The role of 'teams' in work and business tops the agenda of the corporate world. Mobile communications not only helps individual practitioners in the field, but helps the team keep in touch. People still make the world go round (money provides the lubricant?). Books, journals, conferences continue to espouse ways of enhancing team work, and how to overcome barriers to effective teams. Very early on in their careers, the new student or medical intern becomes aware of several teams and their role within or without.

Political factors abound in health care teams, but many of the involved professionals would agree with Randhawa (1978) who preempts much of the qualitative - quantitative and multidisciplinary working debates in health care, remarking that:

'Lately, however, it has been realized that complex social, organizational, technical, and ecological problems require interdisciplinary (wholistic) efforts for sensible solutions.' Randhawa (1978) p.194

In other words no single approach, method or discipline has the answer. In the 21st century our problems are characterised by:

• profound complexity (variables & factors; local-global; multidisciplinary)
• duplication of effort in search of solutions
• problems in information sharing; from articulating problems to disseminating solutions (Hale, et al. 1997)

This issue arises readily in the working of the scientific community, with new courses in multidisciplinary informatics providing lessons for practitioners in health and social care:

'Narrow disciplinary concentration seems to have made many of our scientists what they never intended to be - non-dynamic and non-adaptive systems. Petrie (1976) has emphasized the importance of the factors of idea dominance, psychological characteristics of the participants, and institutional setting if interdisciplinary efforts are to succeed in the face of disciplinary myopia.'

Pierce (1999) suggests, however, that since the 1970s interdisciplinary information transfer is not as uncommon as Petrie found.

Contemporary models of interdisciplinary information transfer treat disciplines as such sharply bounded groups that boundary-crossing publication (contributions to disciplinary literatures authored by researchers from other disciplines) should be very difficult, if not impossible. Yet boundary-crossing authors can be identified in many disciplinary literatures. A study of four core journals in political science and sociology identified 199 articles with first authors from other disciplines published between 1971 and 1990. Two-thirds of these articles had single authors, and only one in six had coauthors from the discipline of the journal in which they were published. Readership and use of these articles, as measured by citation rates, was only slightly below normal.

Results suggest that disciplinary boundaries are less restrictive than the literature suggests, and that boundary-crossing publications are involved in complex patterns of interdisciplinary information transfer.

Funtowicz & Ravetz (1990, 1992, 1993); Haag & Kaupenjohann (2001) describe post-normal science extending the peer community, and anticipates the need for science to change its role and relationship in society, especially from a policy perspective. Science is not a closed shop. Increasingly the work in one field can have major effects in another. Highlighting the ongoing role for the imagination and 'art' in science. Ecological economics is an example of a recognised emerging post-normal science, in which science is differentiated into mode-1 and mode-2 forms. Ecological economics is a transdiscipline - (definition taken from Gibbons et al., 1994): Knowledge which emerges from a particular context of application with its own distinct theoretical structures, research methods and modes of practice but which may not be locatable on the prevailing disciplinary map (Muller, 2003).

A clinical example that epitomises the emergence of new disciplines from the convergence of explanations that lead to extended pooling of knowledge and extension of research methodology is social cognitive neuroscience. The goal of which is to understand social behavior from the perspective of the brain. Disciplines such as anthropologists, cognitive psychologists, social psychologists, neuroscientists, neurologists and sociologists are collaborating in new ways. A key factor is the role played by the Talairach system, a digital space in which to measure structure and function, making possible a new ‘‘close working relationship’’ between the sciences of mind and brain. Standards are necessary to ensure the research/user community develop meaningful brain mapping data. The Talairach system provides involves a measurement space allowing interdisciplinary collaboration. Beaulieu (2002) stresses that this process, emergence of collaboration is not the result solely of theoretical developments or of the application of a technology:

What proportion of the nursing - health care literature is multidisciplinary? What effect is the www having (when the majority of nurses must still rely on access at home, or in their own time)?

There are many areas of study were the methods, perspectives and techniques of one discipline are being applied in another to provide new insights. At the same time, however, the scale and complexity of projects and the need for collaboration across disciplines makes demands on individuals and organizations beyond traditional means of synchronization and coordination. Judge explains in the: 'search of software combining artistic and conceptual insights,' this as a concern about:

'.. obtaining an integrative perspective on any complex of social issues and potential responses, bearing in mind the need to zoom between levels of complexity and effectively to pan between different ordering systems.'

Tools are needed to provide views of a case depending on context. In mental health for example, the level accorded to patient's in the care programme approach (duplicated in various forms in established mental health services), has been determined by complexity, be that the number of agencies involved, diagnosis, number of treatment episodes and an assessment of risk. There is now a realization that mental health involves more than a 'numbers game'. Tools should reflect this subtlety and need for several 'views' of information. This need is well recognized, but how well has it been executed to date?

Following several homicides reported in the media, the conclusion of investigations repeatedly report on a lack of information sharing between agencies. This is often behind claims of parties preserving client confidentiality. Even were information is shared, it is surely the meaning of that information to the professionals concerned, that is pivotal to action. In our multiagency world - health and social care - physical and mental workers need tools to support collaboration.

There are (at least) two levels of cross-fertilization that may prove fruitful in the future.

1. Cognitive and information sciences influence on health care informatics.

2. Once enabled - by the EPR and personal (mobile) computing - true clinical multidisciplinary working styles will affect care delivery and quality.

A further way of 'throwing the pot' here is to extend our usual notions of collaboration, as follows:

INTRADISCIPLINARY	INTERDISCIPLINARY	INTERDISCIPLINARY (Transdisciplinary?)
Tightly confined within one discipline e.g. Nursing, but within a recognized field of human (professional) activity - health care.	Collaboration between disciplines e.g. Medicine, Nursing, Psychology, Occupational therapy, Physiotherapy, within a recognized field of human (professional) activity - health care.	Interdisciplinary collaboration between disparate recognized fields of human (professional) activity - Ecologist, International Policy Analyst, Political Scientist, Economist, Ethnographer, Anthropologist. One applied example may be impact assessment.

Are there any tools that can span these applications to ease collaboration? Is the Health Career Model a member of a new class of tools? How many tools are not taken up by the disciplines that could benefit from them?

Proponents of evidence based practice and clinical governance seek to publicise the fact that research need not be the province of statisticians and academics alone. Their experience and knowledge is essential in advising on the appropriate analyses and presentation of results, but many would-be practitioner/researchers are put off by numbers. A common assumption as MacGill (1984) recognized. MacGill highlighted that mathematical techniques, such as, Ho's Galois lattice - with a potential for use in the social sciences - may not be accessible to those best placed to apply them. Today, powerful mathematical software removes much 'pain', but perhaps this makes the need for links and guidance even more vital?

Unless there is crossover between disciplines opportunities and tools may be missed. Although policy makers ensure that 'the' appropriate professional groups are mentioned in policy texts, can policy itself influence transdisciplinary working and integration?

The three worlds of personnel, information and hard and soft informatics present problems as well as opportunities. Can existing management approaches such as confrontation management serve to pull these strands together? Bryant (2002) advocates a role for drama theory, reminding us that this continuum from individuals to groups includes organizations and their respective managements.

The development of knowledge and technology are factors, sometimes it really is a case of being in the right place at the right time. For example, it is only recently (the past decade) that supercomputers are finding work in biology and genomics. Supercooled circuitry that previously modelled subatomic particle interactions are now computing protein and molecular interactions.

On an even more positive note developments in blending and conceptual integration, and knowledge management stress the current drive to make use of information as a resource. To achieve this transdisciplinary communication and co-operation are needed given the problems we face in the 21st Century.

Slaughter (1996) and other commentators are seeking to define the field of futures studies, but on a popular, global scale:

The study of futures has advanced significantly over the past decade. The steady development of a futures discourse, the increasing sophistication of methodologies, the growing literature and the many new institutions of foresight (IOFs) which have sprung up all over the world attest to the strength of this emerging area of teaching, study and research. But in the wider world, the outlook remains stubbornly bleak. With the late industrial system, classical economics, international trade, ‘trickle-down’ development, the mechanistic worldview and a deteriorating global environment (to name several aspects of the global problematique) undergoing turbulent change, there is a clear need to critique past practice, to institutionalize foresight, reconceptualize cultural and political assumptions and to ‘steer’ into the future with much greater care. In this context futures study (FS) is a necessary enterprise. While we unquestionably remain caught up in an extensive web of institutional and learning lags, it is clear that the problems addressed by futurists and others will not disappear. Rather, they will become more urgent and pressing as time passes. This can be stated with confidence because we have sufficient insight into the underlying structure of the coming decades-regardless of detailed events-to know with confidence that this will be a most challenging and difficult period for humanity.’ p.799-780.

© Peter Jones 1998

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References

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