Nurse Education in Practice (2005) 5, 317–319

Nurse

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Educationin Practice

GUEST EDITORIAL

Sharing the experience: Interdisciplinaryeducation and interprofessional learning

Introduction

Relative to the other professional disciplines inhealthcare, nursing has only recently entered theacademy for the purpose of providing its profes-sional education and training. Part of the argumentthat was advanced for the education of nurses inhigher education was that opportunities could beafforded to them to study and learn alongsideother healthcare professionals. Aside from the factthat all healthcare disciplines share a body ofknowledge that they each apply in their respectivepractices, promoting the idea of interprofessionalor shared learning was viewed as an importantmeans of promoting early interaction, solidarity,and mutual understanding among the student body,thereby promoting interdisciplinary communica-tion, understanding, and collaboration in the work-place. Indeed, such mutual understanding was andcontinues to be seen as necessary for good patientcare. One official report put the socialization casefor shared learning in the following terms:

Shared learning cultivates an ethos of cooperationbetween disciplines and provides opportunitiesfor enhancing the understanding of each other’sroles in healthcare delivery (Government ofIreland, 2000, p. 61).

The rationalization of shared learning in suchterms seems rather obvious and wholly intuitive,and is easy to countenance, in terms of the develop-ment of new professional roles and relationships inthe workplace (Hyde et al., 2004). For example, theadvent of advanced nurse practitioner roles entailsboth independent and interdependent clinical deci-sion-making and, consequentially, the traditional

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physician–nurse dyadic relationship of asymmetryis no longer sustainable. Moreover, the idea thatnurses could and should study alongside medicalstudents, students of physiotherapy, radiography,dietetics, and so forth has been promoted as logicaland sensible, since it entails effective and efficientutilization of human and material resources.

Postgraduate studies

If interprofessional learning is to become a regularand sustained part of healthcare education, thenwhat is needed is the widest interpretation of thenotion of interdisciplinary education. The view ofhealthcare professionals from different disciplinessitting side-by-side in a lecture theatre whileattending lectures in the biosciences is an alto-gether narrow view of shared learning. Real andmeaningful shared learning can and should takeplace across the spectrum of undergraduate andparticularly postgraduate educational activities. Italready takes place in and through the informaland incidental learning that occurs in the practi-cum and in the more structured learning that isassociated with programmes of in-service trainingin the healthcare setting.

In recent years, I have been teaching on a post-graduate Masters in Child Health programme com-prising a fairly representative group of healthcareprofessionals practicing in childcare and children’shealthcare. The course participants comprisenurses, midwives, general practitioners, socialworkers, and other professionals allied to health,and while the group interactions and dynamics havenot been studied in a formal empirical way, anec-dotal evidence suggests that the mix is inherently

ed.

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stable and practically coherent. Group discussionsprovide opportunities for accounts of individualexperiences and for the expressions of opinionsand unique (disciplinary) perspectives. In this way,metaphorical windows get opened, so that eachprofessional discipline gets the opportunity toglimpse in a particular direction into the world ofthe other, thereby creating new understandings.Furthermore, ideas and experiences relating togood practice get included in the group discussions,so that professional practice in childcare can be theultimate beneficiary. More recently, colleagues inother healthcare disciplines have considered theidea of shared learning in the area of postgraduateresearch training, whereby masters and doctoralstudents conjointly host research seminars. Thisexpression of interdisciplinary education is as mucha part of the spectrum of shared learning as theshared undergraduate lecture or the incidentalshared learning in the practicum. Planning for post-graduate shared learning can include provision forsuch activities as graduate seminars, collaborativepractice, community projects, and shared fieldexperiences (Edwards and Smith, 1998).

Models and principles

The goals of interdisciplinary education in health-care are related to the educational benefits for stu-dent learning that accrue from shared learningexperiences, and as already observed, are alsorelated to the extrinsic function of enhancing inter-disciplinary working relationships and understand-ings. Three models of interdisciplinary educationare recognised; these are �didactic experiences’which involve sharing of courses and modules, �clin-ical practice’, involving learning experiences inand through interdisciplinary care delivery, and�project-based student experiences’, which canincorporate elements of the other two (Lindekeand Block, 1998). Dyer (2003) proposes multidisci-plinary, interdisciplinary, and transdisciplinaryeducational teams as a model for collaborative,team-taught courses that integrate lecturers andstudents fromavariety of disciplines. There is a bodyof evidence that points to the successful implemen-tation of interdisciplinary education, in such areas asthe teaching of health care ethics (Hanson, 2005),and primary health care (Bezzina et al., 1998), andlearning in the practicum in the area of commu-nity-based education (Edwards and Smith, 1998).

Interdisciplinary education requires collabora-tive planning and decision-making and both individ-ual and institutional commitment, and it must be

�deliberative, respectful, and inclusive of key play-ers’ (Lindeke and Block, 1998). Crucially, it re-quires interdisciplinary collaboration. Defined as�a process of shared planning and action towardscommon goals’, interdisciplinary collaboration en-tails mutual recognition of spheres of activity andresponsibilities (Lindeke and Block, 1998, p. 213).Planning for interdisciplinary education will inevi-tably entail decisions regarding the content ofteaching, and the rationale for including contentand learning experiences needs to be based onsound epistemological and pedagogical justifica-tions. For example, decisions need to take accountof whether a body of knowledge has common pro-fessional relevance to the various disciplines thatwill co-study it. These epistemological decisionsrest on questions about which elements of contentought to be taught as discipline-specific and whichelements lend themselves to interdisciplinaryteaching (Lindeke and Block, 1998). Moreover, inthe process of learning, the particular disciplinaryperspective of each group of co-learners, includingtheir values, will determine how the members ofeach discipline engage cognitively with the contentof subject matter (Hanson, 2005).

A principle of teaching in the academy is that thepurveyors of knowledge should also be the genera-tors of the knowledge that they purvey. In termsof true interdisciplinary education, this principleimplies that a part of the knowledge, i.e., the con-tent of interdisciplinary studies, should be based onthe research and related scholarship that the vari-ous participating disciplines contribute. For disci-plines like nursing, whose historical relationshipwith medicine has been one of interdisciplinary sub-sidiarity and deference, the challenge is to make itsprofessional knowledge visible in and through inter-disciplinary teaching content. In a more generalway, interdisciplinary education should work toprotect the disciplinary integrity of each participat-ing discipline (Lindeke and Block, 1998).

While the academic setting provides an obviousopportunity for interdisciplinary education to takeplace on a regular and sustained basis, challengesalso exist. A particular challenge is the weight ofhistory, including the historical gender division oflabour in the practicum, the hierarchical relation-ship between physicians and other healthcareprofessionals, and the different traditions of pro-fessional training; these �ghosts from the past’can influence contemporary professional relation-ships in both practice and educational settings (Ed-wards and Smith, 1998, p. 145). Such �powerdifferentials’ associated with traditional role andgender may thus constrain interdisciplinary collab-oration in the educational process (Lindeke and

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Block, 1998, p. 213). The imperatives that exist foreach individual professional discipline to meet theprofessional training requirements in respect ofcourse content and minimum periods of instructioncan also present a particular challenge. These leg-islative constraints notwithstanding, professionalregulatory authorities are generally open to theprinciples and the practice of shared learningamong healthcare disciplines.

Shared learning in its many expressions can be areality for students of healthcare. While the aim ofinterdisciplinary education is to educate health-care professionals together, the idea that learningtogether helps professionals to work together toimprove care will remain a central tenet of inter-disciplinary education in healthcare.

References

Bezzina, P., Keogh, J.J., Keogh, M., 1998. Teaching primaryhealth care: an interdisciplinary approach. Nurse EducationToday 18 (1), 36–45.

Dyer, J.A., 2003. Multidisciplinary, interdisciplinary, and trans-disciplinary educational models and nursing education.Nursing Education Perspectives 24 (4), 186–188.

Edwards, J., Smith, P., 1998. Impact of interdisciplinaryeducation in undeserved areas: Health professions collabo-ration in Tennessee. Journal of Professional Nursing 14 (3),144–149.

Government of Ireland, 2000. Nursing Education Forum: AStrategy for a Pre-registration. Nursing Education DegreeProgramme. Dublin: The Stationery Office.

Hanson, S., 2005. Teaching health care ethics: why we shouldteach nursing and medical students together. Nursing Ethics12 (2), 36–45.

Hyde, A., Lohan, M., McDonnell, O., 2004. Sociology for HealthProfessionals in Ireland. IPA: Dublin.

Lindeke, L.L., Block, D.E., 1998. Maintaining professionalintegrity in the midst of professional collaboration. NursingOutlook 46 (5), 213–218.

Gerard M. FealySenior Lecturer/Assistant Head of School

UCD School of NursingMidwifery & Health Systems

UCD DublinIreland

E-mail address: gerard.fealy@ucd.ie