# Situation: The nurse works on a 30-bed acute psychiatric unit of a general hospital. The interprofessional team includes psychiatrists, nurses, a psychologist, a social worker, an occupational therapist and trained nursing attendants. The team meets every morning. A 45-year-old man with bipolar I disorder is recovering from a manic episode. The psychiatrist, the nurses, the social worker and the occupational therapist have each written separate goals for him, and some of the goals conflict. The team holds an interdisciplinary care conference to agree on one care plan. What is the main purpose of this conference?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630057  
> language: ko  
> subject: Nursing Practice V — Care of Clients with Maladaptive Patterns of Behavior; Care of Clients with Life-Threatening Conditions, Acute Multi-Organ Problems, High Acuity and Emergency Situations

## 문제

Situation: The nurse works on a 30-bed acute psychiatric unit of a general hospital. The interprofessional team includes psychiatrists, nurses, a psychologist, a social worker, an occupational therapist and trained nursing attendants. The team meets every morning.

A 45-year-old man with bipolar I disorder is recovering from a manic episode. The psychiatrist, the nurses, the social worker and the occupational therapist have each written separate goals for him, and some of the goals conflict. The team holds an interdisciplinary care conference to agree on one care plan. What is the main purpose of this conference?

## 보기

1. To decide which single discipline will direct his care
2. To set shared goals that every discipline works toward **✔ 정답**
3. To let the psychiatrist approve each discipline's goals
4. To reduce the charting that each discipline must do

**정답: 2**

## 해설

An interdisciplinary care conference brings each discipline's assessment together so the team agrees on shared, client-centered goals and each member knows its part. Conflicting separate goals confuse the client and waste effort; one agreed plan coordinates care without making any single discipline the owner of all decisions.

## 심화 해설

Core purpose of the interdisciplinary care conference

When a client with bipolar I disorder is recovering from a manic episode, each discipline naturally sees a different slice of the same person. The psychiatrist focuses on mood stabilization and medication response, nurses on sleep, hydration, and safety, the social worker on housing and family support, and the occupational therapist on daily structure and role resumption. Individually written goals can easily pull in different directions; for example, the occupational therapist may want the client to attend a full morning group to rebuild routine, while nursing may prioritize protected sleep after a night of reduced need for rest. The conference exists to reconcile those tensions into one coherent direction.

The main purpose of an interdisciplinary care conference is to create shared, client-centered goals that every team member deliberately works toward, not to assign ownership of the plan to one discipline. This reflects the shift described in goal-oriented care research: the team moves from asking “what is the matter” to asking “what matters to this patient,” and then aligns their separate assessments around that answer [1]. When the team holds a shared mental model, each member still performs discipline-specific tasks, but those tasks now serve the same agreed-upon outcomes rather than competing ones [2].

| Misconception | Why it is incorrect | What actually happens |
| --- | --- | --- |
| One discipline directs the care | No single profession owns the whole plan; a psychiatrist-led medical decision is not the same as a team-owned care plan | Leadership shifts by issue, but goals remain jointly held |
| The psychiatrist approves each discipline’s goals | Approval implies hierarchy, which undermines the shared mental model that interdisciplinary care requires | Goals are negotiated and agreed upon collectively, with the client’s priorities at the center |
| The conference reduces charting | Documentation burden is not the purpose; coordination may streamline communication, but that is a byproduct | The focus is on aligning assessments and interventions, not on paperwork efficiency |

Watch out! Do not confuse interdisciplinary with multidisciplinary. In a multidisciplinary model, each discipline writes its own plan and works in parallel; in an interdisciplinary model, the team deliberately integrates those separate assessments into one shared plan. The question describes an interdisciplinary care conference, so the correct answer must reflect integration, not parallel goal-setting.

The shared mental model framework helps explain why conflicting goals are clinically harmful, not just administratively inconvenient. When team members carry different assumptions about what the client is working toward, they may give contradictory messages. A client emerging from mania is especially vulnerable to this: inconsistent expectations about activity level, sleep, or social engagement can increase agitation and erode trust. Structured case conferences allow providers to surface those hidden assumptions and build a common understanding of the client’s current needs . In long-term and complex care settings, even disciplines that are not traditionally present at the bedside benefit when they participate in the same conference and hear the same rationale .

For the client recovering from mania, the shared plan typically includes consistent sleep-wake routines, gradual re-engagement in structured activity, medication adherence, and early recognition of mood elevation, with each discipline contributing its specific expertise toward those common targets. The nurse’s role is not to “win” the nursing goal over the occupational therapist’s goal, but to advocate for the client’s overall stability and help the team see how each intervention either supports or undermines that stability.

Key point! The conference does not erase discipline-specific responsibilities. It aligns them. The psychiatrist still manages pharmacotherapy, the nurse still monitors sleep and behavior, the social worker still addresses discharge needs, and the occupational therapist still structures daily activity—but all of them now reference the same shared goals when making decisions.References (research sources)

- [1]On the same page? A qualitative study of shared mental models in an interprofessional, inter-organizational team implementing goal-oriented care.Research articleIm J, Evans JM, Grudniewicz A, Boeckxstaens P, Upshur R, Steele Gray C (2023) · DOI: 10.1080/13561820.2022.2113048

- [2]Promoting interdisciplinary shared mental models.Research articleHerrmann LE, Jarvis L, Bhansali P, Zaveri P (2019) · DOI: 10.1111/tct.12782

## 임상 시나리오

Interdisciplinary Care ConferenceOne Plan, Many Disciplines
The main purpose is to create shared, client-centered goals that every team member works toward. Each discipline contributes its assessment, but the team agrees on one coherent plan.

For a client recovering from bipolar I disorder mania, the psychiatrist addresses mood stabilization, nurses focus on sleep and safety, the social worker on housing and family support, and the occupational therapist on daily structure. These separate goals must be reconciled into one direction.

CautionConflicting separate goals confuse the client and waste effort. No single discipline owns the plan; the team holds a shared mental model while each member performs discipline-specific tasks.

## 핵심 개념

- **Interdisciplinary care conference** — A meeting where multiple disciplines integrate assessments to agree on one shared, client-centered plan.
- **Shared goals** — Outcomes that every team member deliberately works toward, regardless of discipline-specific tasks.
- **Client-centered care** — Care organized around what matters to the patient rather than what each discipline independently decides.
- **Bipolar I disorder** — A mood disorder characterized by manic episodes that may require coordinated recovery planning.
- **Shared mental model** — A common understanding among team members of the patient's goals and each member's role.

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