Are we all on the same page? A discourse analysis of interprofessional collaboration

Interprofessional collaboration (IPC) has become a dominant idea in both medical education and clinical care as reflected in its incorporation into competency-based educational frameworks and hospital accreditation models. This study examined the published literature to explore whether a shared IPC discourse underpins these current efforts.

Using a critical discourse analysis methodology informed by Michel Foucault's approach, the authors analyzed an archive of 188 texts published from 1960 through 2011. The authors identified the texts through a search of PubMed and CINAHL.

The authors identified two major discourses in IPC: utilitarian and emancipatory. The utilitarian discourse is characterized by a positivist, experimental approach to the question of whether IPC is useful in patient care and, if so, what features best promote successful outcomes. This discourse uses the language of "evidence" and "validity." The emancipatory discourse is characterized by a constructivist approach concerned primarily with equalizing power relations among health practitioners; its language includes "power" and "dominance."

This study suggests that IPC is not a single, coherent idea in medical education and health care. At least two different IPC discourses exist, each with its own distinctive truths, objects, and language. The extent to which educators and health care practitioners may tacitly align with one discourse or the other may explain the tensions that have accompanied the conceptualization, implementation, and assessment of IPC. Explicit acknowledgment of and attention to these discourses could improve the coherence and impact of IPC efforts in educational and clinical settings.