January 10th, 2022

Coming Together is Easy. Working Together is Hard, But Worth It.

by Laura Pinsoneault, PhD, Evaluation Plus &
Tobi Cawthra, MPH, Community and Cancer Science Network

​“Group project”- two words that earn a groan from just about any classroom. Most kids don’t enjoy working on team projects and neither do adults. Collaboration is hard. It is especially challenging when you are bringing together people from many different fields and experiences.

So, if collaboration is so hard, why do we do it?
“Collaboration” is a bit of a buzzword; we hear it everywhere. But what does it really mean? By strict definition, when you collaborate two or more people cooperate; they work to achieve something. It’s from Latin, collaboratus, -to labor together. The theory is that in laboring together we can accomplish more than we can alone.

This is especially true when we are working with complex problems, those with numerous interconnected elements. No one person can address every facet of a problem. If one person just works on what they know, they will miss a lot of information and opportunity. An if multiple people are only working on one part of the issue, well, they probably won’t be very effective either.

The more complex or seemingly intractable a problem is, the more broad the knowledge and expertise is needed to find an answer. This requires transdisciplinary collaboration (or transdisciplinary research in academic settings). In transdisciplinary collaboration, people come together representing multiple disciplines and experiences. They work to integrate their individual knowledge to create a new knowledge or understanding .

Transdisciplinary Collaboration- the How of Collaboration
Just bringing multiple disciplines together doesn’t automatically produce good transdisciplinary collaboration. In fact, good transdisciplinary collaboration is often messier and less straightforward than simple multi-disciplinary or interdisciplinary collaboration. Our collaborative, known as the Community and Cancer Science Network (CCSN), consists of researchers, community organizations, providers of care, individuals with direct experience with cancer and disparities, funders and more. When our collective work began, we didn’t use the same language to talk about the problem we were addressing; we didn’t use the same methods to solve problems; we didn’t have exactly the same resources at our disposal and we didn’t have the same motivation for being there. 

Yet, through transdisciplinary collaboration, we have been able to build these differences into collective strengths and develop several transdisciplinary teams whose efforts center on reducing cancer disparities. The process to develop these teams has contributed to our learning on ways that transdisciplinary teams can work.

Start with a consolidated understanding of the problem
When CCSN brings partners together, we start by finding ways to help them see the wealth of knowledge and expertise each partner brings. This comes through facilitated discussion that surfaces the collective awareness of the group. In one CCSN team, we used the “5-whys” exercise to explore the collective knowledge of the root causes of disparities for specific cancers. The illustration produced from this exercise demonstrated three things. First, it showed visually the breadth and depth of knowledge and expertise on the team. Next, it pointed to linkages across disciplines. Last, and perhaps most importantly, it illustrated each person’s unique contribution to solving the problem.

This team returned to this document on several occasions to reground the team on the interconnections between team members. The team also updated the document periodically to reflect new knowledge or understanding allowing them to document their progress and learning. This simple and important exercise proved helpful whenever the team struggled with collaboration or were not advancing as quickly as they would like. It reminded them that they need all the perspectives to fully understand and address cancer disparities.

Coach and convene; don’t dictate and control
A shared understanding is not enough. CCSN also uses coaching tools. Instead of focusing facilitation on moving through an agenda, we used meetings to coach collaboration and identify barriers and promoters for collaboration. Tobi, who served as the primary facilitator, focused on developing trust among team members and identifying group communication styles and preferences, while still advancing the work. As the developmental evaluator, Laura, focused on frameworks and processes to draw out nuanced perspectives.

After each meeting, we reflected together on how the meeting went, where collaboration could be enhanced and what strategy would get us there. For example, when team members did not offer opinions or insights in a meeting, we provided opportunities to get insights and feedback between meetings via email or one-on-one conversations. We also led the team in small group activities, always assigning team members to groups to expand the interaction among team members. Through these types of activities, we were able to draw out engagement across the different sectors represented.

​In this process, we also modeled an inquisitive approach. We did not discourage any ideas or threads of inquiry. We allowed agendas to be flexible or even set aside when a topic arose that was of particular relevance. This approach welcomed others to do the same and developed an environment where everyone was free to explore questions and not be the expert.

Let the collaborators benefit from messiness
Our teams experience a great degree of learning during their time together. And this learning is not a straightforward process. All of the teams have felt stuck and confused at times. Often, team members felt that they were re-hashing decisions or rethinking steps. At times, they were, but they were approaching those decisions and steps with a new and deeper understanding of an issue.

CCSN teams are eager to advance solutions. As a result, they struggle, at times, to be patient with learning and incorporating new knowledge. This happens most frequently when a collaboration is struggling or when necessary information to solve the problem is missing. At these times, we intentionally slow down progress to either address how the team could work better together, or perhaps find ways to draw in missing information.

CCSN teams mature as collaboratives by working through this messiness and discomfort together. We have observed that the harder the challenge, the more connected the team becomes once they push past this discomfort. For example, the original CCSN team members continue to stay connected as well as bring in other partners. Initial team members have gone on to lead a transdisciplinary team or participate on one, and many report seeing how a transdisciplinary approach could benefit their other collaborations. They describe the original team as the “Dream Team” and continue to reflect upon how this collaboration changed how they do their work and how they understand the issue.

And, this is why we struggle through collaboration. Yes, it can make work go more smoothly and yes, it can streamline processes. But, why we struggle through collaboration is that it changes us. It makes us better at our vocations and our avocations.

*Cross posted on Evaluation Plus*