Journal of Nursing Education

Editorial Free

Collaboration—For Whose Benefit?

Janis P. Bellack, PhD, RN, FAAN; Edward H. O’Neil, PhD, MPA, FAAN

Over the past few years, the Journal of Nursing Education has experienced a rather significant rise in manuscript submissions focused on collaborative relationships that nursing schools have established with professional and community partners. These arrangements typically are driven by the partners’ need to expand or supplement their capacity to fulfill their mission or achieve defined goals. With several accepted manuscripts awaiting publication that address partnerships and other collaborative relationships, we have chosen to publish them together in this special focus issue. The articles reflect an array of collaborations ranging from team-based learning in an undergraduate nursing course to a multi-university consortium in the western United States.

Such collaborative arrangements appear to be on the rise in nursing education, as well as in the broader arenas of higher education and health care. The forces driving this upswing include a combination of declining resources, increasingly sophisticated and available technologies, expanding economic and cultural interdependence, and the proliferation of knowledge specialization, resulting in the concentration of recognized expertise in certain areas of inquiry in a small number of individuals or organizations.

Collaborative relationships may be temporary “let’s work together” arrangements to achieve common goals or address common interests at a given point in time or, at the extreme, may involve permanent realignment of organizations and finances, as in the case of mergers and acquisitions. In nursing education, formal collaborative partnerships are most likely to be driven by curriculum goals and the need to access and secure resources that are not readily available or likely to become available in a given school or program. Such need, in turn, can prompt a search for a suitable partner or partners who can provide or supplement the missing expertise or resources.

Collaborative arrangements most often involve the sharing of knowledge and expertise. They also may involve the sharing of human, material, and financial resources to increase productivity, efficiency, recognition, and ultimately impact in meeting goals to an extent greater than the individual partners can achieve on their own. Collaboration can also be an effective strategy to increase cooperation and reduce competition among like-minded entities in times and situations of declining or constrained resources. Perhaps the most common example of such collaboration in nursing education is arrangement to effectively manage competition for clinical placements, especially in metropolitan areas where numerous programs vie for available clinical partners. These range from loosely coupled regional planning groups to formal partnerships such as dedicated education units.

Collaborative relationships are not all alike, and different arrangements are needed to serve different purposes and require varying degrees of investment of people, time, and resources. As highlighted in this issue’s articles, collaborative relationships range from changing a teaching–learning strategy in a single nursing course to a large, multi-institutional nursing education exchange to a complex community-based partnership involving different levels of prelicensure students and an Aboriginal population.

Amid continuing demands for increasing efficiency and reducing costs, as well as the ongoing challenges of addressing faculty shortages and assuring sufficient, high-quality clinical placements, it is reasonable to expect that we will see continued expansion of collaborative partnerships in the coming years. In addition, with growing calls for teamwork in both learning and work environments, including interprofessional teamwork in clinical practice, learning to collaborate effectively has become an essential competency for students, practitioners, and organizations.

Keys to success begin with understanding how the world is changing and embracing certain guiding principles to shape the nature and scope of the partnership to ensure that desired—and shared—goals and outcomes are achieved and, when appropriate, sustained over time. Regardless of the scope and complexity of a potential collaborative partnership, it is essential from the start to be clear what the purposes are, what is driving the need, what investments will be required, what each partner hopes or expects to accomplish, and who will be served or benefitted. Although in most cases the initiating partner has an unmet need or needs that it hopes the collaborative partner will be able to fulfill, success will depend on the extent to which both partners contribute to and benefit from the engagement, especially in the case of organizations and cultures with diverse histories, assets, and needs. Thus, nurse educators and schools of nursing must first clarify for themselves not only what they need but also what they can offer or contribute to the potential partner before initiating contact and conversation.

Questions such as “What assets do you have that others might need for success?” and “What assets do others have that you might need?” can help frame the initial exploration. Possible assets and needs may include reputation, people with specific knowledge or skill sets, capital, geographic location, physical facilities, legal authority, and adaptive capacity or flexibility to change. Answering the questions above can help identify potential partners and the nature—both form and scope—of the collaborative relationship to be explored and is an essential early step in laying a strong foundation on which to build and cultivate a successful collaborative arrangement.

As important as this early step is, however, it will not ensure long-term success. Even when all aspects of the collaborative relationship have been delineated and agreed on by both partners, success is more likely to be determined by and dependent on the motivations, commitment, and the sheer time and effort invested by those responsible for carrying out the vision.

Although sponsors and champions are essential, ultimately those at the front line will determine the success or failure of the partnership. When interpersonal tensions or conflicts arise over whose goals and wishes have priority or who has final authority, well-intentioned plans can quickly go awry. When the motivations driving the collaboration for each partner are at odds, disagreements over goals, desired outcomes, decision making authority, and resource allocation can have devastating and long-lasting consequences. As one example, the history of community partnerships, especially those supported with time-limited grant funding, is littered with failures. Too often, after the funding period has ended, the well-intentioned partnership folds and the community is left once again to fend on its own, albeit perhaps with some useful remnants, such as new knowledge or skills, greater capacity for self-management, or, in some instances, a new facility. Communities have become especially wary and weary of university-based researchers who promise much, gain what they need, then disappear, leaving disappointment and distrust in their wake.

To ensure such mistakes of the past are not repeated, faculty and schools of nursing must carefully examine their motivations and goals for seeking collaborative relationships. Effective collaborations are those that are mission-centric for both partners, create capacity and synergies that would not be possible for either partner alone, reap benefits (e.g., resources, efficiencies, recognition, reputation) for each partner, and ultimately, and perhaps most importantly, add value for those being served, whether students or communities. To adapt Katzenbach’s and Smith’s (1993) classic work, The Wisdom of Teams, successful collaborative relationships will depend on each partner bringing to the relationship a core group of dedicated people with complementary skills who have a common purpose, clearly delineated goals, an operational plan for how they will work together, and a willingness to hold each other accountable for achieving the desired aims of the partnership.

The articles in this issue reflect the various aspects of successful collaborative relationships and offer important lessons for the nursing education community to consider when contemplating potential future collaborations.

Janis P. Bellack, PhD, RN, FAAN
Editor

Edward H. O’Neil, PhD, MPA, FAAN

Former Director, Center for the Health
Professions, University of California,
San Francisco

Reference

  • Katzenbach, J.R. & Smith, D.K. (1993). The wisdom of teams. Cambridge, MA: Harvard Business School Press.

10.3928/01484834-20130123-10

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