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Louder than words: power and conflict in interprofessional education articles, 1954-2013
Elise Paradis1, Cynthia R Whitehead
1Department of Anaesthesia, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Postgraduate Medical Education, Faculty of Medicine, University of Toronto, Ontario, Canada.
Context:
Interprofessional education (IPE) aspires to enable collaborative practice. Current IPE offerings, although rapidly proliferating, lack evidence of efficacy and theoretical grounding.
Objectives:
Our research aimed to explore the historical emergence of the field of IPE and to analyse the positioning of this academic field of inquiry. In particular, we sought to investigate the extent to which power and conflict - elements central to interprofessional care - figure in the IPE literature.
Methods:
We used a combination of deductive and inductive automated coding and manual coding to explore the contents of 2191 articles in the IPE literature published between 1954 and 2013. Inductive coding focused on the presence and use of the sociological (rather than statistical) version of power, which refers to hierarchies and asymmetries among the professions. Articles found to be centrally about power were then analysed using content analysis.
Results:
Publications on IPE have grown exponentially in the past decade. Deductive coding of identified articles showed an emphasis on students, learning, programmes and practice. Automated inductive coding of titles and abstracts identified 129 articles potentially about power, but manual coding found that only six articles put power and conflict at the centre. Content analysis of these six articles revealed that two provided tentative explorations of power dynamics, one skirted around this issue, and three explicitly theorised and integrated power and conflict.
Conclusions:
The lack of attention to power and conflict in the IPE literature suggests that many educators do not foreground these issues. Education programmes are expected to transform individuals into effective collaborators, without heed to structural, organisational and institutional factors. In so doing, current constructions of IPE veil the problems that IPE attempts to solve.
