Work

Position and Power Defining Hierarchical Power in Interprofessional Collaboration (IPC): A Concept Analysis

Year: 2026

Type: article

Abstract: Effective interprofessional collaboration (IPC) is essential for the delivery of healthcare globally. A central component of effective IPC is clear, respectful communication among healthcare professionals. Relational elements of communication, such as power dynamics within the interprofessional team, are critical to effective team communication. Historically and currently, the healthcare system is hierarchical, giving physicians power and control over patient care. These entrenched hierarchies limit IPC. Across the healthcare literature, there is no consistent definition of hierarchical power or differentiation relative to related constructs, leading to conceptual ambiguity. This concept analysis aims to clarify the meaning of hierarchical power in IPC, using Walker and Avant’s eight‐step framework to identify defining attributes, antecedents and consequences. A literature review was conducted using CINAHL, MEDLINE, PsycINFO, ERIC and Scopus, focusing on publications from 2010 to 2025. Fifty‐one articles were included in the analysis. Defining attributes of hierarchical power included power imbalance, inhibited voice behaviour and professional marginalization. Antecedents included professional identity formation, organizational structures and cultural norms. Consequences included moral distress, reduced psychological safety and impaired collaboration. By examining the literature across healthcare professions, the defining attributes, antecedents and consequences of hierarchical power were identified, leading to an operational definition and strategies to reduce power imbalances, encourage voice and counter marginalization. Hierarchical power is defined as the authority and resources held by individuals with a perceived higher rank to influence or limit the exchange of ideas related to patient care. This refined conceptualization provides a foundation that will guide practice, education and research to enhance IPC.

Source: Nursing Forum

DOI: 10.1155/nuf/9419863

Authors: Denise Delorey, Jane Tyerman, Michelle Lalonde, Judy King

Institutions: University of Ottawa, Institut du Savoir Montfort

Language: English

Topic: Interprofessional Education and Collaboration

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $840