A Sample Briefing Paper

Multidisciplinary Team Working Indicators of Good Practice

Valerie Wilson and Anne Pirrie

Introduction

(Introductory Section begins here)

The establishment of new community schools in Scotland has focused attention on the need for members of different professional groups to work together effectively for the benefit of pupils and young people. This paper draws together the factors that support and inhibit multidisciplinary working in order to provide a guide to good practice.

Classrooms are beginning to 'open-up' in schools throughout the UK. Teachers may no longer find themselves working alone or exclusively with members of their own profession, but may also be in multidisciplinary teams composed of classroom assistants, nursery nurses, learning support auxiliaries, educational psychologists, community educators, health and social workers, and parent volunteers.

New Community Schools will bring together in a single team professionals from a range of services. Improved co-ordination of existing services is not enough to achieve the fundamental improvement in children's lives that the Government is seeking. This will require radically new approaches (Scottish Office, 1998, p.4).

This brief sets out to identify published sources of information on multi-disciplinary team working and to draw out the implications for policy and practice in Scottish education.

Understanding Multidisciplinary Teamwork

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What Is Multidisciplinary Teamwork? (Subheading)

What does the term “multidisciplinary team working” mean? At first glance, it may seem obvious that the definition is members of different professions working together. And yet it becomes only too apparent from the literature that it is far from a clear concept. It is clear from the literature that 'putting people together in groups representing many disciplines does not necessarily guarantee the development of a shared understanding' (Clark, 1993). As Nolan (1995) explains, 'interdisciplinary care, although not denying the importance of specific skills, seeks to blur the professional boundaries and requires trust, tolerance, and a willingness to share responsibility' (p.306). Pirre, et. al. (1998) believe multidisciplinary team working requires the notion of interdependence that goes beyond merely working in the same physical space and entails a shared purpose. When this happens a team becomes more than the sum of its parts and develops a “metaperspective'.

What Encourages Multidisciplinary Teamwork? (Subheading)

From the published literature, it is possible to identify a number of factors that encourage the development of multidisciplinary team working. These include some or all of the following. (Example of bulleted list)

· Personal commitment: It is difficult to overestimate the contribution of committed individuals, or 'champions' to the success of multidisciplinary team working. Research projects on multidisciplinary education (Pirrie et al, 1998) and organizational learning (Wilson et al, 1996) made it clear that some of the commitment to this way of working is an essential first ingredient.

· A common goal: It is now generally accepted in the management literature that successful organizations develop a shared vision of the organization's future with their staff. Organizations who share a common vision or goal demonstrate increased confidence and inspiration to learn.

· Clarity of roles and communication: Multidisciplinary teamworking does not require all members of staff to perform the same roles but role clarification is essential. By allocating and rotating team roles to form 'a sort of roles and responsibilities matrix', motivation is maintained (Wilson et al, 1996). Models of professional development suggest that members of professions develop by reflecting on their practice (Schon, 1983). This can be encouraged by team members sharing insights with others.

· Institutional support: Work teams usually exist within an institutional framework that is supportive of multidisciplinary teamworking. Support from organizations for multidisciplinary team working varies considerably. The must be clear evidence for staff that the policy-making center of the organization supports multi-disciplinary team working.

What Inhibits Multidisciplinary Teamwork? (Subheading)

While the above factors may support multidisciplinary team working, it was also evident that the development of multidisciplinary team working can be inhibited. Inhibiting factors include: (Example of bulleted list)

· Logistics: Research (Pirrie et al, 1998) suggests that without proper accommodations, resources, library, and IT facilities multidisciplinary team working is severely restricted. A particularly important logistical factor is provision of “time to get together for problem solving."

· The role of professional bodies: The primary functions of a professional body are to safeguard professional standards and to ensure that education and training are appropriate to that purpose. Professional associations usually guarantee professional standards through accreditation of professional competence. In practice, there is little liaison between different professional bodies, leading to the growth of unsynchronized validation cycles and profession-accreditation of competence.

· Attitudes of team members: Multidisciplinary team working requires mutual understanding between professions. Good communication is only one aspect of multidisciplinary interaction. Teams must also together develop an awareness of each other, begin 'breaking down barriers' and develop an 'appreciation of strengths and weaknesses' (p.23) of team members.

What are the Implications for Education?

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The following six implications should be considered: (Example of number list for emphasis)

1. We conclude that there is very little evidence regarding the efficacy of multidisciplinary team working in educational settings. We have, therefore, utilized evidence arising from studies in related social policy areas of health and social care. We readily admit that situation-specific factors may account for some of the findings but believe that, in the absence of better matched studies, these studies provide some useful pointers to issues which need to be addressed in the education sector.

2. It is now apparent that the Scottish Executive is committed to fostering social inclusion and has announced ambitious targets (Scottish Executive, [1999]). We think that multidisciplinary team working will be one way of addressing complex cross-cutting social issues as members of different professional and occupational groups, including education, work towards the social inclusion targets.

3. We believe that leading and managing multidisciplinary teams requires increased skills and sensitivity. Evidence from successful teams in healthcare provides us with the model of the 'player manager' who is able to develop and lead teams drawn from different professional groups. Appropriate models for education now need to be developed and evaluated.

4. We found that roles in multidisciplinary teams were rarely static. Teams worked best when roles were clarified, when role extension and rotation were included, and members were provided with feedback on their performance. Training in multidisciplinary team working is required if team members are to function effectively together.

5. Research indicated that resources influence the way teams work. Further work on the relationship between physical space, its utilization, and team working is required.

6. And finally, we still do not know whether multidisciplinary teams in education will be more effective at raising standards than traditional ways of organizing staff. If policy is to be underpinned by evidence, then further study of this topic is required.

Raising standards and fostering social inclusion are continuing challenges facing schools. We believe it is unlikely that either can be achieved by teachers working alone. We have aimed here to provide guidance as to the skills teachers will require in order to work in multidisciplinary teams and also the pitfalls to avoid.