Physician-nurse collaboration in research in the 21st century.

The complexities of cancer and its treatment, rapid advances in biomedical science and technology, growing concerns about the quality of health care, and intense competition for limited research dollars contribute to the urgent need for interdisciplinary collaboration in cancer research. Collaboration in the design and implementation of significant research initiatives will advance the discovery of knowledge to improve outcomes for patients and care providers, with both medicine and nursing standing to benefit from close collaboration. In this editorial, we explore the concept of interdisciplinary research collaboration specifically between nursing and medicine, and draw on the interdisciplinary research experiences of the authors. Interdisciplinary collaboration is extensively described in the health professional literature and promoted by organizations such as the American Society of Clinical Oncology, the National Academies of Practice, and the W.K. Kellogg Foundation as well as our respective professional organizations. Notably, the American Society of Clinical Oncology’s strategic plan [1] includes within its first goal the objective to promote multidisciplinary cancer prevention, management, and research. Collaboration in clinical research is defined as a complex phenomenon that brings together two or more individuals, often from different professional disciplines, who work to achieve shared aims and objectives [2]. It is well established that interdisciplinary collaboration offers great potential. The sharing of ideas across disciplines enables a comprehensive and intellectually vibrant examination of the research problem at hand [2,3]. Interdisciplinary research is of utmost importance in the current period of rapid scientific and technologic discovery coupled with urgent medical and social problems. In this climate, scientists of diverse backgrounds must be willing to share expertise and resources to expand cross-cutting research capacity to improve patient outcomes [4,5]. Although research collaboration is viewed as important in improving health outcomes, little is written about the process of collaboration, and its benefits [6]. It is recognized that diversity of backgrounds and viewpoints, vigorous debate, and respectful disagreement enriches the process [7] and that commitment to common goals contributes to enduring and effective collaborative research partnerships. Lancaster [8] described the collaborative process as consisting of six Cs: contribution, communication, commitment, consensus, compatibility, and credit. Particular to research collaboration between physicians and nurses, the traditional hierarchical nurse-physician relationship is gradually evolving into a collaborative model [9,10]. Historically, physicians assumed the lead role in many collaborative research initiatives. However, contemporary research collaboration between physicians and nurses is more often nonhierarchical in nature, with the implied assumption that power is based on knowledge and expertise, rather than role or function [6-12]. The synergism that results from a successful collaborative relationship between a physician and nurse yields combined outcomes greater than the sum of individual actions [13,14]. For nurse-physician research collaboration to work well, shared interests and open lines of communication are required. Goals, objectives, roles, processes, and outcomes must be explicitly articulated and agreed on by members of the collaborating team. Details about when and how to collaborate, how to structure interactions, and how to evaluate outcomes must be negotiated. Wellarticulated and deliberate strategies ought to be in place JOURNAL OF CLINICAL ONCOLOGY COMMENTS AND CONTROVERSIES VOLUME 22 NUMBER 5 MARCH 1 2004