DQ 2 : Why is it so difficult to establish a collaborative culture in health care organizations?
Support your position turns this into an argument. Several obstacles are real; the post has to claim one is decisive in health care specifically and defend that claim against the alternatives.
Editorial process
Last reviewed · August 18, 2026
Why collaboration keeps failing in hospitals specifically
The obstacles are not hard to list and listing them is not the task. Professions are trained separately for years before they meet at a bedside; accountability is bounded by licence, so a physician, a pharmacist and a nurse each answer to a different board for the same patient; care is delivered across shifts, so the team that starts a plan is rarely the team that finishes it; and status differences make it expensive for the lowest-status person present to say the thing that matters. Any of those will fill a paragraph. The instruction to support your position means you have to say which one is decisive and defend that against the others, which is a harder and more interesting job than assembling the list. Every post on this board will contain most of that list, so the argument has to come from somewhere the list cannot supply.
Separate structure from culture while you argue, because the two get conflated and the conflation is what produces the weak recommendation this discussion collects most often. Team-building days, values statements and communication training address culture, and they are cheap and popular for exactly that reason. Separate training pipelines, licence-bounded accountability and shift discontinuity are structural, and no amount of culture work dissolves them. That is why interventions with structural teeth — interprofessional education before qualification, structured handover protocols, shared documentation, joint rounds with a named time — show up in the evidence when goodwill initiatives do not. Take the position that the structural obstacle dominates and you have an argument you can defend with citations. Take the opposite position and defend it just as hard, but say which structural constraint you are claiming culture can overcome. That is a testable claim rather than a preference, and a testable claim is what this prompt means by a position.
Likely learning objectives
- Identify structural and cultural obstacles to collaboration and keep them apart.
- Argue that one obstacle is decisive, against named alternatives.
- Explain why culture-level interventions leave structural obstacles intact.
- Support a position with evidence rather than with plausibility.
Assignment instructions
Read the full question
Review every instruction before using the planning guidance that follows.
HCA 822 Topic 5 DQ 2 DQ 2 : Why is it so difficult to establish a collaborative culture in health care organizations? Why is it so difficult to establish a collaborative culture in health care organizations? Support your position.
Course-wide instructions that accompany this question
Important information for writing discussion questions and participation Hi Class, Please read through the following information on writing a Discussion question response and participation posts. Contact me if you have any questions. Important information on Writing a Discussion Question Your response needs to be a minimum of 150 words (not including your list of references) There needs to be at least TWO references with ONE being a peer reviewed professional journal article. Include in-text citations in your response Do not include quotes—instead summarize and paraphrase the information Follow APA-7th edition Points will be deducted if the above is not followed Participation –replies to your classmates or instructor A minimum of 6 responses per week, on at least 3 days of the week. Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article Each response needs to be at least 75 words in length (does not include your list of references) Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count. Follow APA 7th edition Points will be deducted if the above is not followed Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points. Here are some helpful links Student paper example Citing Sources The Writing Center is a great resource Welcome to class Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to. I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you. Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted. If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations. Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements. Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week. I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course! HCA 822 Topic 5 DQ 2 Name: Discussion Rubric Grid View List View Excellent 90–100 Good 80–89 Fair 70–79 Poor 0–69 Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources. 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references. 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references. 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references. Main Posting: Writing 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style. 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Posting: Timely and full participation 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date. 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date. 7 (7%) – 7 (7%) Posts main Discussion by due date. 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date. First Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. First Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. First Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Second Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%) Response is on topic and may have some depth. 0 (0%) – 6 (6%) Response may not be on topic and lacks depth. Second Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English. 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. Second Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date. 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date. 3 (3%) – 3 (3%) Posts by due date. 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date. Total Points: 100 Name: Discussion Rubric
Turn the brief into deliverables
- 01At least three obstacles, described with a mechanism.
- 02A stated position on which obstacle dominates.
- 03A defence of that position against at least one alternative.
- 04The structure-versus-culture distinction, made explicitly.
- 05Evidence supporting the position, not merely illustrating it.
Naming the obstacles, then arguing which one dominates
The obstacles, with mechanisms
Set out separate training, bounded accountability, shift discontinuity and status.
What the assessor is likely looking for
A mechanism for each, showing how it blocks collaboration.
Structure versus culture
Draw the distinction that decides which interventions can work.
What the assessor is likely looking for
A test that sorts a proposed remedy into one category or the other.
The position
Claim one obstacle is decisive and say why.
What the assessor is likely looking for
A claim specific enough to be wrong.
The strongest objection
State the best case for a competing obstacle and answer it.
What the assessor is likely looking for
An objection engaged rather than mentioned.
What would follow if you are right
Name the intervention your position implies.
What the assessor is likely looking for
An intervention that matches the obstacle's category.
Evidence on what blocks interprofessional collaboration
Recommended databases
- PubMed Central
- World Health Organization
- Interprofessional Education Collaborative
- NCBI Bookshelf
Search sequence
- 1.Read the WHO framework for why interprofessional education is treated as the structural lever.
- 2.Find a study of interprofessional identity formation for the socialisation obstacle.
- 3.Look for evidence on psychological safety in a clinical team for the status obstacle.
- 4.Choose the position first, then look for the evidence that could disconfirm it.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Framework for Action on Interprofessional Education and Collaborative Practice
World Health Organization · 2010
The WHO framework, which treats separate training as the structural obstacle worth acting on.
Fostering interprofessional identity formation to support interprofessional collaboration
Advances in Health Sciences Education · 2026
Interprofessional identity formation — evidence for the professional socialisation argument.
Psychological safety in an ECMO retrieval team: a qualitative study to inform improvement
BMJ Open Quality · 2024
Psychological safety in a clinical retrieval team; the status obstacle studied rather than asserted.
IPEC Core Competencies for Interprofessional Collaborative Practice: Version 3
Interprofessional Education Collaborative, Washington, DC · 2023
The IPEC competencies, which define what a collaborative culture is supposed to produce.
COLLABORATION WITHIN THE INTERPROFESSIONAL TEAM
Nursing Management and Professional Concepts, NCBI Bookshelf · 2022
An open chapter on interprofessional collaboration in practice, for the shift and handover obstacles.
Review before submission
Common mistakes
- Listing obstacles without taking the position the prompt requires.
- Recommending team-building as a remedy for a structural obstacle.
- Conflating poor communication with the conditions that produce it.
- Supporting the position with a source that only restates it.
Submission checklist
- Have you actually taken a position on which obstacle dominates?
- Do you address at least one competing explanation?
- Is each obstacle explained by a mechanism, not just named?
- Have you separated structural from cultural obstacles?
- Does your evidence test the position rather than illustrate it?
Use this guide to plan and review your own work. Follow your institution's rules and read Brinevia's academic-integrity policy.
Written by
Maren Caldwell
MSN, RN, CNE
Medical-surgical nursing, pharmacology and NCLEX preparation
Maren is a registered nurse with over 15 years of clinical and educational experience in medical-surgical nursing. She writes on NCLEX preparation, patient care fundamentals, pharmacology and evidence-based practice.

Reviewed by
Dr. Tessa Redmond
DNP, RN, CNE
Evidence-based practice and clinical education
Tessa is a doctorally-prepared nurse educator. She reviews Brinevia content for clinical accuracy and alignment with current evidence-based guidelines.