Conflicting Messages

Abstract

A collaborative approach to leadership may be challenging for interprofessional teams embedded in traditional health care, education, and medical-legal systems that reinforce the idea that physicians sit at the top of the hierarchy. By openly recognizing and discussing the tensions between traditional and interprofessional discourses of collaborative leadership, it may be possible to help interprofessional teams, physicians and clinicians alike, work together more effectively.

The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom

“…Interviews with MDT members in primary care (n = 121) identified sources of conflict and barriers to conflict resolution, alongside team and individual strategies to resolve conflict 15. However, an intervention study conducted with teams in general internal medicine did not achieve improvements in communication or collaboration because of lack of senior staff support or positive role modeling,16 whereas an observational study revealed hierarchical behaviors in interprofessional teams, despite team leaders (physicians) espousing collaborative leadership values 17. Much of the research is focussed on the MDT meeting and its function or validity.…”

Does your discussion realize its potential?

“…For example, in a paper from our healthcare teamwork research, the Introduction spotlighted the main characters of inter-professional care, collaboration and leadership. The Discussion summarized the key finding of a double bind for physicians navigating the competing values of leadership and collaboration, and then explicitly introduced a new suite of characters that were necessary to understand this double bind: “To explore this provocative explanation for our findings, we briefly consider three of the broader systems that support physicians’ privileged status: the education system, the health care delivery system, and the medical-legal system.” [4, P. 1765] The bulk of the Discussion elaborated these new characters. As this example demonstrates, such explicit signposting – ‘this provocative explanation for our findings’ – is critical in a  Surprise insight storyline, in order to minimize the chance that the reader may perceive a random detour.…”

The Conversion of a Peer Teaching Course in the Puncture of Peripheral Veins for Medical Students into an Interprofessional Course

“…Correspondingly, they attempt to reinforce their own interests and professional influence within the context of IPE [ 10 ]. To ensure good cooperation within an interprofessional team, a form of leadership based on joint decision making is required, which represents a challenge to lecturers with traditional, hierarchical role models [ 11 ]. In contrast to lecturers with years of experience, peer tutors’ role models have yet to be defined [ 12 ], and hierarchical gradients between tutors and students are at a minimum [ 13 ], [ 14 ].…”