Beyond the discipline: Nurse practitioner members and leaders of interdisciplinary research teams

Abstract

Complex clinical questions and problems require expertise beyond one discipline to answer or resolve. Research teams that include members with different foundational perspectives across various disciplines are needed. In particular, the growing trend toward technological innovations to help patients self-manage health has been the impetus for the development of interdisciplinary research teams. The goal of this study was to provide guidance for nurse practitioners who are interested in developing effective and successful interdisciplinary teams to complete clinical research projects. A case example is used throughout the study to illustrate the process of interdisciplinary team building. The success of interdisciplinary teams requires team members who are fully invested in the project, available and willing to engage and communicate with other members of the team, and able to form relationships of trust and respect for each discipline’s unique contributions to the project.

Introduction

Clinical questions and problems in the 21st century often require expertise beyond one discipline to answer or resolve. Research teams, which include members with different foundational perspectives across various disciplines, are needed (Proctor & Vu, 2019; Thompson, 2009). In particular, the growing trend toward technological advances to meet the health care needs of individuals with chronic health conditions has expanded the focus of nursing research. Nurses are investigating innovative, technologically advanced, creative methods, to help our patients self-manage health conditions in real-time (National Institute of Nusing Research, 2016). This growing call for technological innovations to help patients self-manage health has been an impetus for the development of interdisciplinary research teams. The National Academies defines interdisciplinary research as “a mode of research by teams, or individuals, that integrates information, data, techniques, tools, perspectives, concepts, and/or theories from two or more disciplines, or bodies of specialized knowledge, to advance fundamental understanding, or to solve problems whose solutions are beyond the scope of a single discipline, or area of research practice” (2004, p. 26). Indeed, interdisciplinary research is becoming a necessity in today’s complex, technologically challenging, clinical environment. Expertise in one area of science is, in many instances, too limiting (Proctor & Vu, 2019).

Nurse practitioners often contribute to clinically focused teams. Nurse practitioners have led clinical intervention projects (e.g.; Anderson & Ferguson, 2019; Mora, Dorrejo, Carreon, & Butt, 2017) and have been members of interdisciplinary health care provider teams (Gigli, Dietrich, Buerhaus, & Minnick, 2018). One publication highlighted a nurse’s experience as a principle investigator on a transdisciplinary team proposal (considered the most integrated form of team research; Kneipp et al., 2014). To be sure, nurse scientists on interdisciplinary teams are able to connect the nonhealth interdisciplinary team members to the practice setting (Jang, Weberg, & Dower, 2018). Nurse researchers are encouraged to join interdisciplinary research teams, both to contribute their expertise in health care and to benefit from collaborations with researchers from other disciplines (Solis, 2017). Although nurses and nurse practitioners have been members of interdisciplinary research teams, the role of nurses, and more specifically nurse practitioners, as interdisciplinary research project team leaders has not been detailed or recognized in the literature. Yet, nurses are well suited to be team leaders for projects that focus on the many aspects of health.

The purpose of this study was to provide guidance for nurse practitioners who are interested in developing effective and successful interdisciplinary research teams from one who has had led such a team. A case example is used throughout the study to illustrate the process of interdisciplinary team building to successfully complete complex clinically relevant research projects.

Interdisciplinary team project development

To develop an effective interdisciplinary research team, the nurse practitioner must identify the expertise that is needed on the team (Bennett, Gadlin, & Levine-Finley, 2013). Depending on the clinical questions, or problems, these experts may be engineers, biologists, computer scientists, environmentalists, biostatisticians, psychologists, or business administrators. For those fortunate enough to be part of a large university community, researchers from other disciplines are most likely members of the same campus community. In addition, health care centers use a diverse group of scientists. To find them, the nurse practitioner must look beyond the borders of their own school or clinic. In other words, nurse practitioners need to venture beyond their “comfort zone.” Attending meetings where different disciplines will be present is a great way to start networking with scientists across disciplines and to engage with them in conversations about clinical research interests. Academic and clinical researchers should consider joining research-focused groups, campus or community committees, or attending symposiums, where diverse scientists are likely to gather.

Case example

Three members of a stress research team consisting of a nurse practitioner, a neuropsychologist, and a biostatistician/psychologist had worked together for several years investigating the health outcomes of childhood adversity, particularly, changes in the stress response that has been repeatedly associated with health problems (Campbell, Walker, & Egede, 2016; Kalmakis & Chandler, 2014). The team became aware of new technologies that allowed for detection of cortisol in sweat using skin sensors (Heikenfeld, 2016; Kim et al., 2017). The team members recognized that this technology could revolutionize the self-management of stress. Through networking on the university campus, the three were able to connect with a polymer scientist who was conducting early research with skin sensors. This led to further meetings in which a general enthusiasm for the idea developed. The scientists agreed to future collaboration to develop a skin sensor, reflective of biological stress, and together, the team procured funding. A new interdisciplinary team was formed for the purpose of completing the goals of the funded project. The team comprised the following members: a nurse practitioner (team leader), a neuropsychologist, a biostatistician/psychologist, an industrial engineer, a polymer scientist, a graduate nursing research assistant, two research assistants from polymer science, and one visiting professor from polymer science.

Once an interdisciplinary team has been formed, the question becomes, how can the team accomplish the required scientific goals and objectives when the researchers are not familiar with each other’s science? Each discipline comes to the team with their own knowledge that includes terms specific to their science (Thompson, 2009). So, how do they talk to each other? Team members must be willing not only to share the research progress in their discipline’s area but also to sufficiently educate others on the team so they may understand and engage in the discussion (Thompson, 2009). It is through team discussions that links between the sciences are made, and goals accomplished. Therefore, regular team meetings during which members from the various disciplines provide updates on their progress toward the team goals is a must to insure success.

It is critical to develop trust and mutual respect between team members (Tracy & Chlan, 2014). The members depend on each other to carry out their project-related activities so that the team can accomplish the goals and objectives set. By clearly acknowledging each members’ area of expertise and their unique and valued role on the team, a mutual respect for the unique knowledge each brings will develop (Tracy & Chlan, 2014). Methods for demonstrating this trust and appreciation for the sciences may be facilitated by visiting the different laboratories, reading scientific publications in the various disciplines, and setting aside time for presentations at meetings.

Case example

The newly formed interdisciplinary team first discussed project goals and measurable objectives. Monthly meetings were scheduled during which members provided updates on their progress, including their work in the polymer science and nursing laboratories. During the meetings, conversations often centered around the sharing of member activities and progress toward the team goals. These discussions were often complex and included language that was discipline specific. The discipline-specific language used by the member of the team was one of the most significant obstacles to team communication. The lack of understanding of specific terminology used to describe the work led to periods of confusion and uncertainty. The polymer scientists talked about microfluidic channels, and nurses about sympathetic responses. However, over time, team members developed a sense of comfort, trust, and rapport that allowed for free expression, resulting in members feeling comfortable enough to freely ask clarifying questions when the information shared was unclear.

On several occasions, to improve communication within the team, the nurse practitioner and neuroscientist visited the polymer science laboratories to learn more about the sensor development process and progress. Of interest a connection was found when the nurse practitioner toured the “clean room” in the polymer laboratory wearing gown, gloves, and foot wear. The experience was very similar to preparing for entry into a surgical suite. The opportunity not only allowed for a better understanding of the science but also presented a chance to bond over procedures similar across the disciplines, further strengthening team relationships.

Undeniably, personality matters in interdisciplinary research teams (Lyall & Meagher, 2007). Congenial members, who are truly interested and invested in the research, are essential for the team’s success. The ability to laugh and get to know each other personally through efforts to reach across disciplinary boundaries was key to the teams’ ability to work well together.

Over time, the engineer and polymer scientist (team members) became more difficult to engage and became less committed to the team. Attempts to re-engage them were not successful. The two continued their role supervising the work in the polymer laboratories but were not engaged members of the team. This may have been the result of diverse disciplinary research goals. The polymer scientist and industrial engineer were focused on the device itself and the possibility of outside industry interest. Nursing and psychology members were most interested in the scientific innovation and how it could influence research in stress and health. Unfortunately, these parallel goals were not fully discussed and appreciated, and therefore, the team members lacked a common understanding. This likely led to the disengagement and distancing of the two engineering scientists because the road to industry partnerships was not clear.

Interdisciplinary teams may have varying philosophical views that influence the atmosphere, communication, and progress of the team. Although team members join the team with common goals, the impetus behind their interest may differ. Indeed, different disciplines often focus on different aspects of the project that ultimately bring the entire team closer to their goal (Proctor & Vu, 2019). It is important to discuss why members are interested in the project and what outcomes they value most. For example, members may focus on product development, creating new methods of analysis, studying the process of the team, or developing a trajectory of research that they can continue to pursue.

The lack of engagement by two members was a cause for concern among the remaining members of the team because communication about progress and plans for next steps were uncertain at times. Nevertheless, the research continued with the leader keeping the team focused on the goals and objectives of the project. There was no challenge of leadership, or “jockeying for power,” at any time during the year-long project (Thompson, 2009, p. 284). Indeed, with the waning interest of the two engineering scientists, the members looked to the nurse scientist for leadership to keep the team focused on successful attainment of the project goals.

Leadership is very important to a research team but becomes even more important in multidisciplinary teams. Leaders provide direction and guidance (Merriam-Webster Dictionary, 2019) to the team, set the tone, and keep the team focused on the aims and goals of the project (Proctor & Vu, 2019). A team leader must be able to communicate clearly, share information, and articulate the vision and goals of the team (Lyall & Meagher, 2007). As nurse practitioners are naturally effective problem solvers and leaders (Grossman, 2018), they are well suited to the role of an interdisciplinary research team leader—not only for their communication skills and organizational skills but also for their ability to relate well with people and extend care and concern for the well-being of team members.

Case example

The interdisciplinary team project ended with progress on the development of the skin sensor in the polymer laboratories, and two students were able to use their work on this study to complete their dissertations. The data collected in the human laboratory were also very useful and provided evidence for the relationship between early adversity, stress, and fatigue. The data were used to apply for further grant funding.

The nurse practitioner, along with the neuropsychologist and biostatistician/psychologist, recruited new interdisciplinary team members from engineering because the work to develop a skin sensor continues. The members have engaged in open discussions pertaining to expectations of individuals and goals of the team. Details of each members’ responsibilities, as well as plans for funding, and implications for both future research and product outcomes continue to be discussed with guidance from the experts in research-industry interface.

Conclusion

The 1-year grant limited the time needed to form a fully cohesive interdisciplinary team. The subteam of three members had the advantage of working together for several years before expanding the team for this project, which likely instilled some stability within the larger interdisciplinary team (Lungeanu, Huang, & Contractor, 2013). Although a few members of the interdisciplinary team did not remain engaged and committed to the goals of the team, the remaining members did establish an atmosphere of trust and respect and, in the end, made significant progress. The three core members persisted and recruited new team members who could provide needed expertise to continue the work of the team. Lessons learned include being frank and open about time commitments for meetings and reports, creating a realistic timeline for specific incremental goals, engaging in clear conversations about desired outcomes, and each members responsibilities to the team. The success of interdisciplinary teams requires team members who are fully invested in the project, who are available and willing to engage and communicate with other members of the team, and who are able to form relationships of trust and respect for each discipline’s unique contributions to the project. Nurse practitioners and other nurse scientists should boldly take on the role of interdisciplinary research team leaders on research projects that are intended to affect clinical care, thus bringing nonhealth-related sciences and clinical science together to meet complex research goals.