期刊名称：Journal of Research in Interprofessional Practice and Education
印刷版ISSN：1916-7342
出版年度：2014
卷号：3
期号：3
DOI：10.22230/jripe.2014v3n3a112
语种：English
出版社：Canadian Institute for Studies in Publishing Press
摘要：Background: A central paradox dwells at the heart of interprofessional care: the tension between autonomy and interdependence. This report uses an ethnographic study to understand how this tension shapes collaborative practice on a distributed, interprofessional transplant team in a Canadian teaching hospital.Methods & Findings: Over four months, two trained observers conducted an ethnography through 162 observation hours, 30 field interviews and 17 formal interviews with 39 consented participants. Data collection and inductive analysis proceeded iteratively. Loose coupling theory was used as a resource to make sense of key themes. We describe the transplant team as a constellation made up of core, inter-service, and outside hospital dimensions. Next, we trace the nature of coupling activities within and across these dimensions of the team constellation, focusing on recurring communication challenges which can signal the relationship between autonomy and interdependence in collaborative acts.Conclusions: We conclude that coupling is fluid and subject to human agency, and that the tension between autonomy and interdependence can be highly productive. Team members, including patients, may negotiate and construct their relations on an autonomy/interdependence axis for strategic purposes. Far from being trapped in a paradox, team members use autonomy and interdependence as resources to achieve complex goals in collaborative settings.
关键词：Education; Professional Communication; Medicine;Team communication; Interprofessional collaboration; distributed teams; Ethnography; Organizational theory
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