The (stalled) progress of interprofessional collaboration: the role of gender

Abstract

Researchers have demonstrated that team-based, collaborative care improves patient outcomes and fosters safer, more effective health care. Despite such positive findings, interprofessional collaboration (IPC) has been somewhat stunted in its adoption. Utilizing a socio-historical lens and employing expectation states theory, we explore potential reasons behind IPC's slow integration. More specifically, we argue that a primary mechanism hindering the achievement of the full promise of IPC stems not only from the rigid occupational status hierarchy nested within health care delivery, but also from the broader status differences between men and women--and how these societal-level disparities are exercised and perpetuated within health care delivery. For instance, we examine not only the historical differences in occupational status of the more "gendered" professions within health care delivery teams (e.g. medicine and nursing), but also the persistent under-representation of women in the physician workforce, especially in leadership positions. Doing so reveals how gender representation, or lack thereof, could potentially lead to ineffective, mismanaged and segmented interprofessional care. Implications and potential solutions are discussed.

Interprofessional Clinical Ethics Education: The Promise of Cross-Disciplinary Problem-Based Learning

“…The field of medicine continues to be predominantly male (66 percent men, 33 percent women) [7], while the field of nursing continues to be predominantly female (91 percent women, 9 percent men) [8]. Gender underrepresentation in medicine (for women) and nursing (for men) can be sources of ineffective or fragmented interprofessional patient care, perhaps due to power differentials rooted in each field's historically situated hierarchies and gender dynamics [9]. Adding to this, in the US health care system, physicians provide billable services, which create revenue, whereas nursing services-depending on the level of care-are not always billable [10,11].…”

Interprofessional Collaboration in Health Care : Education and Practice

“…These inequalities of professional culture and stereotypes have been highlighted in more recent research regarding the education of medical and nursing students, as affecting how students look upon themselves, their future profession, collaboration and professional practice (Wilhelmsson, Ponzer, Dahlgren, Timpka, & Faresjö, 2011). The same principles though are expected also to apply to other health care professionals (Bell, Michalec & Arenson, 2014). Hofseth et al (2010), have argued that professional cultures seem to reflect social class, power and gender issues.…”

“…That kind of practice arrangement may lead to questions on how the students perceived professional cultures and stereotypes. Previous studies have shown that educational experiences and socialisation processes during training and professional practice reinforce professional stereotypes and cultures, which then become barriers to a successful IPC (Bell et al, 2014;Hall, 2005;Mandy, Milton & Mandy, 2004).…”

“…Bell et al, (2014), have argued that factors such as rigid occupational status hierarchy but also status differences between men and women hinder the achievement of IPC. There are only a few research studies that report on the role of power and gender issues regarding educational activites in general (Wilhemsson et al, 2011) and IPTWs specifically.…”

“…In the case of gender issues, individuals can have stereotypical presumptions about how women and men will act in a group (Bell et al, 2014). Beyond individuals, organisations can also be gendered, which means that gender inequality is built into the structures of the work place (Acker, 1999;Martin, 2006).…”