Distributed Expertise and Professional Collaboration: Recognizing Relational Interdependence in Healthcare

Background

Healthcare work in the context of the hospital is characterized by the need for collaboration. There are several reasons why this is the case; for example that the complexities involved in modern diagnostic and therapeutic practices require highly specialized services as well as health professionals with a multitude of expert knowledge. Bringing this knowledge together in every instance of patient care requires, amongst other things, that individual professionals acknowledge the mutual dependencies and collaborative needs that arise from the distributed nature of expertise in clinical settings. However, professional cultures, hierarchical relations and differences in communication practices may give rise to inequalities in the recognition of expertise and hamper the open exchange of knowledge in decision-making processes.

 

Study and methods

The paper is based on two separate studies of professional work in hospitals. The studies were carried out using a qualitative design. Data were collected by participant observations as well as by individual and focus group interviews with doctors and nurses. The professional groups were interviewed separately, and more nurses than doctors participated, which reflects the ratio of nurses to doctors.

 

Outline of paper presentation

The purpose of the presentation is to describe how different modes of expert knowing gives rise to relational interdependence between doctors and nurses, using the management of oxygen therapy and mechanical ventilation of preterm newborns as illustrative cases.  Based on findings from the studies, questions to be discussed are; how is the collaborative relationship experienced and performed by the two professional groups and what determines the exchange of knowledge between nurses and doctors in concrete clinical situations? The discussion is informed by a theoretical framework that captures the relational aspects of professional work performance.