D'Amour Danielle, Oandasan Ivy
Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada.
J Interprof Care. 2005 May;19 Suppl 1:8-20. doi: 10.1080/13561820500081604.
This paper proposes a new concept and a frame of reference that should permit the development of a better understanding of a phenomenon that is the development of a cohesive and integrated health care practice among professionals in response to clients' needs. The concept is named "interprofessionality" and aims to draw a clear distinction with another concept, that of interdisciplinarity. The utilization of the concept of interdisciplinarity, which originally concerns the development of integrated knowledge in response to fragmented disciplinary knowledge, has caused some confusion. We need a concept that will specifically concern the development of a cohesive practice among different professionals from the same organization or from different organizations and the factors influencing it. There is no concept that focuses clearly on this field. Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives as well as determinants and processes inherent to interprofessional collaboration. Interprofessionality also involves analysis of the linkages between these two spheres of activity. An attempt to bridge the gap between interprofessional education and interprofessional practice is long overdue; the two fields of inquiry need a common basis for analysis. To this end, we propose a frame of reference, an interprofessional education for collaborative patient-centred practice framework. The framework establishes linkages between the determinants and processes of collaboration at several levels, including links among learners, teachers and professionals (micro level), links at the organizational level between teaching and health organizations (meso level) and links among systems such as political, socio-economic and cultural systems (macro level). Research must play a key role in the development of interprofessionality in order to document these linkages and the results of initiatives as they are proposed and implemented. We also believe that interprofessionality will not be pursued without the requisite political will.
本文提出了一个新的概念和参照框架，有望促进对一种现象的深入理解，即专业人员为满足客户需求而发展出的一种具有凝聚力和综合性的医疗保健实践。这个概念被命名为“跨专业协作性”，旨在与另一个概念——“跨学科性”——明确区分开来。跨学科性这一概念最初涉及针对碎片化的学科知识发展综合知识，但在使用过程中造成了一些混淆。我们需要一个专门关注同一组织或不同组织中不同专业人员之间凝聚性实践的发展及其影响因素的概念。目前尚无明确聚焦这一领域的概念。跨专业协作性涉及影响跨专业教育举措的过程和决定因素，以及跨专业协作所固有的决定因素和过程。跨专业协作性还包括对这两个活动领域之间联系的分析。弥合跨专业教育与跨专业实践之间差距的尝试早就该进行了；这两个研究领域需要一个共同的分析基础。为此，我们提出一个参照框架，即“以患者为中心的协作性跨专业教育实践框架”。该框架在多个层面建立了协作的决定因素与过程之间的联系，包括学习者、教师和专业人员之间的联系（微观层面）、教学组织与卫生组织之间在组织层面的联系（中观层面）以及政治、社会经济和文化等系统之间的联系（宏观层面）。研究必须在跨专业协作性的发展中发挥关键作用，以便记录这些联系以及所提议和实施举措的结果。我们还认为，没有必要的政治意愿，就不会有跨专业协作性的推进。
