Lecture 6 - Interprofessional Collaborative Practice

Teams vs. groups

Teams have clear roles, shared goals, and interdependence; groups may just share ideas without shared accountability.

GROUP DEVELOPMENT – TUCKMAN & JENSEN’S FIVE PHASES

Forming: Orientation, politeness, uncertainty; nurse provides structure and builds trust.
Storming: Conflicts arise; nurse facilitates communication and models respect.
Norming: Cohesion and trust develop; nurse supports collaboration and reinforces positive roles.
Performing: Team efficiently achieves goals; nurse encourages autonomy and sustains progress.
Adjourning: Group disbands; nurse acknowledges accomplishments and supports transition.

Fo Sho No Problem A-hole

What is Group process? How is it different from Group Development

moment-to-moment interactions—how members communicate, share leadership, make decisions, manage emotions, and participate. It differs from group development, which is the stages a group goes through over time.

Roles in group process:

• Task roles: Help the group achieve goals (initiating, clarifying, summarizing, consensus-taking).

• Maintenance roles: Maintain harmony and trust (encouraging, harmonizing, gatekeeping, compromising).

• Non-functional roles: Disrupt progress (aggressor, blocker, joker, avoider, self-confessor, recognition-seeker).

• Balance: Healthy groups need both task and maintenance roles.

Types of Leadership in groups:

• Effective leaders balance task and maintenance, are self-aware, encourage participation, maintain boundaries, and support the emotional climate.

• Styles: Autocratic (one person makes all decisions), Democratic (shared decision-making, most effective), Laissez-faire (minimal guidance, often ineffective).

• Informal & co-leaders: Can shape mood, norms, and collaboration.

Common Process Challenges:

• Monopolizing: One member dominates discussion, limiting participation; addressed by redirecting, using time limits, and encouraging equal input.

• Groupthink: Members avoid conflict to maintain harmony, suppressing critical evaluation; prevented by inviting dissent, assigning a devil’s advocate, and fostering psychological safety.

• Boundary Problems: Blurred professional or personal lines (oversharing, role confusion, confidentiality breaches) disrupt trust and group focus; nurses maintain clear roles and confidentiality.

Group Types:

• Open Groups: Flexible membership, good for support/education; group may revisit early stages with new members.

• Closed Groups: Fixed membership, ideal for therapy or goal-focused work; deeper trust and stable process.

Therapeutic Groups in Nursing:

• Purpose: Promote healing, growth, coping, and skill-building in a structured, supportive environment.

• Nurse’s role: Facilitate trust, empathy, open communication, and safe participation; model respectful interaction.

• Co-leadership: Two facilitators share workload, support each other, and model healthy communication.

Erikson’s Theory Application

Therapeutic groups rebuild trust, identity, and connection in mental health contexts.

Long-Term Care

Reminiscence, reality orientation, remotivation, and resocialization help residents reconnect, feel valued, and improve daily functioning.

Wahkohtowin (Cree concept)

Emphasizes kinship and interconnectedness; nurses create safe, inclusive spaces, promoting healing through relationships built on trust and shared responsibility.

Devil’s Advocate

A person who intentionally challenges the group’s ideas or decisions to stimulate critical thinking, uncover risks, and prevent errors, without personally opposing the team’s overall goals.

Group Types:

Intraprofessional: Members of the same discipline (e.g., all nurses).
Interprofessional: Different healthcare professions working together for patient care; goal is coordinated, holistic, safe care (e.g., nurse and doctor adjusting pain meds).
Interdisciplinary: Different academic or knowledge-focused disciplines collaborating to solve problems or develop curriculum (e.g., nursing, psychology, and sociology faculty designing a course).

Interprofessional Communication:

• Essential for shared understanding, patient safety, and effective teamwork.
• Methods: verbal (SBAR/I-SBAR-R) and written documentation (PIE, DAR, SOAP).
• Promotes trust, clarity, role clarity, and reduces errors.

CIHC Framework Competencies for Collaboration:

• Role Clarification: Know your role and others’ roles.

• Team Functioning: Work efficiently and respectfully within a team.

• Interprofessional Communication: Share information clearly.

• Collaborative Leadership: Share decision-making appropriately.

• Patient/Client/Family-Centred Care: Include patients and supports in decisions.

• Interprofessional Conflict Resolution: Handle disagreements constructively.