Shared Metacognition and Interprofessional Collaboration in Healthcare Education: Is Teaching the Ideal Enough?

Friday, March 27, 2020: 3:35 PM

Mechelle Jean Plasse, PhD, MS
Program Coordinator for psychiatric mental health nurse practitioner tract at the Graduate School of nursing, UMMS Graduate School of Nursing, Worcester, MA, USA

Purpose: Present an overview of metacognition and interprofessional collaboration (IPC).

Methods: A review of the literature on metacognition and IPC spanning 15 years. Medline, CINAHL, OVID, SCOPUS and PsychInfo were searched for metacognition, IPC, reflective practice, teamwork and healthcare.

Results: A scoping literature review was conducted to determine the current state of the science regarding metacognitive skills and IPC in an effort to identify possible gaps in the literature. The findings revealed an increasing awareness of metacognitions impact on teamwork and increased focus on metacognition within interprofessional education, however this concept was rarely explored among currently practicing healthcare providers. The new graduate may be faced with a challenge as they are armed with a novice level of interprofessional competence yet are entering an environment which may or may not be fertile ground to enhance this new skill. Additional review findings will be discussed, gaps in the literature identified and recommendations for future research offered.

Conclusion: Quality interprofessional collaboration mitigates medical error (Agency for Healthcare Research and Quality [AHRQ], 2015). Since the Institute of Medicine (IOM, 1999) highlighted the high US patient mortality rate, numerous initiatives to standardize communication-laden points of patient care have been developed. Some reform strategies have been successful however many yielded only a negligible improvement, falling short of the hoped-for impact (AHRQ, 2015). The lack of success begs the question, what are we missing? I propose it is the metacognitive experiences within collaboration and teaming that maybe the missing piece.

Working in unison during some of the most highly pressurized moments in life is an expectation for the healthcare provider. Hypothesized but not fully understood are the individual-level and group-level factors which can foster success of working in unison. Individual-level professional competence is a nod towards metacognitive knowledge and experience and group-level interprofessional competence is possibly linked to the related concept of shared metacognition (Josephson, 2017; Welp, Johnson, Nguyen & Perry, 2018). Metacognition, or “thinking about one’s thinking”, is a reflective position or an awareness of our cognitive processes as well as an awareness of our thoughts and feelings about our cognition (Flavell, 1979). Metacognition is one-part content knowledge which refers to the tasks, strategies and procedures of our work. Metacognition is also thought and emotional knowledge, termed metacognitive experience, which refers to thoughts and feelings about our current intellectual pursuit. The cognitive and emotional aspects of our metacognitive experience influence decision-making, behavior, perceptions and, therefore, our ability to work within an interprofessional team. Despite such a far-reaching impact, very little is known about the dynamics of this collective cognition in the clinical setting and therefore little is understood about how our students will utilize their novice interprofessional competency as new graduates. With the growing research beginning to highlight the impact of metacognition on collaboration quality, the importance of gaining a better understanding of this dynamic cannot be understated.

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