Running head: INTERPROFESSIONAL COMMUNICATION INTERVIEW 1

Interprofessional Collaboration Interview

Whitney Hyde

SUNY Delhi

NURS 604, Graduate Practicum/Capstone 1

Dr. Digger

February 13, 2019

Abstract

Interprofessional collaboration is important between professionals to provide optimal patient

care. Four interprofessional core competencies were developed; Values/Ethics,

Roles/Responsibilities, Interprofessional Communication, and Teams and Teamwork, with the

goal for professionals to be able to work effectively in teams and communicate with each other

(IEC, 2016). I interviewed Sandra Gibson PA on her experiences with interprofessional

collaboration. During the interview, I learned that when professionals engage in the four core

competencies they are able to provide effective and efficient healthcare.

Interprofessional Collaboration Interview

Sandra (Sandy) Gibson is a Physician Assistance (PA) at the SUNY Upstate Outpatient

Neurology clinic where I work. Her email address is [email protected]. Her hours are split

between the neurology clinic and the neurology infusion center. When she is in the clinic, she

sees patients with multiple sclerosis (MS) and when she is in the infusion center, she injects

Botox and Sphenopalatine Ganglion Nerve Blocks and administers intravenous infusions for MS.

Sandra graduated from SUNY Upstate in 2014. After graduation, she worked at the SUNY

Upstate pain management clinic two years and she has been working in the neurology clinic for

the past two and half years. At the neurology clinic, she works with the multiple sclerosis team.

The MS team is composed of a doctor, a nurse practitioner (NP), a physician assistance (Sandra),

a registered nurse, and a secretary. Sandra Gibson’s main roles within her team is to see patients

in the clinic, address patients’ symptoms and concerns, and order medications and testing. She

also covers the doctors and NPs patient load if they are not in the office.

Interview Questions

During my interview with Sandra Gibson, I asked the following comprehensive

questions.

1. How do you communicate and how do you best liked to be communicated with? Do you
feel you communicate well with others?

2. Can you tell me about a time that your were asked to do something that was not within
your role or scope of practice and how you handled the situation?

3. Who is on your team? Do you feel that your team functions well together? What areas
could be improved?

4. Can you identify a time where you experienced or witnessed interprofessional conflict?
How was the conflict resolved?
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5. Can you explain how your team practices leadership (i.e. collaborative or traditional) and
if this is effective?

6. How does your area of work practices interprofessional collaboration? Can you explain
if it is effective or ineffective?

Interprofessional Practice Competencies

In 2009, four interprofessional core competencies were developed, Values/Ethics,

Roles/Responsibilities, Interprofessional Communication, and Teams and Teamwork, with the

intent to build on each profession’s expected disciplinary competencies and for interactive

learning to occur between different professions (IEC, 2016). During my interview with Sandra

Gibson PA, I learned how she engaged in each of the four interprofessional core competencies.

Values/Ethics

Sandra Gibson primarily treats patients with Multiple Sclerosis. MS is an immune-

mediated inflammatory disease that attacks myelinated axons in the central nervous system

resulting in sensory loss, gross and fine motor symptoms, autonomic symptoms, cognitive

problems, vision defects, depression, and many other symptoms (Luzzio, 2018). The symptoms

of MS can be embarrassing to patients and patients have told Sandy about their sexual

disfunction, bladder incontinence, and mental health issues as a result of their chronic disease.

Sandra Gibson has engaged in ethics by showing her patients dignity while they disclose their

intimate symptoms and problems and by maintaining confidentiality. When appropriate and

with the patient’s permission, she has discussed her patients intimate symptoms with other

healthcare providers that would be better suited to care for the patients symptoms. Sandy

mentioned during the interview that it was important for her to develop trusting relationships

with her patients. She acknowledged that MS can greatly impact every aspect of her patients’
INTERPROFESSIONAL COMMUNICATION INTERVIEW 5

lives and she wants her patients to know that she is there for them to contact with any problems

or concerns. Another way Sandy engages in values and ethics is by maintaining her

competencies within her scope by reading research articles to stay up to date with the latest MS

medications and research studies available to her patients and by meeting with her MS team

monthly to discuss any new policies and procedures or standards of care. Sandy identified an

ethic interprofessional issue that she has recently been involved in, a new MS physician joined

the practice and has different ideas then the previous MS physician on prescribing MS patients’

narcotics, anti-depressants, or anti-anxiety medications. The new physician feels patients should

follow up with pain management or their primary providers for these medications and is asking

the MS team to stop prescribing these medications. This has caused somewhat of an ethical

dilemma for Sandy, who has been prescribing these medications for years for her patients. She

and the MS NP are trying to work with the new physician to explain that this is a change that will

take time to implement because patients will need time to be referred to these services and they

are concerned that immediate action with detrimentally impact the trusting relationships they

have developed with their patients. During the interview with Sandra Gibson, I could feel her

passion for her patients and how deeply she cares for their well being.

Roles/Responsibilities

The roles and responsibilities competency is an area that Sandy expressed as her greatest

challenge. Although she engages in the competency by communicating her role to her patients

and providers and by working with other health care providers to promote good healthcare for

the patients, she does not always feel that other healthcare providers understand her role as a

professional. There have been instances when she was asked to do things that were not within
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her knowledge base and she was not comfortable doing. For example, she was covering for her

MS physician one day and was asked to review a MRI of a patient who was suspected to have

dementia, Sandra Gibson did not feel comfort reviewing the MRI because she has only been

trained on how to read MRIs for MS. She attempted to reach out to a physician in the clinic who

specialized in dementia to see if they could interrupt the MRI, but they refused. Therefore, Sandy

had to wait until the MS physician returned for the MRI to be interrupted. I thought that Sandy

handled this situation well and engaged in the roles and responsibility competency because she

was asked to do something that she was not trained in and instead of just declining, she used her

resources and went to a physician who specialized in dementia and asked them to read the MRI.

During the interview, she mentioned that she felt her MS team worked well together because

each member of the team had their own specific role that enhanced the teams performance.

Interprofessional Communication

Sandra Gibson felt that she is an effective communicator because she can adapt her

communication style to the individual she is communicating with. However, she acknowledged

having conflict with other professionals with traditional leadership. She does not like to be

dictated a task or spoken to in a condescending way and she prefers to work in a team with

collaborative leaders. Collaborative leadership is characterized by shared values and vision,

shared responsibility, mutual respect, effective communication, and interdependence (Lawrence,

2017). Collaborative leadership allows for effective communication because, instead of the

information coming from the top-down, communication is openly discussed between all levels of

the team and each member has shared responsibility (Lawrence, 2017). By Sandy practicing

collaborative leadership, she is meeting the interprofessional competency by choosing effective

communication techniques to facilitate discussions that enhance her teams functions (IPEC,

2016).

During the interview, I asked Sandy if there was a time that she had witnessed

interprofessional conflict. She had told me about a time when the physician on her team

questioned a protocol to the medical director, the medical director interrupted the questioning as

challenging the protocol. This situation then erupted into Sandra Gibson’s office and she was

asked to be included in a conflict that she was not prepared to be included in. Sandy did not

want to be included in the discussion because both physicians were not having effective

communication, but they were speaking over one another. A few days later, at a MS meeting,

the topic was brought up again, however, this time everyone in the meeting was able to express

their concerns openly and equally. By Sandra waiting to express her feelings about a protocol in

the appropriate setting, she was able to actively listen to other opinions and share her own

opinions in a respectful way.

Teams and Teamwork

Sandra Gibson mainly works with her MS team made up of a physician, a nurse

practitioner, a register nurse, and a secretary. All members on the team have identified roles

with the main focus on patient-centered problem solving. Sandy has worked in the neurology

clinic for two years and although she is confident in her role as a physician assistant, there are

times when she asked members of her team for guidance and advice. Sandra mentioned that her

team works well together because there is no sense of hierarchy; the physician will cover both

Sandy’s and the NPs patient load, and she and the NP will both cover the physicians. The

supportive collaborative practice and team effectiveness allows for Sandra to engage in the
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teamwork competencies because the team members are able to provide patient care safely,

timely, and efficiently (IPEC, 2016).

One study found that the hierarchal order of professional responsibilities may contribute

to the pattern of conflict, reluctance to question, and emphasis on individual responsibility rather

than team responsibility (Thomas, Outram, Gilligan, & Levett-Jones, 2015). The study also

found that a lack of effective, transparent communication and team functioning resulted in

tension between professions because each profession had a different perception of the others’

beliefs and attitudes (Thomas et al., 2015). For example, the doctors were frustrated with the

nurses because they were not participating in team discusses whereas, the nurses thought the

doctors did not want their input during team members. This study showed how important

working as a collaborative team is in healthcare.

What I learned

Interprofessional collaboration can occur more frequently when you are working with a

team with similar values and beliefs, but it can be very challenging and uncomfortable when

working with people with different communication styles. The interview with Sandra Gibson

reinforced that effective interprofessional collaboration within a team does not just occur

overnight; it takes time to learn how each member of your team communications and to find the

most effective way to communicate with them. However, there are also instances where

effective communication is not going to occur between two individuals because of

communication styles, attitude, beliefs, and tone. Sandra acknowledged that she still needs

growth in interprofessional collaboration and working with professionals that she does not

communicate effectively with. She identified one individual that she occasionally has to work
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with who she tried to practice professional communication with, but she does not feel it is

returned. As a professional, when dealing with this individual, Sandra removes her ego and

addresses the patients’ needs. However, as a result of the uncomfortable interactions, she never

seeks this person out for advice and/or guidance and limits her interactions with the person. The

interview with Sandra Gibson showed me that similar interprofessional collaboration issues

occur in all professionals regardless if you are a registered nurse or physician assistant. It is

ultimately important that as professionals, we strive to improve our collaboration to improve

patient care and outcomes.

Personal Practice

Before the interview with Sandra Gibson, I was not familiar with the four core

interprofessional competencies. I recall briefly learning about interprofessional collaboration

and communication throughout my nursing education. According to an article, although schools

offer interprofessional education, the education is provided all at once instead of threaded

throughout the whole curriculum (Foronda, MacWilliams, & McArthur, 2016). The article

recommended that medical school, schools of nursing, and other profession should incorporate

interprofessional simulations throughout the curriculum to improve interprofessional

communication. During my interview with Sandy, she had discussed on how she would

encounter problems with interprofessional collaboration and the communication between herself

and the other provider was ineffective. Going forward in my nursing educator role, I will

incorporate interprofessional collaboration throughout my course or clinical to better expose

nursing students to different interprofessional situations and solutions.

Conclusion
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Interprofessional collaborative practice can be rewarding to healthcare providers and can

positively impact patients care and outcomes. Sandra Gibson engages in all four of the core

competences for interprofessional collaborative practice. She identified how her and the MS

team practice interprofessional collaboration, but she also identified challenges that have

occurred while working with other healthcare providers. This interview taught me how

important is it to engage in the four core competencies. As a future nursing educator, I will

incorporate the competences into my teaching practice to provide nursing students with exposure

to interprofessional collaborative situations. As healthcare becomes more complex, it is

important for professionals to practice effective interprofessional collaboration to provide

optimal healthcare to patients.

References

Foronda, C., MacWilliams, B., & McArthur, E. (2016). Review: Interprofessional

communication in healthcare: An integrative review. Nurse Education in Practice, 19,

36–40. https://doi.org/10.1016/j.nepr.2016.04.00.

Interprofessional Education Collaborative. (2016). Core competencies for interprofessional

collaborative practice: 2016 update. Washington, DC: Interprofessional Education

Collaborative.

Lawrence, R. L. (2017). Understanding collaborative leadership in theory and practice. New

Directions for Adult & Continuing Education, 2017(156), 89–96. doi:10.1002/ace.20262.

Luzzio, C. (2018). Multiple sclerosis. Retrieved from https://emedicine.medscape.com

Thomson, K., Outram, S., Gilligan, C., & Levett-Jones, T. (2015). Interprofessional experiences

of recent healthcare graduates: A social psychology perspective on the barriers to

effective communication, teamwork, and patient-centred care. Journal of

Interprofessional Care, 29(6), 634–640. doi:10.3109/13561820.2015.1040873.