Understanding Communication Dynamics Among Healthcare Professionals: Implications on Collaborative Practice and Interprofessional Learning in the Clinical Environment

Researchers from six disciplines examined dialectical tensions among healthcare professionals in simulated medical error disclosure conversations. Using Relational Dialectics Theory (RDT), we examined how communication tensions manifested in one-on-one and interprofessional team disclosure. Tensions healthcare professionals experienced included transparency and protectionism, and leadership and support.

Collaborative patient care requires shared leadership wherein power is shared as a function of appropriate knowledge and experience rather than isolated by role, and decisions are made interdependently based on expertise. Leadership in complex environments is co-produced rather than fixed, and ideally involves the cooperation of leaders and followers to achieve patient outcomes. Depending on the situation, all members of the team may lead or follow at times, yet all enhance and influence the collaborative process. Leaders in this context must be able to involve team members in clinical decisions who may be separated by hierarchical barriers yet recognize instances when one team member is better equipped to lead. Helping learners understand and traverse the leadership-support tension occurring in disclosure offers a useful approach for teaching, learning, and understanding collaborative team leadership and decision-making.

Although the context of this study was medical error disclosure, the knowledge gained may transcend disclosure and impact many situations where understanding interprofessional communication dynamics and tensions can improve collaboration, mutual respect, and reduce conflict potential. Various ways that individuals and teams handle medical error disclosure in this study may generalize beyond the current study even if different institutional environments exert different pressures. The learning activity described during this presentation is a reproducible interprofessional learning activity that can be implemented in a clinical setting for licensed and pre-licensure trainees to promote interprofessional competencies and meet accreditation standards in a clinically authentic way.

Funding Attribution: Funded by National Center for Advancing Translational Sciences, National Institutes of Health, through Grant [UL1TR000117].