Abstract
As we seek to develop effective collaboration among multidisciplinary clinical or design teams, we can observe interactions that incorporate differing levels of expertise as they relate to any given topic. Team participants may have deep expertise in their own areas, but varying levels of knowledge or understanding of the other domains represented on the team. Physicians, nurses, pharmacists, and respiratory therapists each have their own areas of specific and detailed expertise, but they may or may not have a useful knowledge or understanding of their colleagues' specialties. Architects, engineers, interior designers, contractors, financiers, and the owner's vice presidents of facilities also have their own areas of specific expertise, and they may or may not have knowledge or a clear understanding of their teammates' specialties. One important aspect of high-performing teams is, of course, the benefit of complementary skill sets among the members; yet there is the possibility that performance could be improved further as team members develop knowledge and understanding in the domains of their colleagues' expertise.The development of specialty and subspecialty expertise occurs in medicine, nursing, and architecture, and no one doubts that this extreme focus on increasingly narrow domains of knowledge has benefitted each field in which it occurs-and that it has served society. The tendency to develop skills and expertise within these narrow silos, however, may hinder understanding and shared knowledge across disciplines. This, in turn, may negatively affect team performance, where shared goals, knowledge, and experience contribute to outcomes.Patricia Benner, RN, PhD, has written about the development of nursing skills across five levels from novice to expert (Benner, 2001). She bases much of her thinking on the Dreyfus Model of Skills Acquisition (Dreyfus & Dreyfus, 1980). The Dreyfus Model was developed as an Air Force study of pilot skills as applied in crisis situations, and Benner adapted it for clinical skill development. I have found Benner's descriptions of expertise levels derived from the Dreyfus Model to be useful in my own teaching in the graduate design studio where I measure 14 aspects of design skill across the spectrum from novice to expert and ask my students to assess themselves using the same matrix.* Novice: someone first exposed to a subject, but with no meaningful experience;* Advanced beginner: someone who understands the subject on the basis of theory, didactic explanation, and practical book learning, but with only limited experience;* Competent: someone with good understanding of the practical and theoretical knowledge base and enough experience to make reasoned responses to emerging situations;* Proficient: someone with full understanding of the knowledge base and enough experience to allow automatic response to many emerging situations;* Expert: someone with full understanding of the knowledge base and sufficient experience to allow highly nuanced responses to any presenting situation.The Dreyfus Model and Benner's interpretation have helped me better understand how individual expertise can be developed. One of the salient points is the recognition that, for many forms of practice, the acquisition of practical and theoretical knowledge by means of classroom or book learning does not lead to expertise. The development of expertise in practice requires a significant dose of experience to give meaning to book learning and to illustrate how often variance from theory or relatively simplistic book descriptions occurs. Experiential learning is based on the notion that authentic experience will provide more powerful learning and retention than the didactic presentation of concepts (Kolb, 1984). Experienced clinical practitioners and design professionals have more to offer than do well-trained entrants to the field. …
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