Understanding disciplinary perspectives: a framework to develop skills for interdisciplinary research collaborations of medical experts and engineers | BMC Medical Education

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Understanding disciplinary perspectives: a framework to develop skills for interdisciplinary research collaborations of medical experts and engineers | BMC Medical Education

Expertise is highly domain-specific, and learned by being immersed in professional practice [1]. However, today’s rapidly evolving health care systems require clinicians who are capable of meeting complex challenges [2], which often requires interdisciplinary and interprofessional collaborations between experts from distinct disciplines.Footnote 1 With the increasingly central role of innovative medical technologies in many medical specialties [3], health professionals will presumable participate in interdisciplinary and interprofessional research collaborations. But interprofessional and interdisciplinary research collaborations are notoriously difficult (e.g., [4,5,6,7]). Boon et al. (2019) argue that the complexity of current medical practices requires interdisciplinary expertise, which is an extension of adaptive expertise [8]. Interdisciplinary expertise involves the ability to understand the role of disciplinary perspectives.

In this paper, we combine insights from the philosophy of science on disciplinary perspectives and practice experience from an interdisciplinary medical research project aimed at the development and implementation of diffusion MRI for the diagnosis of kidney cancer. Based on these insights and practice experience, we propose a framework for mitigating cognitive and epistemological barriers caused by different disciplinary perspectives. In addition, we present a detailed example of the use of the framework to analyse and explain the experts’ disciplinary perspectives in the aforementioned interdisciplinary research project aimed at developing a diagnostic technology. This case study demonstrates the use of the framework in interdisciplinary research projects. The framework can be used by health professionals to facilitate their interdisciplinary research projects, by analysing and explaining their disciplinary perspectives.

Interdisciplinary research

To address the barriers to interdisciplinary research, various authors have developed analytical frameworks to guide the research process and help disciplinary experts understand what it takes to execute projects together with experts from other disciplines [9,10,11,12]. Menken et al. (2016), for example, provide a method for interdisciplinary research that is much similar to the traditional empirical cycle, including steps such as “identify problem or topic,” “formulate preliminary research questions,” “data collection” and “draw conclusions” [11]. Other frameworks describe which steps need to be taken in the interdisciplinary research process. In the literature on team science, several authors also aim to provide a better understanding of the process of interdisciplinary research. For example, Hasan et al. (2023) focuses on the ‘micro’ layers of the team science ecosystem proposed by Stokols et al. (2019) – the layer of individual team members collaborating in interdisciplinary research projects [13, 14]. From their analysis of an online collaborations between early academics from different fields, they provide insights into common issues in interdisciplinary research and methods for dealing with them. By applying their framework from the start of the interdisciplinary research process, they argue, interdisciplinary capture [15] can be avoided.

Although the aforementioned frameworks provide valuable guidance on the process of interdisciplinary collaboration, they do not address the deeper cognitive and epistemological challenges of interdisciplinary research collaboration [5, 16], which is the objective of our contribution. A crucial assumption in current frameworks seems to be that interdisciplinary research collaboration is learned by doing, and that the integration of different disciplines will automatically follow.Footnote 2 In our view, however, the integration of different disciplines is both crucial and one of the most challenging aspects of interdisciplinary research collaboration. In previous work we have argued that the inherent cognitive and epistemological (knowledge-theoretical) challenges of integration have been neglected by most authors providing models for interdisciplinary research [8]. In this paper, our focus is therefore on challenges of using and producing knowledge in interdisciplinary research collaborations that aim at solving complex real-world problems. Examples are collaborations between distinct medical specialists in the diagnosis and treatment of a specific patient (e.g., an oncologist and radiologist), but also collaborations between medical experts and biomedical engineers aimed at innovative medical technology for clinical uses. In this paper, we focus on interdisciplinary research projects, in which two or more academic fields are integrated to solve real-world problems, and not on transdisciplinary projects in which one or more academic fields are integrated with expertise from outside of academia such as policy-making or practice.Footnote 3

The challenge of interdisciplinary research collaborations aimed at solving a shared problem is that each expert is guided by his/her own disciplinary perspective. However, the results produced by experts from different disciplines, although internally coherent, are not mutually coherent, so that they are not easily integrated. Furthermore, approaches and results understood within a contributing disciplinary perspective are not easily understood by experts specialised in other disciplinary perspectives, even though each expert aims to contribute to the same problem.

In short, the way in which experts use and produce knowledge is guided by the disciplinary perspective typical of their own practice. But experts are often unaware of having a disciplinary perspective. We argue that this is an obstacle to participating in interdisciplinary research collaborations focused on using and producing knowledge for complex problem-solving. Moreover, disciplinary perspectives are often considered impenetrable —as they are acquired by doing— which makes dealing with the disciplinary perspective of other experts a difficult learning objective. In this paper, we defend that disciplinary perspectives can be made explicit in a systematic manner, and that their role in ‘how experts in a specific discipline use and produce knowledge’ can thus be made understandable for experts and students in both their own and other disciplines.

To this end, we have developed a framework, based on new insights in the philosophy of science and on practice experience of interdisciplinary research collaboration aimed at the development of a medical technology, which can be used by experts in a particular discipline to analyse different elements of their discipline and, together with collaborators, to analyse the same elements from other disciplines. We believe that this systematic approach to understanding disciplinary perspectives will facilitate interdisciplinary research collaborations between experts from different fields. It will create awareness of one’s own disciplinary perspective and the ability to understand the disciplinary perspective of other experts at a sufficient level. Our framework thus aims to alleviate the challenge of integration in a collaborative research project by providing a tool for analysing disciplinary perspectives. We suggest that the concrete descriptions of disciplinary perspectives that result from the application of the framework, clarify the approaches of experts in a multi-disciplinary team. It thus enables effective communication through improved understanding of how each discipline contributes. Once researchers sufficiently understand each other’s discipline, they will be able to construct so-called conceptual models that integrate content relevant to the problems at hand.Footnote 4

Education in interdisciplinary research

In addition to professionals using our framework to facilitate collaboration in interdisciplinary research projects, we suggest that this framework can also be implemented in medical education. It can be used to teach students what it means to have a disciplinary perspective, and to explicate the role of disciplinary perspectives of disciplinary experts participating in an interdisciplinary research collaboration. We have implemented this framework in an innovative, challenge-based educational design that explicitly aims to support and promote the development of interdisciplinary research skills [22]. Research into the intended learning objectives has not yet been completed, but our initial findings indicate that the proposed framework effectively supports students in their ability to develop crucial skills for conducting interdisciplinary research projects. We suggest therefore that the framework can also be implemented in HPE as a scaffold for teaching and learning metacognitive skills needed in interdisciplinary research collaborations, for example between medical experts and engineers.

Research has shown that interprofessional education courses for healthcare students can have a positive effect on the knowledge, skills and attitudes required for interprofessional collaboration, but that organising such interventions is challenging [23, 24]. In the HPE literature, it is generally assumed that the limitations of interprofessional and interdisciplinary teamwork are due to problems of communication, collaboration and cooperation [25, 26], which are linked to barriers and enablers at institutional, organizational, infrastructural, professional and individual levels (e.g., [27, 28]). Therefore, interprofessional and interdisciplinary collaborations are discussed extensively in the HPE literature – our focus is challenges of interdisciplinary research collaboration.

The ability to use and produce knowledge and methods in solving (novel) problems is covered in the HPE literature by the notion of adaptive expertise, which encompasses clinical reasoning, integrating basic and clinical sciences, and the transfer of previously learned knowledge, concepts and methods to solve new problems in another context (e.g., [1, 29,30,31,32,33,34]). In previous work, we introduced the concept of interdisciplinary expertise, which expands on the notion of adaptive expertise by including the ability to understand, analyse and communicate disciplinary perspectives [8]. In this paper, we address the challenge posed by how this ability to understand, analyse and communicate disciplinary perspectives can be learned. The framework that we propose can be implemented in HPE to function as a tool to scaffold metacognitive skills of health professions students, facilitating the development of interdisciplinary expertise.

Aims and contributions of this paper

Our first objective is to show that interdisciplinary collaboration in (medical) research faces not only institutional, but also cognitive and epistemological barriers. Therefore, we first provide a theoretical explanation of the concept of ‘disciplinary perspective’ as developed in the philosophy of science, in order to make it plausible that the cognitive barriers experienced by experts in interdisciplinary collaboration are the result of different disciplinary perspectives on a problem and its solution.

Our second objective is to provide a systematic approach to improve interdisciplinary research, for which we propose a framework, in the form of a series of questions, based on new insights from the philosophy of science into the epistemology of interdisciplinary research. We provide a detailed explanation of the application of the proposed framework in an interdisciplinary medical research project to illustrate its applicability in a multidisciplinary research collaborations, by showing that the different disciplinary perspectives that inform researchers and technicians within a multidisciplinary research team can be made transparent in a systematic way.

In short, our intended contribution is (i) to explain cognitive and epistemological barriers by introducing the concept of disciplinary perspectives in medical research collaborations, (ii) to offer a framework that enables the mitigation of these barriers within interdisciplinary research projects that are caused by different disciplinary perspectives, and (iii) to illustrate the applicability of this framework by a concrete case of an interdisciplinary research collaboration in a medical-technical research setting.

Methods

We developed a framework for making disciplinary perspectives of experts participating in an interdisciplinary research collaboration explicit, by combining insights from the philosophy of science with practical experience from a medical research project. Philosophy of science provided the theoretical basis for our concept of disciplinary perspectives. Our detailed case-description stems from an interdisciplinary medical research project to develop and implement a new imaging tool for the diagnosis of kidney cancer, in which the first author participated. We then applied the framework to analyze and articulate the disciplinary perspectives of experts involved in this interdisciplinary medical research project.

The usefulness and applicability of the proposed framework was tested by the first author who, in her role as PI, was able to use it successfully in coordinating an interdisciplinary research project aimed at developing a biomedical technology for clinical practice [35, 36]. Below, we illustrate how the framework was systematically applied to this specific case, providing initial evidence of its applicability. However, to test whether the proposed framework reduces the cognitive and epistemological barriers caused by different disciplinary perspectives, experts need to be trained in its use. We suggest that training in the use of this framework requires, among other things, some insight into the philosophical underpinnings of the concept of ‘disciplinary perspective’. Our explanation of the so-called epistemology of disciplinary perspectives in this paper aims to provide such insight.

Developing a framework for analysing and articulating a disciplinary perspective

The framework proposed here is based on insights about disciplinary perspectives in the philosophy of science. These insights concern an epistemology (a theory of knowledge) of scientific disciplines. In other words, the framework is based on an account of the knowledge-theoretical (epistemic) and pragmatic aspects that guide the production of knowledge and scientific understanding by a discipline [21].

The epistemology of scientific disciplines developed in our previous work is based on the philosophical work of Thomas Kuhn [37]. Building on his seminal ideas, we understand disciplinary perspectives as analysable in terms of a coherent set of epistemic and pragmatic aspects related to the way in which experts trained in the discipline (and who have thus, albeit implicitly, acquired the disciplinary perspective) apply and produce knowledge [38]. In our approach, the epistemic and pragmatic aspects that generally characterize a discipline, are made explicit through a set of questions that form the basis of the proposed framework (see Table 1, and the first column of Table 2). The disciplinary perspective can thus be revealed through this framework. In turn, when used in educational settings, this framework can be used to foster interdisciplinary expertise by acting as a scaffold for teaching and learning metacognitive skills for interdisciplinary research collaborations.Footnote 5

Table 1 Framework for analyzing a disciplinary perspective
Table 2 Analysis by means of the framework (see Table 1) in the first column, of the disciplinary perspectives of four disciplines (I – IV) involved in the development of diffusion MRI for the diagnosis of kidney cancer. Next to the general descriptions of each disciplinary perspectives, each aspects is specified for the case at hand and relative to each discipline

The general aspects indicated by italics in each question in Table 1 are interdependent, so that analysis using this framework results in a coherent description of the disciplinary perspective in terms of these aspects. The framework can be used by experts in an interdisciplinary research project not only to make explicit their disciplinary perspective in a general sense, but to also to specify in a systematic way how these aspects relate to the interdisciplinary research problem from their disciplinary discipline (see Table 2, which contains both the general and problem-specific descriptions for each aspect per discipline). In our view, this approach is productive in overcoming the cognitive and epistemological barriers. It thus contributes to productive interdisciplinary collaboration.

Applying the framework in an interdisciplinary medical research project

To test the applicability of this framework, we applied it to an interdisciplinary medical research project. The interdisciplinary medical research project aimed at developing a new clinical imaging tool, namely, diffusion magnetic resonance imaging (i.e., diffusion MRI) to characterize the micro-structural makeup of kidney tumours, running from early 2014 to mid-2018. The first author was involved in this project as a principle investigator (PI). As an interdisciplinary expert with a background in technical medicine, which combines medical training with technological expertise [41], she coordinated and integrated contributions from experts with medical and engineering backgrounds. In her role as PI, she applied the proposed framework to analyse and articulate the disciplinary perspectives of other experts involved in the medical research project.

The aim of the interdisciplinary medical research project was to develop a new imaging tool for the characterization of renal tumours, i.e., diffusion MRI. Diffusion MRI allows for visualization and quantification of water diffusion without administration of exogenous contrast materials and is, therefore, a promising technique for imaging kidney tumours. In earlier studies, several parameters derived from diffusion MRI studies were found to differentiate between different tumour types in the kidney [42,43,44]. Existing imaging methods in clinical practice can detect the size and location of kidney tumours, but the tumour type and malignancy can only be determined histologically after surgery. The purpose of the medical research project was to assess whether more advanced parameters that can be obtained from diffusion MRI [35, 45] can differentiate between malignant and benign kidney tumours [36]. Being able to make this distinction could potentially prevent unnecessary surgery in patients with non-malignant tumours.

The interdisciplinary medical research project needed to bring together expertise (knowledge and skills) from different professionals, academic researchers as well as clinicians. Therefore, the research team consisted of a physicist, a biomedical engineer, a radiologist, a urologist and the principle investigator. The complex, interdisciplinary research object can be thought of as a system that encompasses several elements: the MRI-machine, the software necessary to produce images, the patient with a (suspected) kidney tumour, and the wider practice of care in which the clinical tool should function. In developing the clinical tool, these elements must be considered interrelated, whereas usually each expert focuses on one of these elements.

The PI utilized the framework to coordinate and integrate the contributions from different experts in the following manner. Throughout the project, she had meetings with each of the team members, where she probed them to explain their specific expertise in regard of the research object, as well as their expert contribution to the development of the imaging tool. Her approach in these meetings was guided by the general questions of the framework (Table 1). In this manner, she succeeded in getting a clear insight in aspects of each discipline relevant to the research object, and also in the specific contribution that needed to be made by each expert (as illustrated in Table 2 below). The level of understanding gained by this approach enabled her to, firstly, facilitate interdisciplinary team meetings in which disciplinary interpretations and questions from the experts about the target system could be aligned, and secondly, integrate their contributions towards the development of the new imaging tool [36].

In the presented approach, the framework was exclusively used by the PI, enabling her to acquire relevant information and understanding about the contributions of the disciplines involved. The other team members in the medical research project were not explicitly involved in applying the framework, nor in articulating their own disciplinary perspective or that of others. Hence, the resulting articulation of the disciplinary perspectives and of the contributions per discipline to the research object (in Table 2) is crafted by the PI. The level of understanding of the role of each discipline that the PI has acquired thereby appears to be sufficient to enable her coordinating task in this complex medical research project. Our suggestion for other research and educational practices, though, is that clinicians (as well as) other medical experts can develop this metacognitive skill by using the scaffold (in Table 1) in order to participate more effectively in these kinds of complex medical research projects.

In the results section we will first present our explanation and justification of the idea that disciplinary perspectives determine the specific approaches of experts (who have been trained in a specific discipline in using and producing knowledge) when faced with a complex problem. In this explanation and justification, we will use insights from the philosophy of science. Next, we will explain and illustrate the systematic use of the proposed framework (Table 1) by showing the results of applying it to the interdisciplinary medical research project.

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