Birch A

Brennan E

Crowther L

King D

Krischock L

Lambert H

Lunn A

Milford DV

Qizalbash L

Saleem M

Sinha MD

Smith T

Swallow V

van der Voort J

Webb NJA

Williams J

Wirz L

BackgroundLong-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\u27 accounts of the way they individually and collectively teach parents to manage their child\u27s clinical care at home is, therefore, important for meeting parents\u27 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\u27s kidney units in Britain.MethodsWe 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.ResultsFour themes emerged that related to the way expertise was distributed within and across teams: (i) recognizing each other\u27s\u27 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\u27 both as the intra-professional we\u27 (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\u27s growth\u27), and the inter-professional we\u27 (a team-identification\u27), when discussing expertise within the team (for example: We work as a team and make sure we\u27re all happy with every aspect of their training before they go home\u27).ConclusionsThis study highlights the dual identifications implicit in being professional\u27 in this context (to the team and to one\u27s profession) as well as the unique role that each member of a team contributes to children\u27s care. Our methodology and results have the potential to be transferred to teams managing other conditions

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

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

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