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Trust

Continuing and Professional Development Blog 

January 2020

TRUST: “assured reliance on the character, ability, strength, or truth of someone or something.”​​

The Merriam-Webster.com Dictionary, Merriam-Webster Inc., https://www.merriam-webster.com/dictionary/trust. Accessed 20 January 2020.

Trust and professional entrustment are common phrases in medical education today, associated with the concepts of progressive growth, assessment, and decisions about degrees of professional autonomy.  Most literature discusses trust and entrustment as characteristics of a provider-patient relationship: a relationship between one person and another person.

What can we glean from the definition of trust, as it pertains to a team of health professionals?  Surely all health professionals share values of high ethical and moral standards, humanistic values of honesty and integrity, commitment to a social contract with our patients, families, and communities that often places their needs ahead of our own, while we hold ourselves accountable and responsible for excellence and continued learning in the face of complexity and uncertainty.  How we, as different health professionals, live those values in our daily work may differ slightly, but the shared values are certainly mutual.  If this is so, what is the relationship of trust to interprofessional culture and teamwork?  Does it go without saying that, if mutually shared values underpin our professional lives and work, that trust is implicit in our interprofessional team relationships?  No, it does not.

True interprofessional collaboration and co-creation of healthcare are behaviorally expressed competencies that are observable and measurable, but lacking a foundation in trust, they are only behaviors.  Creating and building trust is not simply a learned behavior; nor is it independently achieved.

In their qualitative and ethnographic studies, Pullon and Jones respectively explore the characteristics of trust creation in interprofessional teams:  acknowledging and respecting competence in another, creating spatial and relational opportunities for shared learning, knowing the other, building resilience in the face of challenge and leveraging conflict to enhance learning and performance.

From Merriam-Webster: 

Reliance on:

Character:  your and my professional values, integrity and accountability to each other and the persons for whom we share care

Ability:  your and my knowledge and skills that we bring to our shared work

Strength:  your and my determination to respect each other and our team, to reframe conflict as an expected characteristic of the relational dynamics of a multi-faceted team of professionals

Truth: your and my protection of the workplace as a place of safety to speak up on behalf of each other, our shared work, and our patients and families

Pullon S: Competence, respect and trust: Key features of successful interprofessional nurse-doctor relationships. J Interprofessional Care; March 2008;22(2):133-47.

Jones A, Jones, D: Improving teamwork, trust and safety: an ethnographic study of an interprofessional initiative. J Interprofessional Care;2010; Early online 1 - 7; DOI: 10.3109/13561820.2010.520248