Thursday, January 24, 2008

Knowledge Integration

What does integrating knowledge mean? How comprehensive can we be, realistically and ideally? When does interdisciplinary knowledge work best? These were just some of the questions explored during the Founders Day Symposium on January 18th at the School of Nursing auditorium, where President Amy Gutmann moderated a panel of four eminent Penn Integrates Knowledge (PIK) Professors. Their topic: Aristotle’s Brain: Integrating Knowledge in the 21st Century. Thank you, Dr. Neville Strumpf, for planning this on behalf of the University Senate.

The Symposium offered the kind of intellectual discourse that exists in an institution so rich in faculty knowledge and interdisciplinary expertise, and its goal of sparking a scholarly discussion on knowledge integration was well achieved. In the conversation of integration amongst disciplines, for example, I think it is important to remember that the integration of knowledge exists within disciplines, too.

We have so many examples of knowledge integration in our school as exemplified by our faculty teaching and research. Let me just share two, the scholarships of Penn Nursing professors Charlene Compher and Joseph Boullata. Dr. Compher, renowned for her research in parenteral and enteral feeding, and Dr. Boullata, a pharmacist and nutrition expert, have worked together to advance nursing science, most recently studying vitamin D absorption in patients receiving parenteral nutrition and working on strategies to enhance these very much needed nutrients. Together, they have used a different lens to tackle a much larger problem in health care and clinical guidelines.

Societal and health problems are always integrated, which is why there is a need for integrated knowledge. Still, there also exists a tension between knowing a discipline vertically and thoroughly and “knowing” what comes from many different disciplines. In other words, is it better to be a jack of all trades or a master of one? And in the nursing field, where the needs of specialization are evident in roles like nurse anesthetist and clinical nurse specialist, is the job market ready for integrated knowledge or integrated graduates?

These are issues that need to be addressed, and I encourage you, especially those of you unable to attend the Symposium, to challenge yourself by asking these very questions.

Tuesday, January 8, 2008

Fostering Ethical Environments

Two priorities identified by working groups during our November 2007 retreat were to foster an environment of intellectual discourse and enrich it by making it more ethical. These two priorities, of intellectual discourse and ethical climate, are somewhat related to each other. They reflect our strategic focus on making our academic community even more effective in enhancing our productivity, as well as making it more inviting and fulfilling.

So the question is what makes an environment ethical. We could ask collectively, “How do we know if we are abiding by ethical principles?” And respond individually by reflecting on our roles in creating and maintaining an environment that we all could say is principled and ethical.

I will focus here on the ethical aspects of an environment, and I would like to share some of my own reflections as well as the results of my posing the question to colleagues nationally and internationally.

I believe transparency is the most the common attribute found in ethical environments. We must therefore cultivate an environment in which the rules are clear, roles defined, responsibilities delineated, goals shared, and all processes openly discussed. But when transparency is coupled with the sometimes inevitable demands of confidentiality, questions –– “when to share what? To whom? And by whom?” –– invariably arise. Effective transparency allows for a dialogue about conditions and contexts for transparency. For example, transparency in personnel decision making and deliberations would be unethical because confidentiality in such situations must be honored. On the other hand, transparency in deciding other issues, such as how doctoral students are assigned advisors or why we are implementing the mentorship program, should be expected and required. Transparency works best when there is trust and a sense of equity. Equity, in its simplest terms, means fairness, respect for different talents, for different voices, and for seeking and honoring all forms of diversity. Equity must exist on many levels: in policies, responses and resources, but it must be experienced by all members of an organization; but then equity is also a subjective experience.

In an ethical environment, individuals feel confident in their ability to exercise their right to have their voices expressed and heard, while knowing that their opinions may not necessarily prevail. An ethical educational environment is a just one in which there is no intimidation for dissenting voices or for different opinions. A just environment is not necessarily an environment where consensus or harmony prevail; rather, it is an environment where diversity of opinions are accepted, expected, and respected.

But even the notion of equity calls for a pause and dialogue. Questions to be asked are: equity in what? And is total equity possible when we are all at different ages, different ranks, have different expectations, different experiences, different funding levels and different abilities, skills, and goals? How do we establish a sense of equity while allowing differences, honoring different capabilities, and celebrating deviations? How do we avoid normalization and mediocrity?

In sort, how can we have a fundamental sense of equity and yet support and encourage differences?

I propose one principle which may help in revealing these paradoxes of transparency vs. confidentiality, and equity vs. valuing differences. The answer lies in the balance between common good and personal good. I am suggesting here that it is the common good for our discipline and our school which can guide us in mediating both sides of paradoxes.

We should be transparent to the extent that it does not undermine our credibility, our school, our discipline, our individualism. And we should have confidentiality to the extent it advances our school, our discipline, and our individual goals. We should have equity and diversity to the extent it enhances our ability to meet our shared goals and missions, our discipline and professional mission, while at the same time enriches us toward meeting our personal goals.

Ethical environments are transparent, confidential, equitable; environments in which differences are honored, trust promoted, fear eliminated, where space is available for intellectual dialogues, for opportunities to share ideas, and for opportunities to challenge each other without being fearful of consequences.

We are almost there! However, as we get there, we find that “there” has moved and that there really is no “there” there (a la Gertrude Stein). It is all here. And that on the way to “there,” we create the nature of the “there” that we want. And we are creating it together.

Selecting ethical discourse and ethical environments as our top priorities for our community is an indication that we are creating together what we want to be core in all our missions. I am very proud of our school for making these our priorities.