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From Interdisciplinary to Transdisciplinary Research: A Case Study


Wendy Austin, Caroline Park and Erika Goble
Qual Health Res 2008 18: 557
DOI: 10.1177/1049732307308514
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http://qhr.sagepub.com/content/18/4/557

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Pearls, Pith, and Provocation

From Interdisciplinary to Transdisciplinary


Research: A Case Study

Qualitative Health Research


Volume 18 Number 4
April 2008 557-564
2008 Sage Publications
10.1177/1049732307308514
http://qhr.sagepub.com
hosted at
http://online.sagepub.com

Wendy Austin
University of Alberta, Edmonton, Alberta, Canada

Caroline Park
Athabasca University, Athabasca, Alberta, Canada

Erika Goble
University of Alberta, Edmonton, Alberta, Canada
The specialization of contemporary academia necessitates the adoption of a multidisciplinary approach to study topics that cross multiple disciplines, including the area of medical ethics. However, the nature of multidisciplinary
research is limited in some regards, further requiring some researchers to use interdisciplinary and transdisciplinary
approaches. The authors present as a case study a research project in bioethics that began as an interdisciplinary study
and which, through the research process, moved to being a transdisciplinary study in health ethics. They outline not
only this transformation but also the strengths and difficulties of transdisciplinary research in the area of ethics.
Keywords: health ethics; case study; interdisciplinary research; transdisciplinary research; relational ethics

n contemporary academia there is a tension between


disciplinary specialization and the need to acknowledge the complex reality of the 21st century. The specialization that led to strong disciplinarity in the 19th
century (Lawrence & Desprs, 2004) is now coexisting
with multidisciplinary approaches (representatives from
several disciplines, each contributing particular knowledge and methods from their respective fields) that go
beyond the expertise of any one discipline. The outcomes
of such cooperative processes are generally additive in
nature and give rise to both broader, plural perspectives
and, potentially, to new subdisciplines (Dogan & Pahre,
1990). Cooperative processes are not sufficient, however,
when an integrative level of understanding is sought.
Then, interdisciplinary work, the exploration of questions through the integration of knowledge and techniques of multiple disciplines into common ground
(Kokelmanns, 1979), is required. In this approach the
assumptions of each discipline may be called into question and new assumptions developed. Transdisciplinary
research occurs when the collaborative process is taken

Authors Note: The research project presented was funded by the


Social Sciences and Humanities Research Council of Canada and
approved by the Health Research Ethics Board, University of
Alberta.

one step further, often spontaneously emerging from


interdisciplinary research when discipline-transcending
concepts, terminology, and methods evolve to create a
higher level framework and a fundamental epistemological shift occurs (Giri, 2002; Max-Neef, 2005). This step
requires mutual interpretation of disciplinary knowledge
(Gibbons et al., 1994) and a coherent reconfiguration of
the situation. A decade ago Nissani (1995), in an attempt
to develop a working definition of interdisciplinarity,
offered the metaphor of mixing fruits. Fruit (apple,
mango, orange, etc.) may be served alone (disciplinary),
in a fruit salad (multidisciplinary), or blended as a
smoothie (interdisciplinary). Extending this metaphor to
transdisciplinarity, one might imagine using the
smoothie as the basis for a new dessert.
In this article we present a case study of a research
project that began in 1993 as a means of illustrating the
problems and possibilities of transdisciplinary research
in health ethics. Funded by the Social Sciences and
Humanities Research Council of Canada, the project
was initiated as an interdisciplinary study with the purpose of articulating a foundational ethic for health care,
initially termed an ethic of nurturance (Bergum &
Dossetor, 2005). However, through the research process
the project moved from being interdisciplinary to being
transdisciplinary, with its outcomes forming a new
557

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558 Qualitative Health Research

framework (renamed relational ethics) that has been further developed through subsequent research projects.

Background: The Necessity of a


New Approach in Bioethics
The evolution of medical ethics to health ethics can
be understood as ongoing development from a disciplinary to a transdisciplinary perspective. Until World War
II, medical ethics was largely derived from the
Hippocratic oath and was almost exclusively the domain
of physicians (Pellegrino, 1999). Following the war,
there was a pervading sense that medicine had become
dehumanized, prompting academics and clinicians to
turn to other disciplines, notably the humanities, theology,
and the arts (Pellegrino, 1999). During the 1960s, medical ethics evolved into bioethics with the introduction of
philosophy and law to its discourse (Bergum &
Dossetor, 2005; Pellegrino, 1999).1 As changes in medicine increased the complexity of ethical issues, society
was simultaneously also changing (Pellegrino, 1993).
The emergence of the belief in the right for universal
health care is a good example of this change
(Greenfield, 1999). Moral philosophy became a means
of addressing ethics in a pluralistic society (Pellegrino,
1993, 1999). Philosophers began speaking out about
medical ethics issues, and bioethics emerged as an interdisciplinary field.
In the emergence of bioethics, the values of
other health disciplines such as nursing were, for the
most part, bypassed (Chambliss, 1996), although
their practice became overtly encompassed within
bioethics purview. Despite the proposal of various
alternatives (such as an ethics of care, casuistry, and
the reemergence of virtue ethics), bioethics remains
dominated largely by principlism, which is embodied
in the (bio)medical model (Flynn, 1991; Lpez, 2004;
Pellegrino, 1993; Turner, 2002). In her examination
of the emergence of bioethics, Flynn argued that
despite the incorporation of other disciplines, the
hegemonic discourse in bioethics is one of biomedicine and individualism. Furthermore, she argued that
by using the biomedical model, we perceive issues
through a reified screen (we prefer the term lens), which
prevents us from creating other interpretations
of events. Other ways of understanding remain invisible.
To illustrate and to attempt a challenge to this dominant
model, Flynn juxtaposed a physicians detached case
presentation to that of a nurses involved story of the
same patient situation. The nurses account reveals
the problems in communication, the helpless feelings

of the staff, the poignancy of the baby, the distress of


the mother, the heroism of the caretakers (p. 154).
The physicians account is a succinct review of the
medical situation: The mother is Black, has a history
of alcohol and cocaine use, is an intermittent visitor
to the hospital, has a short attention span, and doesnt have a clue to what is going on (p. 153).
Such a disjunction between perspectives affects
not only the assessment of patients and patient care
but also the perceptions of the health care environment and what constitutes an ethical issue. According
to Taylor (1997), a nurse ethicist, everyday ethical
concerns, many of which are based in interdisciplinary team tensions and systemic issues, are invisible
and do not get addressed as ethical issues when a
quandary approach to health ethics dominates. For
instance, a physician ethicist colleague of Taylor once
queried the validity of an ethics consultation request
because no treatment decision seemed to be in dispute (p. 68), leaving Taylor to wonder about the various perceptions among health care professionals as
to what is appropriate for ethical study.
At the heart of this variation are fundamentally different disciplinary worldviews, which often lead to tension and conflict. Research has shown that nurses and
physicians in the same practice environment select different situations and focus on different elements when
asked to describe patient care predicaments. In a 1992
study in which nurses and physicians were asked to
describe situations where they found it difficult to know
the right thing to do, Udn, Norberg, Lindseth, and
Marhaug found that nurses identified situations where
they were restrained from acting in the way they
believed was right. Furthermore, their descriptions had a
personal tone, and physicians were often portrayed as a
source of ethical conflict. Conversely, physicians rarely
mentioned nurses, narrating, rather, episodes where they
felt uncertain regarding clinical decisions. What nurses
and physicians did seem to share was the sense of being
misunderstood by their colleagues in the other discipline. Similarly, in his presidential address to the
American Surgical Association, Greenfield (1999) identified both ineffective communication and differing perceptions of roles as the greatest problems facing the
contemporary nursephysician relationship.
Misunderstandings, outright conflicts, and competing
ethical perspectives in the nursephysician relationship
often emerge in the form of everyday ethics within daily
patient care. A 1996 sociological study confirmed that
nurses experience everyday ethics as a thinly disguised
turf war (Chambliss, 1996). Everyday ethics is defined
by the Canadian Nurses Association (2002) as the way

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Austin et al. / From Interdisciplinary to Transdisciplinary Research 559

nurses approach their practice and reflect on their


ethical commitments to the people they serve. It
involves nurses attention to common ethical events
(p. 5). Whereas professional ethics is a common set of
rules and obligations outlined by a professional body to
be followed by its members (Beauchamp & Childress,
2001), everyday ethics is the actuality of implementing
and enacting ethics in daily practice. According to
Chambliss (1996), nurses, being employees, deal not
so much with tragic choices as with practical, often
political, issues of cajoling, tricking, or badgering a
recalcitrant system into doing what ought to be done
(p. 7). Nurses do not commonly approach ethical concerns from a rationalistic stance as a choice of binary
options. They understand ethics less as the display of
ones moral rectitude in times of crises and more as
the day-by-day expression of ones commitment to
other persons and the ways in which human beings
relate to one another in their daily interactions (Levine,
1977, p. 846). In researching rural and urban nurses
perspectives on ethics, Varcoe and colleagues (2004)
found that nurses were disturbed by an evolving context
shaped by the privileging of biomedicine, by technology
and an emphasis on cure, by corporatization, and by a
scarcity stance on resources. These nurses seemed to be
looking for a distinct nursing ethic because existing
theories did not speak to their needs (Varcoe et al.,
2004). Similarly, physicians seem to be searching for
guidance beyond the traditional ethical theories (Gillett,
1995; Nisker, 2004; Pellegrino, 1993). One charge is
that in using the current bioethical model, bioethicists
misrepresent the ethical moment and lack a practical
understanding of how moral values and ethical behaviors are embodied and lived by social agents (Lpez,
2004, p. 878). New, inclusive, collaborative ways of
approaching contemporary ethical challenges across
disciplines need to be found.

The Difficulties of Multidisciplined


Collaborative Research
Collaborative research, whether multidisciplinary,
interdisciplinary, or transdisciplinary, has an openness
to a multiplicity of perspectives that holds significant
promise for research teams, including those studying
bioethics. Not only do collaborative forms of research
more accurately reflect the world in which we live, but
they also allow for the exploration of various positions
(or lenses, if you will) that explain the situation at hand
and/or point to possible solutions. Collaborative work,

however, is rife with challenges (relinquishing ownership of knowledge; substantial time commitments;
obstructive rather than supportive institutional structures; trust and process issues, including credit allocation) and uncertainties (the expected outcome is difficult
to define; the journey itself depends on the synergy of
group discovery; Denis & Lomas, 2003).
Illustrating the collaborative research process,
including its inherent difficulties, Hinojosa and colleagues (2001) offered as a case study the work of an
interdisciplinary team that collaborated in both research
and service provision. The research team studied (interviews, observation, videotaping of team meetings) a
clinical team working with one child in a hospital-based
early intervention program over a 6-month period. The
researchers used the five-step process for developing
collaborative teams outlined by Dukewits and Gowin
(1996): establishing trust, developing common beliefs
and attitudes, empowering team members, having
effectively managed team meetings, and providing
feedback about team functioning (p. 16).
Time and space to meet were found to be key elements. Teamwork is not magic, and simply getting
along or communicating information to one another
does not constitute collaboration (Hinojosa et al., 2001,
p. 210). The research teams collaboration was based on
evolved common understandings, but this was difficult
to achieve in the clinical setting. There were philosophical conflicts between the educators and the health professionals. Observations revealed an implicit hierarchy:
Therapy trumped educational services. In reality, all
team members were not considered equal. Although it
was a functional team and members tried to get along,
using strategies like humor, empathy, caring, and
attempts to accept one anothers point of view, a true
collaborative process did not occur.
Despite such difficulties, as demonstrated by
Hinojosa and colleagues (2001) case study, the shift
to transdisciplinary research is increasingly deemed
important in contemporary knowledge production
(Gibbons et al., 1994; Max-Neef, 2005; Thompson
Klein, 2004) and enjoys a growing popularity among
researchers. However, some, such as van Manen
(2001), have raised concerns about transdisciplinarity
and the orientation of this new knowledge production. van Manen noted that although it is more context sensitive, eclectic, and inventive than traditional
interdisciplinary practices, it is driven by (and he
cited Gibbons et al., 1994, who advocated for these
purposes) marketability, social policy, and practical
use. This is problematic from the perspective of the

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560 Qualitative Health Research

ethical value of human understanding (van Manen,


2001, p. 850). It becomes, rather than an exploration
of new sources of meaning leading to new and practical understandings, a simplistic and technocratic
view of the world.
The difficulty of transdisciplinary research, then, lies
not only in the question of how one manifests the process
but also its evolving epistemological framing. These pose
difficult and weighty challenges to researchers wishing
to undertake a transdisciplinary process. Its worth, nevertheless, can outweigh such difficulties.

The Case Study


The principal investigators (PIs) of the research
project were Vangie Bergum (a nurse) and John
Dossetor (a physician). Teachers of ethics to students in
the health sciences, Bergum and Dossetor questioned
the concept of autonomy and its dominance within contemporary bioethics. Their view was that bioethics must
encompass community responsibility as well as individual freedom, hermeneutic knowledge as well as
rationality, and relationship as well as definitive principles. They wanted to expand bioethical perspectives
through new attention to ethics as enacted in practice
to turn our thinking about ethics and our ethical commitments to how and where we experience them
(Bergum & Dossetor, 2005, p. 7). In other words, they
wanted a new screen, a new lens through which to
approach ethics in practice. A research group of 18 clinicians (from medicine, midwifery, nursing, psychology,
physical therapy, social work, and pastoral care) and
scholars (from anthropology, law, philosophy, psychology, and theology) was assembled to uncover an alternate way to understand and undertake ethical practice.

A new ethics framework emerged. Titled relational


ethics, the framework was inclusive of, yet extended
beyond, other major approaches to ethics. The name
relational ethics was chosen to make explicit that all
ethics, including reason-based ethics, are grounded in
relation, emergent from a relationship between the individual and the world. Informed by the concepts of interdependency, relational personhood, authentic dialogue,
and the importance of community, the core elements
of relational ethics are engagement, mutual respect,
embodied knowledge, uncertainty/vulnerability, and
attention to an interdependent environment. Results of
the study describing this framework were communicated through articles in scholarly journals, a set of a
slides (art and photos) that captured ethical relations in
health care practice, a drama (And They Want a Child;
Bergum, Dossetor, & Madill, 1996) created by research
group members and actors from a true story and produced as a video, and a book, Relational Ethics: The
Full Meaning of Respect (Bergum & Dossetor, 2005).
Funding was received for a second phase of the
project (1997), in which the researchers took the identified themes of relational ethics and explored them in
three areas: mental health care, genetic counseling, and
team relations of health care providers. The first author
of this article, a member of the original research group,
led the mental health care project with a new interdisciplinary team of clinicians. The original research group
participated directly by contributing to analysis of results
(e.g., during all-day retreats) and indirectly through
advisement on procedural issues. After the second phase,
further projects arose (e.g., moral distress of mental
health practitioners, ethical relationships in forensic psychiatric settings).

Analysis of the Interdisciplinary Process

Research Method

Addressing the Life Cycle of the Research

Interpretive analysis was used by the research group


to explore specific health care scenarios.2 These real situations were brought into the room through such
means as personal testimony, documentaries, or written
narratives. Each scenario was opened within the
research group by discussion of perceived ethical issues
and responses. There was an attempt to attend to the
relational aspects of the scenarios. These discussions (3
to 4 hours in length, five to six times a year for 2 years)
were audiotaped and transcribed as the research data.
Thematic analysis by the investigators and the research
group (including student assistants) was carried out and
summary texts created.

All collaborative research requires some basics:


diversity in the team, shared objectives, shared space to
meet (actual and/or virtual), and a strategic plan with
identified parameters and outcomes. A core characteristic of interdisciplinary work is emergence (Evans &
Macnaughton, 2004), with the emergence of new concepts, problems, or solutions being supported by a synthesis of diverse perspectives. Some vision, then, is
needed in the creation of a research group. The mixture
matters. Bergum and Dossetor (2005) explicitly sought
to bring together a wide representation of perspectives.
For instance, one member, a philosopher, was working
with sociologists in the area of science and technology.

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Austin et al. / From Interdisciplinary to Transdisciplinary Research 561

Another, a linguistic anthropologist, was a member of


the Cree nation and able to offer an indigenous perspective. A third was a family physician with an interest in
East Asian medicine, and so on. It was discovered, as
well, that the research group represented a wide range of
experience as patients and as family members of
patients. These personal experiences enriched rather
than detracted from the discussions.
The size of the research group (18) surpassed the
numbers typically recommended for a project team, 12
or less. However, the group effectively gathered around
a square of tables in the comfortable library of the universitys Ethics Centre. Although lack of institutional
support has been identified as a serious problem for
research across disciplines (San Martin-Rodriguez,
Beaulieu, DAmour, & Ferrada-Videlia, 2005), this
projects funding permitted research assistants as well as
a half-time coordinator, and the Centre provided a
home base.
From the onset, clarity regarding roles and responsibilities was recognized as important, and a contract was
developed and signed by all members of the research
group. It outlined the use of the data (e.g., storage,
project property), the stipulations regarding publications
(e.g., must acknowledge the project and its funding; be
reviewed by the PIs prior to submission; authorship
dependent on contribution), and the commitment and
withdrawal of research group members (2-year commitment desired, able to withdraw at any time, must maintain publishing agreement). Level of commitment has
been identified as a source of turmoil in multidisciplinary
academic groups (Younglove-Webb, Gray, Abdalla, &
Thurow, 1999), with sabbaticals, reassignments, and
other demands interfering with the ability or desire to
continue contributing to a project. Because this was
addressed at the outset, this was not a significant issue
during this project.
Nissani (1995) has offered four criteria to rank
interdisciplinary richness: number of disciplines
involved, distance between them, novelty and creativity involved in combining disciplinary elements, and
degree of integration. The relational ethics project
does well on all four criteria. It is in meeting the last
criterion (the degree of integration), however, that the
research process moved from being interdisciplinary
to being transdisciplinary.
Opening the Dialogue and Keeping It Transcendent
For questions that challenge the status quo to be
raised and new insights articulated, a climate of
safety, trust, and respect must exist (Brown & Isaacs,

1996), as well as an equality that allows researchers


to challenge each others thinking (Schunn, Crowley,
& Okada, 2002). At the first meeting, the research
group explored what each member hoped would and
would not happen during the project. The hopes
involved being able to make a meaningful contribution; the fears, that ones voice would be silenced or
dismissed. The PIs noted:
Within interdisciplinary work we needed to recognize the issue of power: How does one avoid any one
discipline dominating the conversation? How can
one remain aware of the potential that one kind of
discipline, gender, ability, or scholarship may privilege the questions being asked and answered?
(Bergum & Dossetor, 2005, p. 19)

Explicitly acknowledging at the outset the potential for


silencing members of the group, for stifling the expression of opposing opinions, or for creating an atmosphere
of competition seemed to decrease the likelihood of
such outcomes within this research group.
As the researchers coalesced into a team, it became
increasingly possible to address the tensions of diversity and differences. The research group began to
mirror the team process in health care practice, with
all its strengths and stresses, a distinct advantage
when the intent is to explore perspectives on ethical
practice. The following details one such example.
Early in the project, discussion centered on ethical
engagement with patients. It turned to the idea of coming to know the patient as a person. A female nurse
began to describe a situation in which she had cared for
a comatose child, believing that she was giving her
patient the best care she could. One morning when the
nurse entered the patients room, after being absent for
several days, she noticed a drawing left for the patient by
her sister. The nurse realized that she did not know that
her patient had a sister and thought, Christine, I dont
even know you. Her distress as she recalled this was
apparent, and several research group members were
obviously moved by her story. The male physician sitting next to the nurse said, Could we get back on
topic? and then promptly identified a theoretical construct for discussion. This moment nearly passed without reflection as others responded to the direction of the
physician. Then someone said, Wait a minute. What
just happened here? It feels so familiar. This single
question directed the rest of the discussion.
What had just happened? As sometimes occurs in
health care environments, dialogue was shut down
when a practitioners feelings became overt and

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562 Qualitative Health Research

apparent. In the ensuing discussion, research group


members described experiencing relief when the discussion was moved by the physician back to an intellectual level: They were afraid of becoming
emotional and losing credibility with their colleagues. This risk was felt by both the scholars and
the clinicians in the research group. Adherence to
reason is a dominant expectation. As initially
occurred within the research group, a violation of the
expected attitude of objective detachment is not well
tolerated in academia or health care environments.
The difference, however, was that the research
process allowed, even demanded, that this expectation be challenged, that the tensions arising be
addressed, and the unsaid voice be heard. As a result,
the role of embodied knowledge in ethical practice
evolved as a major research theme. Uniquely, recognizing and acknowledging the relational and intuitive,
as well as the rational, is foundational to transdisciplinary research, an important aspect that is often
overlooked or diminished in traditional scholarly and
scientific research (Max-Neef, 2005).
In an examination of interdisciplinarity, Sawa (2005)
addressed the issue of conflict. He noted that conflict is
more likely to occur if there is not time for trust and a
culture of dialogue to develop. Indeed, Bergum and
Dossetor (2005) concur, trust and respect were necessary
for research group members to be willing to consider
and challenge differing views (p. 19). There also needs
to be opportunity for conflicting assumptions and beliefs
to be worked out. Authenticity, which involves genuine
attentiveness, intelligence, reasonableness, and responsibility, guides the appropriate attitude in interdisciplinary work (p. 53). It requires that a person be fully
present to another, aware of their own dependence and
independence, and in dialogue . . . able to engage with
others without manipulating them (p. 129). That an
incident with the potential to undermine the authenticity
of the project occurred early in the research groups
development but evolved in such a positive, affirming
way, generating both new understandings and confidence in the research group itself, was of great benefit to
the research.
Letting Go of the Script
A significant barrier to interdisciplinary or transdisciplinary collaboration is finding the words to express
ideas that transcend disciplinary knowledge.
Disciplines often ascribe different meanings to the
same word, and borrowed concepts can easily be misused (Dogan & Pahre, 1990). Dialogue can be difficult

if a shared language does not exist. Unfortunately, a


feature of disciplinary-focused education is the isolation of students in their education (Baier, Stubblefield,
& Hoechst, 1997). This isolation sustains specialty language and concepts and restrains any motivation to
explore literature outside ones discipline (Barr, 2002).
Yet finding a common language, engaging in authentic
dialogue, and recognizing our disciplinary screens or
lenses are features through which the interdisciplinary process moves toward the transdisciplinary (Giri,
2002). Some scholars believe that these core features in
the movement to transdisciplinarity are essential to
resolving inherent problems in the current academic
system, including disciplinary isolation, the incongruity
between disciplines languages and modes of knowing, and the ever-increasing mass of information
(Hamberger, 2004). They are also central to bridging the
theoryapplication gap (van Manen, 2001) and to
addressing complex social problems whose solutions are
beyond the resources of one discipline (Horlick-Jones &
Sime, 2004).
In the health sciences, experiences with patients and
families provide a common ground. That the research
group gathered around a patients situation facilitated
the discussion. Nevertheless, it was difficult to go
beyond habitual ways of thinking, to develop a shared
language and attempt to consider ethics in a new way.
As one research group member put it, we needed to let
go of the script or, as Giri (2002) described, have the
courage to abandon (p. 109). Transdisciplinary work
requires overcoming disciplinary chauvinism and
becoming open to the perspectives of others (Giri,
2002). This does not mean negating what one knows but
does mean becoming free of restraining perspectives
(Bergum & Dossetor, 2005). Although this process was
not always easy, letting go of the script was a helpful
metaphor to which we often referred.
Metaphors can be significant in transcending disciplinary understandings and disclosing what might
be otherwise invisible (Evans & Macnaughton,
2004). This includes the sharing of metaphors common to ones field. One such metaphor explored by
the research group was that of care maps, a concept
popular with hospital administrators. Consideration
of mapmaking and factors like spatial and political
terrain fostered imaginative reflection on the ethical
implications of maps of care.
Another strategy used by the research group for
expressing tacit understandings and moving the work
forward was the collection of images of ethical relationships in health care (e.g., a photo of a hospital bed

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Austin et al. / From Interdisciplinary to Transdisciplinary Research 563

so surrounded by technology that the patient in the


bed is not immediately evident; a painting of a sick
child, parents, and a physician). The images triggered
rich dialogue and were found to support thematic elements arising in the scenarios.
Conversation has been identified as the most important work in our contemporary knowledge economy, as
it is the means by which knowledge is acknowledged,
shared, and discovered (Webber, 1993). It was certainly
true that informal talk among the research group played
a part in the evolution of the project. These talks might
occur in the parking lot after a meeting (despite the risk
of frostbitten toes) or (more comfortably) over coffee
and cinnamon buns on a break. For the move from interdisciplinary to transdisciplinaryfor the success of the
project itselfthe research group had to let go of the
script and engage in authentic dialogue.
Productivity and Research Results
The collaboration of interdisciplinary and transdisciplinary research can require a different approach to conducting a project (Desprs & Brais, 2004). Analysis and
writing are creative activities not easily accomplished in
a group. As group processes, they require more time
than individual work. Outside the research group scenario meetings there were gatherings for interested
members to work on specific products of the research,
such as scriptwriting for the drama. A weekend retreat
allowed for further analysis and writing. The time dedicated to this was essential for its success.
The PIs took a strong lead in disseminating research
results. All research group members were invited to contribute to articles, scriptwriting, and presentations, but
there was no demand to do so. The book about the
project was authored by the PIs, with interested research
group members critiquing chapter drafts. At the same
time, research group members were encouraged to present the work to their own disciplines and at interdisciplinary conferences. At a conference, the research group
presented on the relationship between principle-based
and relational ethics. The original plan was for a scripted
panel. It was recognized, however, that this was not
going to work: The research group needed to interact
with the audience. The format was changed to one that
directly engaged the persons in attendance. Letting go of
the script in this way highlighted both the risk taking
always involved in such attempts at engagement and our
developed commitment to an ongoing dialogue. To this
end, the book based on the initial relational ethics
project concludes with the acknowledgment that inviting and enacting continual conversation is our most

important task (Bergum & Dossetor, 2005, p. 221) in


the development of relational ethics.

Conclusion
Any collaborative research across disciplines
multi, inter, transadds value in accessing a broad
base of expertise (Schunn et al., 2002). For research
focused on health care, such as that exploring ethical
practice, a further advantage is that it more closely
replicates the real world of health care than do single
disciplinary models. Although practice oriented, the
relational ethics project neither succumbed to a
reductionistic approach to ethics nor adopted a technocratic worldview (van Manen, 2001). Rather,
through turning to cases, images, literature, and dialogue via the nontraditional method of interpretive
inquiry, an alternative approach to health ethics
evolved. Through this process, although unintentionally, the interdisciplinary relational ethics project
evolved into a transdisciplinary one. The research did
not articulate a new approach to health ethics but
proffered an emerging understanding of it, inclusive
of yet moving beyond principlism and an ethics of
care: The foundational knowledge for ethics lies in
understanding our relationships with others. Through
conception, assemblage, and process, the project fostered a natural movement of the research group from
interdisciplinary to transdisciplinary activities.
Although natural, the movement was not always easy.
It was difficult, sometimes painful, but inherently
worthwhile. Our intention in sharing this case study
has been to demonstrate the possibilities and challenges of transdisciplinary research and its reflection
of the complex reality of health care itself.

Notes
1. Although the process that would change medical ethics into
bioethics began in the 1960s, the term was not used until 1972.
2. For a full description of the research method used, please
see Chapter 1 in Bergum and Dossetor (2005).

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Wendy Austin, RN, MEd (Counseling), PhD, is a full professor


and holds a Canada Research Chair in Relational Ethics in Health
Care at the Faculty of Nursing and the John Dossetor Health
Ethics at the University of Alberta, Edmonton, Alberta, Canada.
Caroline Park, RN, MEd (Educational Administration), PhD, is
an associate professor at the Centre for Nursing & Health Studies
at Athabasca University, Athabasca, Alberta, Canada.
Erika Goble, BA/Sc, MA, is a research coordinator at the Faculty of
Nursing, University of Alberta, Edmonton, Alberta, Canada.

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