Exposing interdisciplinary diversity in a health care setting: Working with simulated forms for interaction in roleplay and on video

In the paper we explore challenges in facilitating interdisciplinary knowledge and power relations in a health care setting. Communication practices in health care are dominated by different models for how communication with patients should take place. Our pedagogical approach differs from the normative and evidence based interaction models based on normative theories which are systematically introduced as part of practitioners’ competence development . We question the relevance of this pedagogical approach as we see these models as abstract idealizations whereas practices unfold in situ (Peräkylä & Vehviläinen, 2003). There seems to be a tension between these normative theories and situated embodied practices Phillips, Kristiansen, Vehviläinen & Gunnarsson, 2012). In the paper we investigate how an interdisciplinary and participatory learning environment can be designed to mediate this tension in a productive way and qualify health professionals´ communication competences (Nordentoft & Wistoft, 2012). Our point of departure is to see tensions and differences as dynamic and transformative forces which allow for different voices to be heard. So our intention as facilitators is to make this happen. However, it is a challenge to do so (Olesen & Nordentoft, 2013; Kristiansen, & Bloch-Poulsen, 2011). The interdisciplinary set up means that the participants have different levels of education, different gender, different gender and different knowledge forms (Gunnarsson, Linell, & Nordberg,1997). Inspired by Bakhtin’s dialogical theory, we look at centripetal and centrifugal forces in participants’ talk and also their tolerance for the emergence of multiple, different and interdisciplinary knowledge forms (Phillips, 2011).
Method
In the paper we draw on data from 6 interdisciplinary workshops. In the workshops role-play of practice situations - both live and performed on video - formed the launching-pad for participants’ oral and written reflections on the way in which they experienced their learning. Role play appears to be productive learning method because it transforms normative conceptions of “how one should act” into situated and concrete interactions. The workshops took place over a period of 1 year and peer collaboration in between the workshops was an essential part of the learning design. The participants brought their observations of each other from practice to each workshop where they got feedback from the other participants. Also we worked with simulated forms of interaction live and on video to stimulate for participants’ reflections on why and how they would assess specific interactions with patients and their relatives. Before the play, we facilitated the role play and reflection process orally and in writing. Once the play started, we stepped back as facilitators and let the participants handle the role play and the following dialogical process themselves.
Findings
The participants appear to be challenged by their interdisciplinary and personal differences and we explore how they negotiate different knowledge and power relations in their learning processes. The combination between roleplay, videoobservation and peer collaboration appear to illuminate differences in the way different professionals – i.e. having different education, gender, ethnic background and knowledge – do practice. Our analysis shows how the nurses, represented by the Danish female participants appear to have a majority voice with its cultural preferences and prejudices become visible and affirmed – at the expense of minority voices, represented by other professionals and also other ethnicity and gender. This became particularly obvious in two role plays in which males with a different ethnical background played professionals. Consequently we conclude that a learning design with role play video narratives and peer collaboration has the potential 1) expose interdisciplinary diversity and initiate collaborative learning processes 2) has potential to develop professionals’ sensitivity to the significance of unexpected, embodied and emotional aspects of interaction and expose participants presuppositions of “how one should act” according to normative theories 3) has potential to improve health professionals´ analytic skills and their ability to link observations with relevant actions. However, it is a challenge to facilitate interdisciplinary differences. More research is called for into facilitation of interdisciplinary learning processes.