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Role theory and the practice of interprofessional education: A critical appraisal and a call to sociologists

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Abstract

The stated goals – and therefore manifest functions – of Interprofessional Education (IPE) are to bring students of various health professions together to cultivate mutual understanding and respect for each occupation’s role(s) and foster a culture of collaboration and teamwork to promote more effective and efficient care. Yet, there are telling gaps within IPE literature regarding the application of role theory to IPE pedagogy and research. In this work, we apply a sociological lens and the tenets of role theory to identify and analyze: (a) the apparent tensions nested within IPE aims with respect to issues of role specificity and role blurring; (b) the lack of attention paid to possible role adjustment strategies utilized by IPE students; (c) ambiguities within the IPE (and IPC) literature regarding the role(s) of the patient, including a failure to adequately acknowledge the status hierarchy of health-care delivery; and (d) how IPE may serve as a catalyst to reframe understandings of the physicians as ‘team leader’. In addressing these issues, we suggest discipline-specific qualities that sociologists bring to IPE research, and future directions and applications for sociologists interested in exploring elements of IPE.

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Notes

  1. In this article, we purposely use the term ‘occupation’ as a sociological descriptor. Conversely, we use the term ‘interprofessional’ in keeping with the industry standard for the label of the specific educational initiative.

  2. Although this article is primarily concerned with the IPE literature, we frequently delve into the IPC literature as well to more fully explore and unpack particular concepts and issues.

  3. Emphasis added by original author.

  4. It is also important to note that one can have multiple roles on multiple roles such that there are multiple ‘nurse roles’ but a nurse may also have multiple ‘father roles’ and multiple ‘son roles’ and multiple ‘friend roles’ – all having multiple folders and multiple files detailing ‘how to be’ each of these in various settings.

  5. For the sake of clarity and simplicity we will not be delving into the distinctions among specialties (emergency medicine, medical intensive care, obstetrics and gynecology and so on) and how these different settings and occupational cultures impact perceptions of nurse roles.

  6. A hospital or a health occupations education can be defined as a system of roles. Therefore, from this perspective, the notion of ‘stress’ is at the structural level denoting the conflict and ambiguity between and among the roles nested within the structure.

  7. Emphasis added by original author.

  8. It is important to emphasize that this ambivalence is located in the system of roles, not the emotionality or personal characteristics of the role occupant.

  9. See Sims et al (2015) for an extensive review of the role blurring literature and empirical evidence for the practice of role blurring.

  10. This is not to say that these types of patient-centered IPE programs are ‘wrong’ or disempowering to the patient – we are merely noting the engrained nature of the biomedical model’s perspective of the patient as illness to be diagnosed and treated, and how this has a significant impact on the role of the patient within IPE.

  11. In this sense (patient as catalyst of role activation) the patient serves as an axis for role definition among health-care occupations in that what can distinguish the roles of each of the occupations is, in part, what they ‘do’ for the patient.

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Authors and Affiliations

  1. Department of Sociology, University of Delaware, 18 Amstel Ave, Smith Hall, Newark, 19716, DE, USA

    Barret Michalec

  2. Department of Family & Community Medicine, Thomas Jefferson University, 1025 Walnut Street, Suite 100, Philadelphia, 19107, PA, USA

    Barret Michalec

  3. Program on Professionalism and Ethics, Mayo Clinic, 200 First Street SW, Plummer Bldg 4-26, MN 55905, Rochester

    Frederic W Hafferty

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Correspondence to Barret Michalec.

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Michalec, B., Hafferty, F. Role theory and the practice of interprofessional education: A critical appraisal and a call to sociologists. Soc Theory Health 13, 180–201 (2015). https://doi.org/10.1057/sth.2015.2

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