Distributed expertise: Qualitative study of a British network of multidisciplinary teams supporting parents of children with chronic kidney disease

SWALLOW, Veronica, SMITH, T., WEBB, N.J.A., WIRZ, L., QIZALBASH, L., BRENNAN, E., BIRCH, A., SINHA, M.D., KRISCHOCK, L., VAN DER VOORT, J., KING, D., LAMBERT, H., MILFORD, D.V., CROWTHER, L., SALEEM, M., LUNN, A. and WILLIAMS, J. (2014). Distributed expertise: Qualitative study of a British network of multidisciplinary teams supporting parents of children with chronic kidney disease. Child: Care, Health and Development, 41 (1), 67-75.

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Open Access URL: https://onlinelibrary.wiley.com/doi/full/10.1111/c... (Published version)
Link to published version:: https://doi.org/10.1111/cch.12141


© 2014 The Authors. Background: Long-term childhood conditions are often managed by hospital-based multidisciplinary teams (MDTs) of professionals with discipline specific expertise of a condition, in partnership with parents. However, little evidence exists on professional-parent interactions in this context. An exploration of professionals' accounts of the way they individually and collectively teach parents to manage their child's clinical care at home is, therefore, important for meeting parents' needs, informing policy and educating novice professionals. Using chronic kidney disease as an exemplar this paper reports on one aspect of a study of interactions between professionals and parents in a network of 12 children's kidney units in Britain. Methods: We conducted semi-structured, qualitative interviews with a convenience sample of 112 professionals (clinical-psychologists, dietitians, doctors, nurses, pharmacists, play-workers, therapists and social workers), exploring accounts of their parent-educative activity. We analysed data using framework and the concept of distributed expertise. Results: Four themes emerged that related to the way expertise was distributed within and across teams: (i) recognizing each other's' expertise, (ii) sharing expertise within the MDT, (iii) language interpretation, and (iv) acting as brokers. Two different professional identifications were also seen to co-exist within MDTs, with participants using the term 'we' both as the intra-professional 'we' (relating to the professional identity) when describing expertise within a disciplinary group (for example: 'As dietitians we aim to give tailored advice to optimize children's growth'), and the inter-professional 'we' (a 'team-identification'), when discussing expertise within the team (for example: 'We work as a team and make sure we're all happy with every aspect of their training before they go home'). Conclusions: This study highlights the dual identifications implicit in 'being professional' in this context (to the team and to one's profession) as well as the unique role that each member of a team contributes to children's care. Our methodology and results have the potential to be transferred to teams managing other conditions.

Item Type: Article
Uncontrolled Keywords: children; CKD; distributed expertise; long-term conditions; multidisciplinary teams; parents; CKD; children; distributed expertise; long-term conditions; multidisciplinary teams; parents; Attitude of Health Personnel; Child; Humans; Interprofessional Relations; Interviews as Topic; Parents; Patient Care Team; Professional-Family Relations; Qualitative Research; Renal Insufficiency, Chronic; Social Support; United Kingdom; Humans; Attitude of Health Personnel; Parents; Interprofessional Relations; Professional-Family Relations; Qualitative Research; Social Support; Child; Patient Care Team; Renal Insufficiency, Chronic; Interviews as Topic; United Kingdom; Pediatrics; 11 Medical and Health Sciences; 13 Education; 17 Psychology and Cognitive Sciences; Developmental & Child Psychology
Identification Number: https://doi.org/10.1111/cch.12141
Page Range: 67-75
SWORD Depositor: Symplectic Elements
Depositing User: Symplectic Elements
Date Deposited: 18 May 2020 16:19
Last Modified: 18 Mar 2021 01:45
URI: https://shura.shu.ac.uk/id/eprint/25916

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