408 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
have the opportunity to learn that there is more than one valid way of seeing the world.
In fact, our training encourages loyalty to our own profession with the corresponding
risk that we may reject, at least partially, the other ones.
It is this narrowing of perspectives that can create so many of the communica-
tion misunderstandings regularly seen between the various health professions (Charles
et al., 2010). For example, how one interprets an interaction with a practitioner from
another profession is dependent on one’s own profession’s world view, which is largely
formed in each individual through professional training. If we have not had systematic
exposure to other professions, then it is easy to assume that the way we see the world
is “correct.” Not only does one not automatically try to see the world from the other’s
perspective, but often we are not even aware that there is another perspective. It is easy
to think that if a member of another profession does not agree with us, it is because they
are wrong, misinformed, or maybe just not as well- trained. When two people from dif-
ferent professions take this position when interacting with each other, it is quite under-
standable that there could be serious disagreement and conflict.
Unfortunately, we tend to take this early way we see the world into our prac-
tice. Unless successfully challenged, these ways of interacting with others continue and
can easily be entrenched throughout our practice careers and through the acquisition
of advanced level degrees. Further education does not guarantee that we will become
more open to the viewpoints of other professions. Indeed, there are powerful forces at
play within the practice and academic communities that contribute to ongoing interpro-
fessional difficulties.
There have been a number of barriers identified that inhibit the implementation
of an interprofessional agenda within practice and academic sites (Charles, Bainbridge,
Copeman- Stewart, Art, & Kassam, 2006; Charles, Bainbridge, Copeman- Stewart,
Kassam, & Tiffin, 2008; Paul & Peterson, 2002; Salhani & Charles, 2007). These include, as
mentioned, different philosophies of working and values of the various professions
(Loxley, 1997; Miller, Freeman, & Ross, 2001). Also, there can be a fear of deskilling or
deprofessionalization (Loxley, 1997; Miller et al., 2001). The push for closed role bound-
aries and the protection of our own professional knowledge also contributes to the cre-
ation of barriers (Miller et al., 2001). Other identified barriers include power differences
between the professions, territoriality and fear of domain infringement (Geva, Barsky, &
Westernoff, 2000; Hornby & Atkins, 2000), role insecurity (Hornby & Atkins, 2000), and
the perceived need for clinical freedom or autonomy (Loxley, 1997). The power of these
barriers to hold us in our old ways of doing things should not be underestimated. Most
of the health professions have struggled long and hard to find their place in the system
and are loath to take any actions that would put them at risk regardless of their stated
commitment to collaborative practice. However, until we begin to address our part as
individual practitioners and as members of a profession in contributing to the develop-
ment and maintenance of these barriers, we cannot truly develop healthy interprofes-
sional partnerships. Collaboration of this type means being willing to invite members
of other professions into areas of our practice that we have traditionally claimed as our
own. It also means that being willing to accept that other ways of doing things can be as
effective as the way we have traditionally done them.
Novak also mentions in her chapter how service learning opportunities can con-
tribute to the development of an improved health care delivery system. I strongly agree
with her central message, although once again I would push the unspoken core concept
of what she is saying to examine how these types of experience can help us find new
ways of developing our sense of professional identity, thus changing how we interact
with others. Service learning, similar to interprofessional collaboration, is an attempt