Complexity, collective learning and the education of interprofessional health teams: Insights from a university-level course

Abstract

This paper describes a collaborative action research project carried out by the author and the instructors of a large university-level interprofessional health team course. The research focused on introducing new complexity science-based ideas about collective learning to the course's pedagogy and curriculum, and tracking resultant changes in both thinking and practice. A number of insights emerged from the research, including a deeper understanding of collective learning in interprofessional contexts, a questioning of the meaning of consensus within teams, and the identification of a special role for trust in interprofessional relationships. One significant practical change in the course curriculum, which related to these insights, is also described.

Keywords:

• Interprofessional education
• complexity
• interprofessional teamwork
• trust

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.

Notes

1. The term “interdisciplinary” is used in this paper to denote activities and knowledge that not only draw upon multiple disciplinary insights but also integrate them to produce a more comprehensive understanding of given problem (Klein & Newell, 1998). The term “interprofessional” signals a similar attempt to draw upon and integrate fragmented professional perspectives; however, as D'Amour and Onadasan (2005) point out, interdisciplinarity focuses on the integration of knowledge and may give rise to new disciplinary areas, while interprofessionalism is concerned with integration of professional practice and “does not imply the development of new professions, but rather a means by which professionals can practice in a more collaborative or integrated fashion” (p. 9).

2. Well-grounded articles on the emergence of team-level learning are beginning to appear, including articles by Chatalalsingh and Regehr (2006), Iedema et al. (2005), and Allard et al. (2007). However, while all three concretely describe the development of team knowledge, only the first explicitly addresses the issue of how such knowledge might constitute “more than the sum of its parts”.

3. Both Drinka and Clarke (2000) and Hall (2005) attribute the concept of “cognitive maps” to Petrie's (1976) classic article on interdisciplinary epistemology. In it, he defines cognitive map as “the whole paradigmatic and perceptual apparatus used by any given discipline” (p. 35).

4. This idea of emergent self-organization in the absence of consensus has parallels both in the political philosophy of Hardt and Negri (2004) and in cultural historical activity theory – specifically Engestrom's (2001) account of the “multi-voicedness” of activity systems.

5. The incorporation of this process into the course manual can be considered an example of a “cognitive trail” (Cussins, 1992). That is, it constitutes a physical artefact with a social and symbolic dimension that both shapes activities and is given shape through them.