By John H. V. Gilbert, Ph.D., FCAHS
Project Lead & Chair,
Canadian Interprofessional Health Collaborative,

“Communication” is probably the most overworked and least understood word in the English language.

In the health and human service professions “communication” gets worked out and worked on in every conceivable way. No iteration of e.g. competency or scope of practice would be complete if not accompanied by an injunction about the desirability of being able to “communicate”.

To be able to “communicate” effectively clearly implies a continuum of activity. From talking sense, to writing sensibly, to moving one’s body parts so as not to confuse.

Using any measure, “communication” is more than just the neutral transmission of information. Unfortunately, professional descriptions of the word make an assumption of neutrality.

In interprofessional collaborative team based care, being able to “communicate” is clearly an issue of importance.

The act of “communicating” in an interprofessional environment is poorly understood.

It would be incorrect to assume that it follows the same path as communicating uni-professionally. In a uni-professional setting those engaged in “communicating” are operating with the same set of conditions. They understand eachothers roles, and share a common set of professional values.

They will use words that have a professionally agreed upon meaning.

The private language of the profession will be known to all parties.

None of these conditions hold true for interprofessional conversations. Given that a large number of interactions in health care are by nature interprofessional, it is small wonder that confusion can, and does, occur.

If the move to interprofessional collaborative team based care is the ideal end state of interprofessional education, then the role of “communication” in the creation, recreation, performance, and maintenance of such teams needs to be understood and articulated. How an interprofessional collaborative team is constructed and performs through the ways in which it “communicates” (its “Communicative Constitution) is a question to which we need answers.

In the acute care sector, for example, rounds are really the only time that the team members physically meet for face-to-face discussion.

This is often the only time that members “communicate” with each other.

Such meetings require rapid discussion of a large number of patients and the discussion (communication) about each patient is focused on the immediacy of her/his problem(s).

What the desirable elements of communication are in such settings are not altogether clear. Teams are most usually organized according to hospital unit or ward, for example the emergency department, the surgery ward, or short-stay medical care, which have their own specific language of communication, which is compounded by teams changing from shift to shift, both in numbers and in professional backgrounds. Sometimes members of the team do not even know each other.

If stable team membership is a condition of team performance, then ever changing “communication” patterns presents a challenge. If team membership simply means performing a professional role as learned through professional and organizational training and socialization, then we might ask, how is the team “communicating” interprofessional. The implication is that that during rounds, team members report on their interactions and interventions with the patients and they enact their professional roles. But it doesn’t explain the full story, that is, it doesn’t explain the joint work or teamwork, the performance of the team, or interprofessional practice.

Although communication in an interprofessional environment should be demonstrated through listening and other non-verbal means, and verbally through negotiating, consulting, interacting, discussing or debating – the pressures of practice environments make the ideal hard to achieve.

Until we have a better understanding of its intent “communication” will remain a weasel word, and one about which a far better understanding is required if it is to be embedded in interprofessional collaborative team based practicel.

CIHC Encourages Everyone to Participate in This Online Discussion

Everyone is welcome to join the discussion but you have to register to participate.

Registration is free and easy – just go here -> www.hpgn.org

Here’s a breakdown of the details…

The World Health Organization (WHO) and partners invite you to join the Health Professionals Global Network (HPGN)

Virtual Global Discussion Forum on Interprofessional Collaboration in Education and Practice

Dates of the virtual global discussion forum: 1 – 12 February 2010

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Please take the time to watch this excellent presentation by Dr. Jennifer Gardy from the TEDx Terry 2009 event at UBC.

A truly ‘TED-worthy’ presentation. Inspiring work from the GlobeCampus Nerd Girl herself!

You can also follow her on twitter @jennifergardy and, while you’re at it, you can follow us on twitter @cihc_ca.

Let’s make new connections and improve our collaborative networks!