The view from here
An orchestral metaphor for interprofessional collaborative practice? Gary Rogers, School of Medicine and Health Institute for the Development of Education and Scholarship (Health IDEAS), Griffith University, Gold Coast, Queensland, Australia Janice Chesters, Auckland University of Technology, Auckland, New Zealand
D
uring a workshop discussion at last year’s All Together Better Health VI conference in Kobe, Japan, participants were musing on the metaphor of a sporting team for collaborative practice (CP) that had been touched on by Patrick Kelley in his introductory keynote.1 One of us (JC) suggested that the relationship between players in an orchestra was another useful metaphor – an idea that she had touched on in a 2011 book chapter2 – and the discussion took flight. That dialogue has continued long after the workshop, and indeed the conference. We have become convinced that the orchestral metaphor has deep utility for promoting the development of collaborative practice in existing teams, as well as helping health professional students and educators to understand why interprofessional learning (IPL) is so important.
There is, of course, nothing new under the sun, and on consulting the peer-reviewed literature we discovered that we are by no means the first to come, independently, to this idea.3,4 As we have explored this metaphor further, we have been impressed by its capacity to accommodate many of the complexities that inhere in contemporary discussions of IPL and CP. It is superior to the sportsteam analogy in that it emphasises intrateam collaboration for a shared and noble purpose, without the unfortunate imagery of between-team aggression and competition. The hoary question of the optimal timing for IPL activities can be easily addressed when one considers that musicians can only benefit from learning to play together after they have already
developed some rudimentary skills on their own instrument. On the other hand, from the very beginning of musical learning, students need to be aware that other instruments exist and recognise that different instruments often play together to produce a whole that is greater than the sum of its parts, as well as having a general sense of how other instruments work and what they sound like – an idea that one of us (G.D.R.) has dubbed ‘health professions literacy’.5 Then, once they have acquired some level of ability on their own instrument, early learning in an orchestral setting enables music students to gain skills related to collaboration that would be impossible to acquire in solo practise, while simultaneously further developing their individual instrumental skills.
The orchestral metaphor has deep utility for promoting the development of collaborative practice in existing teams
Furthermore, the musical analogy allows appropriate consideration of the optimal balance between mentored
© 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 317–318 317
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The metaphor takes account of the complexity related to many health professionals being part of multiple different teams at different times
practise on a performer’s own instrument (uniprofessional training) and guided experiential learning through ensemble rehearsal (IPL) to generate the best ultimate performance by the orchestra. Like leaders of health teams, conductors of orchestras can be experts in any original instrument (or indeed not be an instrumentalist at all). They are chosen because of their expertise in relation to the particular genre and pieces being performed, with no particular player being seen as the ‘natural’ leader. Additionally, the metaphor takes account of the complexity related to many health professionals being part of multiple different teams at different times, with varying degrees of overlap, as individual musicians will perform in various groups,
such as a symphony orchestra, a chamber orchestra and a quartet or other ensemble, in addition to occasional solo performances. Musical performers must also concentrate on maintaining their current virtuosity and collaborative ability, which is seen, as it should be in health care, as at least as important as a long-past qualification. We invite further discussion about ways that the musical metaphor might be employed to help students, educators and practitioners to understand why they need to learn together, and to continuously improve their specific collaborative skills, for the benefit of their audience: the patients, clients and communities whom they serve. REFERENCES 1.
Kelley PW. The future of health professional education: leading change
for health equity. Keynote address presented at the All Together Better Health VI conference; 2012 October; Kobe, Japan. 2.
Chesters J, Burley M. Beyond professional conflict: Cultural and structural barriers to interprofessional health care teams. In: Kitto S, Chesters J, Thistlethwaite J, Reeves S, eds. Sociology of Interprofessional Health Care Practice: Critical Reflections and Concrete Solutions. New York: Nova Science Publishers; 2011.
3.
D’Avray L. Interview with George Szasz, CM, MD. J Interprof Care 2008;22:309–316.
4.
Briggs MH. Systems for collaboration: Integrating Multiple Perspectives. Child Adolesc Psychiatr Clin N Am 1999;8:365–377.
5.
Rogers GD, Chan PC, Buys N. Early or late? Addressing the question of optimal timing for preregistration IPE through development of a threephase curriculum. Paper presented at the All Together Better Health VI conference; 2012 October; Kobe, Japan.
Corresponding author’s contact details: Associate Professor Gary Rogers, School of Medicine, GH1_3.26 Gold Coast Campus, Griffith University, Queensland 4222, Australia. E-mail: [email protected]
Funding: None. Conflict of interest: None. Ethical approval: Not required. doi: 10.1111/tct.12142
318 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 317–318
tct_12142.indd 318
5/23/2014 3:11:29 PM
An orchestral metaphor for interprofessional collaborative practice? Gary Rogers, School of Medicine and Health Institute for the Development of Education and Scholarship (Health IDEAS), Griffith University, Gold Coast, Queensland, Australia Janice Chesters, Auckland University of Technology, Auckland, New Zealand
D
uring a workshop discussion at last year’s All Together Better Health VI conference in Kobe, Japan, participants were musing on the metaphor of a sporting team for collaborative practice (CP) that had been touched on by Patrick Kelley in his introductory keynote.1 One of us (JC) suggested that the relationship between players in an orchestra was another useful metaphor – an idea that she had touched on in a 2011 book chapter2 – and the discussion took flight. That dialogue has continued long after the workshop, and indeed the conference. We have become convinced that the orchestral metaphor has deep utility for promoting the development of collaborative practice in existing teams, as well as helping health professional students and educators to understand why interprofessional learning (IPL) is so important.
There is, of course, nothing new under the sun, and on consulting the peer-reviewed literature we discovered that we are by no means the first to come, independently, to this idea.3,4 As we have explored this metaphor further, we have been impressed by its capacity to accommodate many of the complexities that inhere in contemporary discussions of IPL and CP. It is superior to the sportsteam analogy in that it emphasises intrateam collaboration for a shared and noble purpose, without the unfortunate imagery of between-team aggression and competition. The hoary question of the optimal timing for IPL activities can be easily addressed when one considers that musicians can only benefit from learning to play together after they have already
developed some rudimentary skills on their own instrument. On the other hand, from the very beginning of musical learning, students need to be aware that other instruments exist and recognise that different instruments often play together to produce a whole that is greater than the sum of its parts, as well as having a general sense of how other instruments work and what they sound like – an idea that one of us (G.D.R.) has dubbed ‘health professions literacy’.5 Then, once they have acquired some level of ability on their own instrument, early learning in an orchestral setting enables music students to gain skills related to collaboration that would be impossible to acquire in solo practise, while simultaneously further developing their individual instrumental skills.
The orchestral metaphor has deep utility for promoting the development of collaborative practice in existing teams
Furthermore, the musical analogy allows appropriate consideration of the optimal balance between mentored
© 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 317–318 317
tct_12142.indd 317
5/23/2014 3:11:28 PM
The metaphor takes account of the complexity related to many health professionals being part of multiple different teams at different times
practise on a performer’s own instrument (uniprofessional training) and guided experiential learning through ensemble rehearsal (IPL) to generate the best ultimate performance by the orchestra. Like leaders of health teams, conductors of orchestras can be experts in any original instrument (or indeed not be an instrumentalist at all). They are chosen because of their expertise in relation to the particular genre and pieces being performed, with no particular player being seen as the ‘natural’ leader. Additionally, the metaphor takes account of the complexity related to many health professionals being part of multiple different teams at different times, with varying degrees of overlap, as individual musicians will perform in various groups,
such as a symphony orchestra, a chamber orchestra and a quartet or other ensemble, in addition to occasional solo performances. Musical performers must also concentrate on maintaining their current virtuosity and collaborative ability, which is seen, as it should be in health care, as at least as important as a long-past qualification. We invite further discussion about ways that the musical metaphor might be employed to help students, educators and practitioners to understand why they need to learn together, and to continuously improve their specific collaborative skills, for the benefit of their audience: the patients, clients and communities whom they serve. REFERENCES 1.
Kelley PW. The future of health professional education: leading change
for health equity. Keynote address presented at the All Together Better Health VI conference; 2012 October; Kobe, Japan. 2.
Chesters J, Burley M. Beyond professional conflict: Cultural and structural barriers to interprofessional health care teams. In: Kitto S, Chesters J, Thistlethwaite J, Reeves S, eds. Sociology of Interprofessional Health Care Practice: Critical Reflections and Concrete Solutions. New York: Nova Science Publishers; 2011.
3.
D’Avray L. Interview with George Szasz, CM, MD. J Interprof Care 2008;22:309–316.
4.
Briggs MH. Systems for collaboration: Integrating Multiple Perspectives. Child Adolesc Psychiatr Clin N Am 1999;8:365–377.
5.
Rogers GD, Chan PC, Buys N. Early or late? Addressing the question of optimal timing for preregistration IPE through development of a threephase curriculum. Paper presented at the All Together Better Health VI conference; 2012 October; Kobe, Japan.
Corresponding author’s contact details: Associate Professor Gary Rogers, School of Medicine, GH1_3.26 Gold Coast Campus, Griffith University, Queensland 4222, Australia. E-mail: [email protected]
Funding: None. Conflict of interest: None. Ethical approval: Not required. doi: 10.1111/tct.12142
318 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 317–318
tct_12142.indd 318
5/23/2014 3:11:29 PM
