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Interprofessional communication in a sociohierarchical culture: development of the TRI-O guide

Authors Claramita M, Riskiyana R, Susilo AP, Huriyati E, Wahyuningsih MSH, Norcini JJ

Received 3 December 2018

Accepted for publication 18 January 2019

Published 14 March 2019 Volume 2019:12 Pages 191—204

DOI https://doi.org/10.2147/JMDH.S196873

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser


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Mora Claramita,1 Rilani Riskiyana,1 Astrid Pratidina Susilo,2 Emy Huriyati,3 Mae SH Wahyuningsih,4 John J Norcini5

1Department of Medical, Health Professions Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 2The Indonesian College of Health Professions Education (Iam-HPE) and The Indonesian Skills Laboratory Network and Development (ISLaND), Yogyakarta, Indonesia; 3Department of Health Nutrition, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 4Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; 5FAIMER Institute, Philadelphia, PA, USA

Objectives: Interprofessional education (IPE) and collaborative practice are essential for patient safety. Effective teamwork starting with partnership-based communications should be introduced early in the educational process. Many societies in the world hold socio-hierarchical culture with a wide power distance, which makes collaboration among health professionals challenging. Since an appropriate communication framework for this context is not yet available, this study filled that gap by developing a guide for interprofessional communication, which is best suited to the socio-hierarchical and socio-cultural contexts.
Materials and methods: The draft of the guide was constructed based on previous studies of communication in health care in a socio-hierarchical context, referred to international IPE literature, and refined by focus group discussions among various health professionals. Nominal group technique, also comments from national and international experts of communication skills in health care, was used to validate the guide. A pilot study with a pre–posttest design was conducted with 53 first- and 107 fourth-year undergraduate medical, nursing, and health nutrition students.
Results: We developed the “TRI-O” guide of interprofessional communication skills, emphasizing “open for collaboration, open for information, open for discussion”, and found that the application of the guide during training was feasible and positively influenced students’ perceptions.
Conclusion: The findings suggest that the TRI-O guide is beneficial to help students initiate partnership-based communication and mutual collaboration among health professionals in the socio-hierarchical and socio-cultural context.

Keywords: cross-cultural communication, interprofessional communication, interprofessional education, role-play, constructive feedback, wide power distance


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