Interdisciplinary expertise in medical practice: Challenges of using and producing knowledge in complex problem-solving

Abstract

Purpose: Clarification of interdisciplinary expertise as the ability to deal with the cognitive and epistemological challenges of multi- and interdisciplinary problem-solving—such as in developing and implementing medical technology for diagnoses and treatment of patients in collaborations between clinicians, technicians, and engineers—and of the higher-order cognitive skills needed as part of this expertise.

Method: Clarify the epistemological difficulties of combining scientific knowledge, methodologies and technologies from different disciplines in problem-solving, by drawing on recent developments in the philosophy of science.

Conclusion: We argue that interdisciplinary expertise involves the cognitive ability to connect, translate and establish links between disciplinary knowledge, as well as the metacognitive ability to understand and explain the role of the disciplinary perspective—consisting of, e.g. basic concepts, theories, models, methodologies, technologies, and specific ways of measuring, reasoning and modeling in a discipline—in how knowledge is used and produced.

Notes

Acknowledgements

We thank Jan van der Veen, Miles MacLeod, Heleen Miedema, Henk Procee and two anonymous reviewers for valuable discussions and feedback.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Epistemology: Concerns (philosophical) questions of what knowledge is and how knowledge is justified. Generally speaking, epistemological theories seek to illuminate the nature, scope, and utility of knowledge. To this definition we add focus is on how (scientific) knowledge is constructed (i.e. used and produced) for specific problem-solving purposes.

Epistemological constructivism: A philosophical view of knowledge that transcends positivist, scientific realist and social constructivist notions of knowledge (Boon 2017a).

Disciplinary perspective: A cognitive framework that an expert has developed by being educated within a certain discipline. The framework enables her to ‘see’ specific aspects (e.g. in terms of specific categories), to interpret or explain these ‘observations’ in specific ways (e.g. in terms of scientific knowledge), to ask specific types of questions about these ‘observations’ (e.g. about other, not yet manifested symptoms or signals), to come up with possible interventions (e.g. specific treatments fitting to the disease), and to generate novel hypotheses (e.g. drawing new connections or interpretations when faced with new information, for instance from other disciplines).

Interdisciplinary expertise: The cognitive ability to collect relevant information from different disciplinary sources, and to combine these heterogeneous bits of information into a coherent, adequate and relevant ‘story,’ ‘picture,’ or ‘model’ that helps in understanding, reasoning and decision-making about the clinical problem. It also includes the cognitive ability to participate in interdisciplinary collaborations, transferring knowledge, methods and technologies from one domain to another in order to generate new knowledge, methods and technologies for novel problems.

Notes

1 We will use the notions ‘higher-order cognitive skills’ and ‘metacognitive skills’ interchangeably.

2 The notions ‘knowledge-structure’ and ‘conceptual structure’ are used interchangeably.

3 The notions ‘discipline,’ ‘domain,’ ‘specialization,’ and ‘specific practice’ are used interchangeably.

Additional information

Funding

This work is financed by an Aspasia grant (409.40216) of the Dutch National Science Foundation (NWO) for the project Philosophy of Science for the Engineering Sciences, and by the work package Interdisciplinary Engineering Education at the 4TU-CEE (Centre Engineering Education https://www.4tu.nl/cee/en/) in The Netherlands.

Notes on contributors

Mieke Boon

Mieke Boon, PhD, graduated in chemical engineering (cum laude) and is a full professor in philosophy of science in practice. Her research aims at a philosophy of science for the engineering sciences, addressing topics such as methodology, technological instruments, scientific modeling, paradigms of science, interdisciplinarity and science teaching.

Sophie van Baalen

Sophie van Baalen, MSc, graduated in technical medicine and in philosophy of science technology and society, both cum laude. Currently she works on a PhD project in which she aims to understand epistemological aspects of technical medicine from a philosophy of science perspective, such as EBM, expertise, interdisciplinarity and technological instruments.

Marleen Groenier

Marleen Groenier, PhD, graduated in psychology and is a researcher in professional learning in high tech healthcare. In her research, she addresses topics such as simulation-based training and assessment complex technical medical skill, modeling learning curves, and psychometrics.