Introduction
When presented with the opportunity to participate in a professional elective that was hands-on and worked directly with a client within our community I knew I wanted to be involved. With previous classes, I always found it hard to relate to case-based assignments as the client-therapist relationship and collaboration components were always missing. I was specifically intrigued to work with Team Tara as I would not only get the opportunity to work with a “real” client, but I would also get the opportunity to work with a group of engineering students. The concept of interprofessional collaboration has been something that I have experienced first-hand with previous stages, however I had never worked with engineers or engineering students before, so I was specifically excited to see how each profession could contribute to the final outcome.
The problem at hand for Team Tara was that she was unable to enter certain stores and buildings within her neighbourhood due to a one to two step barrier as she uses a scooter to mobilize. The goal was to build something lightweight, inexpensive, and portable that she could carry on her scooter and deploy on her own in order to have access to these locations. Unfortunately, the process was not as straight forward as we had all hoped. In the end, the option to design, build, and test out a ramp for Tara was not feasible, bringing to light the challenges of interprofessional collaboration.
Design process
The first meeting with the team went smoothly, we all wrote down the rules and responsibilities we had decided as a team and signed the contract to demonstrate agreeance. Our design process was slow and a bit more complicated than I think anyone had anticipated. I had to teach the engineering students about the contextual factors affecting Tara’s interactions with the scooter and ramp, while the engineering students had to teach me about the mechanical components to consider. This exchange of knowledge was very valuable to our design process, as all this had to be considered in order for Tara to have success with the ramp.
For the first 2-3 months, we went through multiple different designs. It felt that just as quickly as there was a new design, it was being shot down. It became very clear to me that we were not making the progress I was expecting to make by this timeframe. We continued to move forward, however it was apparent to me that the team was not working cohesively. I can see now that through the first months of the design process, there was a divide between the group of 4 engineering students. They were all working on their own projects, in their own design books, simultaneously without communicating with me or with each other. This is where the rotating door of designs came from, there was no collaboration of ideas to create one design that fits Tara; it was more of a competition of who could come up with the best design. During these meetings I felt a bit useless, I was not experienced enough with the equations, and angles to really create my own design, so my role became more of a critic than a collaborator. I would point out any parts of the designs that I believed could become an issue later on such as effects from weather, placement, Tara’s preferences, etc. I saw that the team was struggling to incorporate Tara’s needs into the design, so I did what I could to guide the design.
Eventually we had solidified a design that Tara and the rest of the team were excited about; it was finally coming together. By mid-November we had a prototype made out of cardboard, completed the necessary tests and measurements. I felt confident that this design was going to work. At this time, we had also received an addition to the team, Alexa, an OT student whose project fell through. I was excited to have another clinical student with me because I was hoping she could see things that I may have missed, but also give me a bit more support in terms of my place in the team. By the end of the semester, we had set a plan that our next steps were to determine what material would work best and start the process of making a working prototype.
Alexa and I were both in stage when the winter semester began, and the engineering students were instructed that this was the time they were to use to build the working prototype. With my previous concerns about the group’s collaboration, I decided that I would check in with the engineering student about 3 weeks into the semester, hoping to get some updates on their progress and to help if they had any questions. To my disappointment all I got back was “currently updating drawings and having them looked over by technicians”. I had responded to that asking a few more questions about start dates for building and if they had talked about materials yet, and I got no response. After another 3 weeks of not hearing anything, I reached out again to ask for updates and once again I received no response. I was hoping that they had another group chat they were using to communicate with each other (rather than not talking to each other at all), but still felt that Alexa and myself were being left out. Once we finished stage and were back on campus, I asked the team for a meeting to go over what they had been doing for the past 2 months. To my surprise I came back to a completely new design, new material, and an even more divided team. This is when I reached out for help and guidance, as I feared that the project would not get done. After many discussions and thinking about what would be best for Tara and her needs, it was decided the team would split, and Alexa and myself would begin looking at other alternatives for the ramp. Then with the unexpected COVID-19 pandemic, we decided it would not be feasible for us to make, assess and deliver Tara a working ramp. This was heartbreaking as we had worked with Tara for 6 months to design this ramp that would increase her independence and have such an impact on her daily life, but it was the best decision with keeping the health and safety of everyone in mind.
Challenges faced
One of the main challenges that may have hindered our group’s success was that this was the first time either group of students had worked with each other. There was a learning curve that we have to work through and knowledge that needed to be shared with the other team members. To be successful we had to work hard at ensuring communication is maintained, encourage each other, and collaborate/share our ideas and opinions in a professional manner, unfortunately it did not work out that way. We did not have a real grasp on each other’s roles within the team, or a real understanding of how each member could contribute to the team. Rather than using each person’s strengths to our advantage, it shifted from collaboration to a more individualistic approach, hindering the sharing of information and ideas within the group.
I think communication, was one aspect that we had the most challenge with. As previously mentioned, there seemed to be a divide within our team; a divide between the engineering student and clinical students, as well as, a divide within the engineering students. There was a competition within our team; members working individually, in pairs, or in triads, rather than working as a whole team for the sole purpose of claiming the rights to that design. In the end, information was not being openly shared between all group members, questions and concerns were being ignored, and initiative was not being taken. Although there was a designated communicator within the group, I found that it was the acceptance, acknowledgement, and collaboration of each other’s voices that broke the communication. The reluctance to share ideas and communicate on what has been done and what needs to be prioritized moving forward is what the team was lacking. This created an even bigger challenge as it felt that we were repeating steps and not moving forward with the design process. It was frustrating that every group meeting we would end up moving backwards or end up in a disagreement. It felt like this project was not a top priority and it was being put on the back burner.
A final challenge was that of motivation. As a graduate student who chose to participate in this elective, and chose to participate in this specific project, I was very intrinsically motivated to work with this team and create an assistive technology that would help facilitate independence in someone’s day to day life. I can now see that this was not the case for the other half of the group. For one, they are required to participate in this Capstone project in order to graduate; it was not a choice. Two, this project was not one of their top choices, thus demonstrated that they were not 100% interested by the topic. This different mentality was definitely challenging as I believe the others were more driven by their grades and did not necessarily care about the process. This led to a lot of procrastination, causing tension within the group. It took a lot of following-up, guiding, and reminders for simple tasks to be done. There was also a lot of reluctance for individuals to take initiative to complete certain tasks, which made other members who are taking on more responsibility within the project frustrated. Being intrinsically motivated is not something I expect from everyone; however, it was the procrastination and lack of initiative that created this friction within the team and caused even more of challenges.
What have I learnt from this process?
One of the main lessons that I am taking away from this experience is that interprofessional collaboration is not easy. It is like a house of cards; if one card is out of place, then the whole thing will come crashing down. It requires the commitment and collaboration of all involved in order to build the foundations of trust and respect within the team. It also requires an understanding of each other. Had we taken the time to get to know each other, how we each like to work, our learning styles, and how we are motivated, we may have been able to come together and work as a team. I learnt that this foundation of trust and respect must be developed and in place before we can begin building the rest of the house.
Another lesson I have learnt is that communication really is key. This is something I have also learned through my stages. If the OT does not communicate that the client requires assistance to return home and the doctor discharges him/her without consulting the team, then the client is going to return to the hospital and the team will have to start over again. The waste of time experienced due to inefficient communication definitely held the team back. With all the moving parts in this course, effective communication is essential, and unfortunately, I learnt that there is a certain point where communication can get lost and it is extremely hard to rebuild that foundation. As the only clinical student in my group for the first half, I took a more passive approach in terms of communicating and sharing my ideas. Looking back now, I learnt that this only created more divide within the team and did not necessarily help solve any of the problems. Had I taken more of a leadership role to help guide the team, we may have had a different outcome. As a clinical student, I take pride in my ability to communicate, however I am disappointed with my performance with communicating with my group. I let my feelings of being out of place and hesitation take over. Something I would change if I were to redo this whole experience would be to take more of a leadership role and truly demonstrate my ability to advocate not only for my client’s needs, but also for the needs of the team.
Lastly, I learnt that everyone has their own way of learning. Specifically working with this set of engineering students, who were not as motivated to take initiative with this project, I learnt that it is important to know someone’s learning style in order to have a better understanding of why they do things a certain way. I do not want to put all engineering students into a box, but what I have noticed of this particular group is that they have their own way of organization, it is like having a messy room but knowing exactly where everything is. Compared to me who likes to have everything planned out, know where I am going, and have things done in advance; I found it difficult to embrace their way of working, as I did not truly understand it. Learning the lesson that not everyone has the same levels of motivation and initiative was frustrating. But I think that it all goes back to building that connection and foundation with the team to get to know and understand each other that could help eliminate these feelings of frustration. Rather than trying to “fix” their way of working, I could have tried harder to understand why it works for them, and maybe we could have shared different strategies and tips to help each other stay productive and organized.
Recommendations
From my experience throughout the past 6 months, I have three main recommendations. The first is for the purpose of this course, I think it could be very beneficial to have an intro session (like what we had the first weeks about disability talk and how to interact with clients) about engineering basics, such as definitions for terminology, different softwares, etc. that could be useful for the clinical students who, like myself, felt a bit useless when it came down to the design process, especially since I was the only clinical student. I feel that this could have given me enough of a background of knowledge that I could have directed my questions to the team better and have a bit more understanding of the lens that they are using to look at this problem.
My second recommendation is specific to being the only clinical student in a group of engineers. I often felt alone when it came to course assignments and projects because my other group members did not have the same assignments as me. I think that if there could be a way to coordinate the Capstone assignments with the POTH 625 assignments, this could eliminate some of the divide felt between the two groups, as well as facilitate better group work, as the Capstone students often had separate meetings and group chats to work on their respective assignments. I also recommend any other clinical student who finds themselves in the same position I was in, to not take a passive approach and express your ideas, because as clinical students we have different experiences and see things through a different lens that in the end can only benefit your team.
Lastly, my most important recommendation to any group is to get to know your teammates. As previously mentioned, having a better understanding of how your other group members work, their motivations, and learning style will help guide your team through this process. Creating a relationship with your team will foster better collaboration because you have the understanding that everyone is working towards one goal. One of my groups biggest mistakes was not taking the time to fully get to know and understand each other, leading to tension and disagreements. One adjustment to the course could be to have the first “team meeting” be without the client, just so the students can get to know each other without the added pressure of the engineering students having their first interaction with a client at the same time. I understand that the client is a critical component of the team, however, I think that the student-student relationship is different than the student-client relationship and requires a lot more effort and bonding to be made in order for the team to work.
Conclusion
Although this course did not go as originally hoped or planned, I am still able to take the experiences and the lessons that I learned and integrate them into my future collaborations. This experience allowed me to collaborate with a new profession and learn more about what makes a great team. The lessons I learned will definitely be put to use for my future collaborations as teamwork and interprofessional collaboration is something that no one can escape from. The more experience I have and the more mistakes I make will only help me become a better collaborator. In conclusion, I learned valuable lessons on teamwork, communication, and overall problem-solving skills that can only be taught through error. Yes, a lot of mistakes were made throughout this process, but that is ultimately what brought me here, and allowed me to reflect on what I have gained from this experience rather than looking at what I have loss.