive operations of academic institutions. What Sá calls the “disciplinary departmental nexus” has existed for over a hundred years in American universities.4 Institutional theorists, summarized by Sá, explain that such arrangements eventually “come to be seen as ‘natural,’” with a network of personnel structures, processes, and culture defined as the unit’s tradition. Entrenched interests become manifest in those who retain power over present and future operations through control of hiring and promotion—a situation that tends to perpetuate the status quo and results in resistance to change. Universities’ current financial challenges and the inevitable internal competition for attention and resources pose additional barriers for advocates of change. Particular constraints exist for the health professions due to their highly structured curricula, stringent graduation requirements, and separation from other parts of the campus, all tending to keep the attention of faculty, students, and administrators focused within their own academic unit.

These disciplinary and institutional practices lead to barriers faced by individual faculty members and students. Drawing on previous studies and their survey of environmental researchers, Roy et al. explain that those pursuing interdisciplinary research must find the time and energy to learn about other disciplines, overcome communication challenges and sometimes tension with collaborators, and find mentoring and funding alternatives if their efforts lack support in their own department.5 Roy et al.’s survey also found that 83 percent of their respondents had often or sometimes faced difficulties in publishing their research because it “did not adhere to or fit neatly within traditional disciplinary frameworks.” With research and publication tied directly to academic rewards systems, faculty members working towards promotion and tenure, as well as graduate students seeking academic posts, are particularly affected.

In spite of the barriers, however, interdisciplinarity is growing in the university environment, and research is identifying keys to success and models to follow. As always in academics, leadership is critical. Though the stimulus for interdisciplinary endeavors may be bottom-up or top-down, validation of interdisciplinarity ultimately depends on support from upper-level management (presidents, vice presidents, provosts, deans, etc.) because it likely involves allocation of resources, policy change, and articulation of priorities in, for instance, strategic plans and mission statements. Harris’s 2010 study of U.S. research universities that have adopted interdisciplinarity highlights supportive strategies that foster a collaborative climate: these range from seed money for interdisciplinary projects, creation of campus-wide research units, and support for interdepartmental hires to revision of tenure and promotion policies and construction of interdisciplinary facilities.6 Harris’s findings emphasize the necessary “role of senior administrative leadership to demonstrate that collaboration is a priority both symbolically and substantively.”

Among his many examples of institutional statements, Harris notes that the University of Colorado ties its support for interdisciplinary research “to its mission as a public institution” and the University of Minnesota ties theirs to its “land grant mission” and “the needs and resources of Minnesota.” Harris also quotes now former Chancellor James Moeser of the University of North Carolina at Chapel Hill explaining his vision for interdisciplinarity: “Only a truly great university can bring all the resources needed to examine [interdisciplinary] issues from all perspectives. We intend to be that university.”

For health professions schools interested in promoting interprofessional education (IPE), the good news is that many are part of the universities in Harris’s study as well as other universities and health science centers embracing interdisciplinarity. Western University of Health Sciences in California, for instance, now has a Department of Interprofessional Education that coordinates and supports collaborations across its nine colleges.7 Schools that move toward IPE may thus align themselves more closely with the priorities of their parent institutions. Support for IPE may also come from national funding guidelines and growing college-level interdisciplinarity, which in time may supply the health professions with students and faculty more attuned to collaborative ways of thinking (see the April 2014 newsletter for examples). Demographic trends will continue to raise population-based issues, such as those regarding the burgeoning elderly population, that require involvement of multiple health professions for effective resolution. In order to ease concerns and build understanding among disciplinary specialists, schools should also consider management strategies like interdepartmental working groups, cultivation of core opinion leaders, and faculty development that educates individuals about other professions and the range of collaborative projects possible.

Many of these moves supporting IPE are demonstrated by recent developments at the Oregon Health & Science University School of Dentistry. As Dr. Jeffery Stewart explains, his school’s introduction of IPE has been supported by the health science center’s Provost, who provides funds for a steering committee; a core group of committed faculty members, who develop courses and define competencies; and their students, who see the benefits of IPE in courses and through collaborative practice in clinical rotations.8 The developments Stewart describes show that barriers to IPE can indeed be overcome.

References:

  1. Siedlok F, Hibbert P. “The Organization of Interdisciplinary Research: Modes, Drivers, and Barriers.” International Journal of Management Reviews 16, no. 2 (2014): 194-210.
  2. Haden K. “Is Interprofessionalism a Paradigm Shift?”  AAL Newsletter, December 2013 .
  3. Bridle H, Vrieling A, Cardillo M, et al. “Preparing for an Interdisciplinary Future: A Perspective from Early-Career Researchers.” Futures 53 (2013): 22-32.
  4. Sá CM. “‘Interdisciplinary Strategies’ in U.S. Research Universities.” Higher Education 55 (2008): 537-52.
  5. Roy ED, Morzillo AT, Seijo F, et al. “The Elusive Pursuit of Interdisciplinarity at the Human-Environment Interface.” BioScience 63, no. 9 (2013): 745-53.
  6. Harris M. “Interdisciplinary Study and Collaboration: A Case Study of American Research Universities.” Journal of Research Administration 41, no. 1 (2010): 22-34.
  7. Formicola AJ, Andrieu SC, Buchanan JA, et al. “Interprofessional Education in U.S. and Canadian Dental Schools: An ADEA Team Study Group Report.”Journal of Dental Education 76, no. 9 (2012): 1250-68.
  8. Dr. Jeffery Stewart on Interprofessional Education.
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