Complex Care and the Need for Collaborative Brains*

With the rising complexity of patient care comes a rising need for collaborative work. The articles in JRIPE’s sixth issue ( explore two important questions in this regard: How should we organize collaborative work? And how should we prepare future generations for it?

Packard et al. [1] test whether students’ performance working up a case and perceptions of interprofessional skills would improve if they are given modeled examples of interprofessional communication and a team reasoning framework.

Holmqvist et al. [2] highlight the need for co-ordinated research efforts to determine the usefulness of student-run clinics as ideal sites to advance learning in teamwork and social accountability.

Newhouse et al. [3] add to our understanding of how to design effective heart failure management programs. Using a Delphi process, they report data from a series of consultations among health professionals, patients, and family caregivers.

Hutchison et al. [4] test the hypothesis that clinical pharmacists, physicians, and other healthcare professionals providing medication therapy management can improve outcomes and reduce costs among patients at high risk of adverse reactions from medication.

Arar et al. [5] provide insights into the cycles of growth through which multidisciplinary research teams operate. And finally, Butson et al. [6] examine the problems that can affect the creation of interprofessional virtual communities of practice.

All of these studies reflect variations on the theme of care complexity and the need for multidimensional platforms to address that complexity. These studies also highlight the kinds of skills we need to hone—dialogue, compassion, attention to the other, extending loyalties, and social interdependencies.

Indeed, when care is complex, when interactions among health professionals and patient become intricate, with the need to process higher amounts of information, it pays to hone our collaborative brains to broaden our perspective, widen our insights, and extend our predictive abilities. Such collaborative brains would work their way, through successive approximations, toward a better understanding of interprofessional practice. Armed with ideas, tools, and vocabulary, they would elevate their approaches to problems—each new understanding building on another, each new insight the source of a productive vitality that can carry the group for a while, until the next problem, the next challenge to its imagination, the next insight.

* Published as editorial for JRIPE, Vol 2 (3), 2012.

References (available as pdf at

1. Packard, K., Chehal, H., Maio, A., Doll, J., Furze, J. Huggett, K, Jensen, G., Jorgensen, D., Wilken, M., & Qi, Y. (2012). Interprofessional Team Reasoning Framework as a Tool for Case Study Analysis with Health Professions Students: A Randomized Study. Journal of Research in Interprofessional Practice and Education 2(3), 250-263.

2. Holmqvist, J., Courtney, C., Meili, R., & Dick, A. (2012). Student-Run Clinics: Opportunities for Interprofessional Education and Increasing Social Accountability. Journal of Research in Interprofessional Practice and Education 2(3), 264-277.

3. Newhouse, I., Heckman, G., Harrison, D., D’Elia, T., Kaasalainen, S., Strachan, P.H., & Demers, C. (2012). Barriers to the Management of Heart Failure in Ontario Long-Term Care Homes: An Interprofessional Care Perspective. Journal of Research in Interprofessional Practice and Education 2(3), 278-295.

4. Hutchison Jr., R.W., Hash, R.B., & Nault, E.C. (2012). Multidisciplinary Team of a Physician and Clinical Pharmacists Managing Hypertension. Journal of Research in Interprofessional Practice and Education 2(3), 296-302.

5. Arar, N.H., & Nandamudi, D. (2012). Advancing Translational Research by Enabling Collaborative Teamwork: The TRACT Approach. Journal of Research in Interprofessional Practice and Education 2(3), 303-319.

6. Butson, R., Hendrick, P., Kidd, M., Brannstrom, M., & Medberg, M. (2012). Developing a Virtual Interdisciplinary Research Community in Clinical Education: Enticing People to the “Tea-Room.” Journal of Research in Interprofessional Practice and Education 2(3), 320-338.


Published Research, Data, and the Promise of Understanding*

There is something comforting about categorizing objects and events in the world. Categories provide structure to what we see and what we talk about. They are often useful real-world distinctions that extend our capacity to understand and intervene in the world. Scientific instrumentation extends that capacity further, and I believe that scientific publications can do the same. Scientific articles can serve as springboards for reflection, conception, and intervention in the same way that a telescope can open the skies to our eyes and expand our knowledge of the cosmos; hence my commitment to JRIPE as an open access journal for the dissemination of peer-reviewed research.

In this issue (available in PDF at, we publish seven new research articles for which I offer the following categorization. The first three articles can be grouped on the basis of their research method. Using a Participatory Action Approach, Huijbregts et al. [1] describe a pilot study of the implementation of a Canadian mental health guideline in a long-term care residence; Baker et al. [2] use Action Research to develop an educational module on Adult Suctioning for multi-professional groups of students; and Brynes et al. [3] report on the development and evaluation of collaboration in three clinical settings in Southeastern Ontario, Canada, using a quasi-experimental research design.

The next two articles have their unit of analysis as their most salient aspect. Not that these studies were without method; they used specific research designs to collect data, but their particular distinction was in the target of their analyses; namely, students and their interprofessional learning needs. Baerg et al. [4] explore collaboration learning needs among health professionals, teachers, and students, while Flynn et al. [5] reports on differences between Family Medicine Residents and other healthcare learners.

The last two studies have common ground in their research settings: rural communities in Australia. Jacob et al. [6] investigate the perceptions of and opportunities for interprofessional education from the perspectives of staff from three rural health services, and Woodrofe et al.[7] report on three years of results from a mixed methods evaluation of the Australian Interprofessional Rural Health Education Pilot. As both studies seem to suggest, the rural context may be an ideal place to showcase effective interprofessional practice.

We will never have an omniscient view of the nature of interprofessional learning and practice. We can only have categories and forms of reasoning about it. You will find plenty of both in the articles in this issue. How accurate those forms are is an empirical question which only sustained data collection can answer—more or less completely, and more or less precisely, depending on research design and the string of limitations that all scientists worth their salt acknowledge unabashedly. May the data keep coming and may our understanding of interprofessional education keep improving.

*Published as an editorial in Vol 2, Issue 2 of JRIPE at

References (available at:

  1. Huijbregts, M., Guttman, Lisa, Sokoloff, X., Feldman, S., Conn, D.K., Simons, K., Walsh, L., Dunal, L., Goodman, R., Khatri, N. (2012). Journal of Research in Interprofessional Practice and Education, 2(2), 134-151.
  2. Baker, C., Medves, J., Luctkar-Fluke, M., Hopkins-Rosseel, D., Pulling, C., & Kelly-Turner, C. (2012). Evaluation of a simulation-based interprofessional educational module on adult suctioning using action research. Journal of Research in Interprofessional Practice and Education, 2(2), 152-167.
  3. Byrnes, V., O’Riordan, A., Schroder, C., Chapman, C., Medves, J., Paterson, M., & Grigg, R. (2012). Southeastern interprofessional collaborative learning environment (SEIPCLE): Nurturing Collaborative Practice. Journal of Research in Interprofessional Practice and Education, 2(2), 168-186.
  4. Baerg, K., Lake, D., & Paslawski, T. (2012). Survey of interprofessional collaboration learning needs and training interest in health professionals, teachers, and students: An exploratory study. Journal of Research in Interprofessional Practice and Education, 2(2), 187-204.
  5. Flynn, L., Michalska, B., Han, H., & Gupta, S. (2012). Teaching and learning interprofessionally: Family medicine residents differ from other healthcare learners. Journal of Research in Interprofessional Practice and Education, 2(2), 205-218.
  6. Jacob, E.R., Barnett, T., Walker, L., Cross, M., Missen, K. (2012). Australian clinicians’ views on interprofessional education for students in the rural clinical setting. Journal of Research in Interprofessional Practice and Education, 2(2), 219-229.
  7. Woodroofe, J., Spencer, J., Rooney, K., Le, Q., & Allen, P. (2012). The RIPPER experience: A three-year evaluation of an Australian interprofessional rural health education pilot. Journal of Research in Interprofessional Practice and Education, 2(2), 230-247.

Emoticons and Interprofessional Education: A Topic for Research?

By Lindsey Wright* & Hassan Soubhi

Interprofessional Practice and Education (IPE) helps understand how groups of professionals from different fields learn and work together. A key factor in achieving IPE is making certain that the different members of the group form a cohesive working relationship using as many tools as possible. In today’s technological society, diverse people need to find ways to communicate effectively. This can be from many technological platforms such as collaborating information through online classes and message boards, social networking, and more.

One way to optimize communications may be with emoticons. Attitude towards emoticons is as variable as the people who use them. For example, a manager might send a quick email or text to an employee that lets the person know they are doing a good job and add a smiley face at the end for added effect. Similarly, a team leader might have to let his or her team know they will be working late and add a frowny face to let everyone know it’s an unpleasant job, but it needs to be done. Using emoticons in this way may help to foster a positive work environment and allow all the different members of a team to feel connected.

In particular, younger members of a group are more likely to use emoticons more often than older team members. Having grown up in an environment in which texting and symbols often replace real speech, younger members use emoticon to add a tone to a sentence that might otherwise be misinterpreted. For example, when sending an email message about an error, they may include  an emoticon at the end of the message to indicate the benign nature of the error.

Several lines of research evidence from neuroscience suggest potential explanations for how emoticons might have these effects. Research indicates that our brains are able to mirror not only other people’s emotions (what they feel), but also their understanding of things (how they see things cognitively). Research also suggests that people make personality inferences from facial appearance despite little evidence for their accuracy, and an important part of the mirror neuron system seems even implicated in persuasion.

However, experts remain divided about whether emoticons might be used both within a familiar setting and in professional correspondence. In the blog “The Work Buzz,” author Kaitlin Madden addresses the importance of being professional in correspondence, specifically stating that emoticons are strictly forbidden, as well as “text abbreviations,” such as LOL (laughing out loud) or using “B” instead of the word “be.”

In the end, using emoticons seems to be based upon the sort of correspondence being sent, as well as the relationships between sender and receiver. Someone wanting to send an informal email to a colleague might be perfectly at ease with adding an occasional emoticon to the message. On the other hand, someone sending a letter to a potential client or to someone involved in a professional capacity will want to stay away from using emoticons or anything that might detract from the message itself.

As for IPE, if IPE is about learning with, about, and from each other, then emoticons might have a role to play in optimizing that learning. Considering how many times we use e-mails in our daily communications and the great strides that neuroscience is making in understanding how the brain affect our communications, there seems to be a limitless supply of research questions to answer. How effective emoticons are in promoting a positive work environment for IPE is one of them.

*Lindsey Wright is fascinated with the potential of emerging educational technologies, particularly the online school, to transform the landscape of learning. She writes about web-based learning, electronic and mobile learning, and the possible future of education (


Pillay, Srinivasan S. (2010). Your Brain and Business: The Neuroscience of Great Leaders (Kindle Locations 1447-1448). Pearson Education (USA). Kindle Edition.

Said, C.P., S.G. Baron, and A. Todorov, “Nonlinear amygdala response to face trustworthiness: contributions of high and low spatial frequency information.” J Cogn Neurosci, 2009. 21(3): p. 519–28.

Gallese, V. and A. Goldman, “Mirror neurons and the simulation theory of mind-reading.” Trends Cogn Sci, 1998. 2(2): p. 493–501.

Kaplan, J.T. and M. Iacoboni, “Getting a grip on other minds: mirror neurons, intention understanding, and cognitive empathy.” Soc Neurosci, 2006. 1(3–4): p. 175–83.

Online College Classes and Academic Courses for Lifelong Learners. Web. <;.

Madden, Kaitlin. “7 Tips for Improving Email Etiquette.” The Work Buzz., 6 June 2011. Web. <;.

How Many Ways Are There to Build a Bridge?*

The prefix “inter” in “interprofessional” can refer to a bridge that joins two professional “locations.” However, as in real life, this metaphoric bridge also separates two locations. The metaphor draws attention to the flexibility and indeterminacy of the term “interprofessional.”** There can be as many forms of interprofessionality as there are professions—how many ways are there to build a bridge? Probably as many different ways as there are bridges.

I take it as a sign of vitality of a field when its practitioners combine elements from different sources. Eclecticism characterizes fields that are complex and multifaceted, like interprofessional practice and education (IPE). No one set of theoretical and methodological orthodoxy can confine the ways we construct bridges between professions. Likewise, no such limit can be imposed on how we investigate the linkages between concepts, processes, and ways of implementing and assessing IPE in the real world.

The articles in the current issue of JRIPE (available in PDF at reflect this eclecticism. Anderson et al., using a quasi-experimental design, ask whether there is a dose-response between the exposure to interprofessional learning and improvement in knowledge, attitudes, and skills among pre-licensure students [1].

Vingilis et al. used a participatory action approach and a pre-experimental design for a formative evaluation of nine pre-licensure workshops on interprofessional, client-centred mental healthcare [2].

Hall et al. describe a formative evaluation of what they call the Interprofessional Day, an innovation in educational programming for first- and second-year health professions students at the Medical University of South Carolina [3].

Tashiro et al. describe how they developed an interprofessional framework to create computer-based simulations that can automatically assess interprofessional competencies of undergraduate health sciences students [4].

Suter et al., using a framework grounded in complexity science, examined factors essential to building capacity to sustain an intervention in interprofessional collaboration in three different healthcare settings [5].

Weaver et al. report their exploration of how complexity science can explain the experiences of a group of stakeholders as they developed learning activities for an IPE placement in a non-acute-care hospital [6].

Finally, Rowland reports on the Coordinated Management of Meaning Model as an analytic tool to support scholars, practitioners, and educators to reflect critically on the meanings they make within interprofessional education initiatives [7].

How many ways are there to build a bridge between professions? Perhaps as many different ways as there are individuals who think of building them. Each bridge entails a specific arrangement of knowledge that permits certain ways of operating while excluding others. Our job as readers, practitioners, researchers, and policy-makers is to use those bridges—not only to move between professions and ways of thinking, but also to explore the vistas they offer. After all, the journey over a bridge matters as much as its final destination.


* This article was published as an editorial in Vol 2, Issue 1 of JRIPE at

** Joe Moran applies a similar argument to the term interdisciplinary in Interdisciplinarity. 2nd Edition. The New Critical Idiom. Routeledge, Taylor & Francis Group, 2010.

References (available at:

  1. Anderson, J.E., Ateah, C., Wener, P., Snow, W., Metge, C., MacDonald, L. Fricke, M., Ludwig, S., & Davis, P. (2011). “Differences in Pre-licensure Interprofessional Learning: Classroom Versus Practice Settings,” Journal of Research in Interprofessional Practice and Education, 2(1), pp. 3 – 24.
  2. Vingilis, E., Cheryl Forchuk, C., Shaw, L., King, G., McWilliam, C., Khalili, H., Edwards, B., & Osaka, W. (2011). “Development, Implementation, and Formative Evaluation of Pre-licensure Workshops Using Participatory Action Research to Facilitate Interprofessional, Client- Centred Mental Healthcare,” Journal of Research in Interprofessional Practice and Education, 2(1), p. 25 – 48.
  3. Hall, P.D., James S. Zoller, James S., West, V.T., Lancaster, C.J., & Blue, Amy V. (2011). “A Novel Approach to Interprofessional Education: Interprofessional Day, the Four-Year Experience at the Medical University of South Carolina,” Journal of Research in Interprofessional Practice and Education, 2(1), p. 49 – 62.
  4. Tashiro, J., Byrne, C., Kitchen, L., Vogel, E., & Bianco, C. (2011). “The Development of Competencies in Interprofessional Healthcare for Use in Health Sciences Educational Programs,” Journal of Research in Interprofessional Practice and Education, 2(1), pp. 63 – 82.
  5. Suter, E., Siegrid Deutschlander, S. & Lait J. (2011). Using a Complex Systems Perspective to Achieve Sustainable Healthcare Practice Change,” Journal of Research in Interprofessional Practice and Education, 2(1), pp. 83 – 99.
  6. Weaver, L., McMurtry A., Conklin, J., Brajtman, S., & Hall, P. (2011). “Harnessing Complexity Science for Interprofessional Education Development: A Case Study,” Journal of Research in Interprofessional Practice and Education, 2(1), pp. 100 – 120.
  7. Rowland, P. (2011). “Making the Familiar Extraordinary: Using a Communication Perspective to Explore Team-Based Simulation as Part of Interprofessional Education,” Journal of Research in Interprofessional Practice and Education, 2(1), pp. 121 – 131.