Transdisciplines are hard to engineer. Academe is organized into departments and disciplines, and it is there where decisions of tenure and promotion, as well as judgments about standards of research are anchored.19
Moreover, scientific advances tend to be incremental and specific to disciplinary paradigms20
such that members of distinct disciplines adopt different languages and intellectual gestalts when confronting the same phenomenon. A second challenge concerns the reductionist strategy employed in most scientific research. Most scholarship attempts to establish a single, specific cause, rather than consider how trends and causal pathways at multiple units of analysis interrelate. In short, the organizational structure of academe and its incentive system, the epistemic cultures distinguishing fields and the tendency to specialize and identify reductionist answers leads to a degree of balkanization that is difficult to overcome.
Interdisciplinary science is a great example of where emergent collaborations may result in important innovations, but not in new fields of investigation or in the integrated understanding of a larger social problem. Instead, innovations are translated back to individual disciplines and integrated into growing textbooks, or translated piecemeal to certain therapies or bedside practices, but are generally not integrated into a broader, deeper understanding of how and why a complex health problem evolves and how it can be eradicated by an assortment of social policy and clinical efforts. The second challenge of transdiscipline, then, is practical: what can be done to bring distant collaborators repeatedly together, to integrate their disparate perspectives, to adapt organizational rules to facilitate this process and to continually self-assess whether the desired intellectual community is emerging or not?
To overcome these challenges and to accomplish bridging collaborations and intellectual integration, the March of Dimes Prematurity Research Center has taken concrete efforts to forge new intellectual foci, promote network integration, (re)align institutional rules and procedures and develop means of self-assessment and refinement. summarizes the challenges of intellectual, relational and institutional integration and the Center's working solutions to them. We elaborate the table's contents in ensuing sections published in the electronic Supplementary Material
. We present the practices as concrete examples that other institutions and medical researchers can consider for their own use in forging teams and intellectual communities that span and integrate multiple disciplines.
Challenges to transdisciplinary research and proposed solutions
The presence of intellectual silos in academe is well established.20
These silos emerge from specialization and incentive structures reinforcing departmental appointments and disciplinary standards of inquiry.21
To facilitate a ‘meeting of the minds' among members of multiple disciplines, the Center has identified a series of joint intellectual tasks that the team of heterogeneous researchers engage in: from the focus on preterm birth and appropriate data concerning it (ontological); to different methods the group will develop to span their perspectives (methodological); to shared concepts, lexicon and joint theories (epistemological). A variety of concrete efforts are being taken to bring about intellectual integration on each of these foci.
The boundaries and separation of disciplines is not just intellectual, however. It is also relational. Laboratories, departments and disciplines all have established relations and groups with histories, and they can become loci of jurisdictional disputes.19
Collaborating beyond these enclaves can be seen as an act of disloyalty. To overcome this tendency to reinforce silos and to facilitate transdisciplinary mixing, the Center has begun efforts at network integration that help forge collaborations across disparate parts of the university or even between universities (see column 2 of ). These local forms of integration build a community supportive of transdisciplinary research on campus, and global integration creates a broader field that can support the careers of new types of transdisciplinary scholars.
Various center activities and research personnel help foster a sense of community that spans disciplines. A transdisciplinary community arises from a series of network progressions: from the initial interrelation of distinct network populations and groups, to one that has a clear thoroughfare of communication across them, to a ultimately quasi-independent community of collaboration that has its own transdisciplinary identity—that is, the transdiscipline. The vehicles for local network integration are many of the same ones mentioned for intellectual integration: frequent meetings and subgroupings around points of shared expertise and points of mutual interest. Such activities generally pull from a broader set of scholars than occurs in a department and lab. Moreover, the frequency of contact and points of shared interest become a basis for collaboration.22
Also essential to the creation of strong relational linkages is the development of mechanisms of communication and virtual working environments. The number and diversity of Center participants preclude, at least at present, a common physical plant. As an alternative, several internet-based collaborative systems are being explored, including those that depend on or mimic social media platforms, often termed a ‘central desktop' (ones that follow guidelines of medical human subjects research). Here, entire areas can post versions of their papers, receive feedback, share a thread of comments on a problem and more. This provides a means to communicate and helps document and catalog the collective process of knowledge creation. With heterogeneous groups of participants that are distantly located, this tool proves helpful as has been recognized by the Indiana Clinical and Translational Sciences Institute.23
Network bridging can also be facilitated through the management of key research personnel. For team science, the key project personnel are graduate students and postdoctoral students who carry out the research under a faculty member's guidance. To encourage greater collaboration across silos, the Center devised a seed grant program where faculty from multiple departments could propose projects in which they share postdoctoral students and research assistants. In this way, seed grants forged network bridges that integrated the heterogeneous community and enabled expertise to pass from one lab and department to the next. In addition, one condition of continued seed funding was that the principal investigator must apply for additional external funding. In this manner, the seed grants encourage broader, sustainable collaborations that helped integrate the heterogeneous community of preterm birth researchers.
At the global level, the intent is to form a larger transdiscipline that interconnects university networks into a national network and community on preterm birth research. With the maturation of the transdiscipline, there is an increased likelihood it will form its own conferences, professional societies, funded programs and job opportunities, and this will support scholars doing this type of work. This will in turn break the problem of disciplinary reproduction, because transdisciplinary students and postdocs will graduate and find work that expands their integrated research efforts at other universities. In effect, the fully mature transdiscipline will become a community of scholars who share an intellectual focus and approach that improves in its effort to solve a medical problem and has its own professional societies, career and funding systems, and identity.
On the surface, this may seem at odds with our characterization of successful transdisciplines dying when they solve a medical problem. After all, how can a transdiscipline then offer their students and faculty continued careers? Through their involvement in the Center, transdisciplinary scholars will likely develop skills in constructionist forms of research. These skills may place them at a deficit when competing for departmental positions against disciplinary scholars who adopt specialized, reductionist approaches. However, these same constructionist approaches and skills can prove an asset for other complex health problems and their emerging transdisciplinary efforts. Just as the March of Dimes reinvented itself after the eradication of polio, transdisciplinary scholars will need to take their ‘constructionist' skill-set and apply it to a new problem and transdisciplinary center—for example, from preterm birth to birth defects, from diabetes to cardiovascular disease. As such, we envision a parallel institutional arrangement to disciplines and departments, a matrix organization of transdisciplinary centers and disciplinary departments that affords sustained careers to transdisciplinary scholars and values their distinctive contributions.24
The vehicles for creating global bridging ties are team collaborations on grants and papers, as well as the extension of old partnerships and the creation of new partnerships well beyond Stanford, including researchers from other institutions. More broadly, the Center intends to help facilitate greater national and international collaboration devoted to addressing preterm birth. As transdisciplinary activities mature, the expectation is that the Center will help develop conferences, coordinated research programs, seed grant initiatives and other activities to create a community of scholars, clinicians and policymakers with a common focus on the prevention of preterm birth. Based on similar strategies in the high-technology world, the Center will provide opportunities for select groups of young investigators and well-established experts from around the country and world to interact with Center scientists and each other. In addition, leading innovators from the high-technology and venture capital communities have been invited to interact with Center investigators and provide guidance regarding the development of highly collaborative engines of technical innovation and translation to product launch. These all act as vehicles that help develop a larger transdiscipline network, extending well beyond Stanford University.
The continued support of transdisciplinary ties is essential for the sustainability of the Center. Various additional efforts are being made to forge such networks, such as graduate student training opportunities, identification of journals receptive to publishing transdisciplinary research (for example, Science Translational Medicine) and even identification of ‘sister' centers that might later hire individuals who have this same perspective on research and are able to apply the transdisciplinary ‘creole'. Such features act as vehicles for reproducing and sustaining transdisciplinary careers beyond the life of the Center. In practical terms that might mean creating new criteria for appointments and promotions that are different than the usual ones, for example, an interdisciplinary metric that reveals how much a scholar has intellectually spanned and integrated ideas from multiple disciplines as a criterion used in addition to the traditional ones. The Centers members are exploring whether such a criterion can be included in Stanford University's tenure review process, and in that way prevent the penalization of young interdisciplinary scholars. Were this standard to be used for reviews and promotions in transdisciplinary and interdisciplinary centers, we may witness the emergence of a career path for a new breed of scholar.
The establishment of the Center is an effort to provide infrastructure that might foster ‘intellectual foci' and ‘network vehicles' that encourage the ‘meeting of minds' and the types of network integration and extensions inherent in transdisciplinary science. However, such infrastructure development will involve novel forms of institutional alignment that alter traditional administrative and academic processes rooted in disciplinary units. Institutional alignments resolve a variety of organizational challenges.
One challenge is the problem of imbalanced representation and how this can inhibit mixing and integration. Many projects attract participants from one or two departments, or they overwhelmingly serve the interests of one area of research over another. The Center counteracts this tendency by monitoring departmental representation at group meetings, and ensuring a broad range is present. In some cases, representation is a more sensitive issue and can create conflict. For example, the crediting of authorship in transdisciplinary teams can be a point of struggle. Laboratory convention is that the lead author carries the ball, and the mentor or lab head who secured funds is the last author. But what happens when multiple labs are involved equally? Does the principal investigator of one lab go last and the lead trainee of another lab goes first? And what constitutes equal contribution? Is data collection secondary to theory or method? The decision becomes more complex when one considers the convention of authorship changes in the social sciences where order is everything. Then there are concerns of rank and credit when it has greater impact by career stage from student to post doc to junior faculty to senior faculty. To cope with this, the Center has formed a committee to address such thorny issues as authorship standards. The committee is taking the first steps in the Center's development of interpersonal trust and collectively imagining what a transdisciplinary collaboration might look like.
Another institutional challenge for transdisciplinary research concerns the alignment of rules across multiple organizations and subunits. Because each unit can have different rules for managing funds, conducting promotion, and so on, rules can work at cross-purposes and inhibit collaboration. Moreover, these units can have divergent goals, and this can create goal ambiguity in the transdisciplinary center, making it hard to know the best direction in which to collectively proceed. The allocation of a transdisciplinary Center's resources can be especially challenging in this regard. If the Center is to be truly transformative, then the leadership needs the flexibility to move funds around to the most promising areas of inquiry. Universities are not generally set up to deal with such fluidity, resulting in conflict and the need to compromise across schools and departments that may have their own funding priorities as well as sources of funding. To add to the complexity, funding must be aligned with salaries and the appointment and promotion of faculty working at the interstices of the traditional disciplines need to be reinforced. This may require the creation of new rules and job titles, new expenditure categories and new legal definitions so as to forgo restrictions and bring all the transactions, constraints and rules into alignment across the university, supporting foundations and government agencies focused on preterm birth. Compromise is required in an environment which is traditionally very compliance and rule driven when it comes to funding and reporting. Another powerful solution would be the creation of an endowment to protect the key infrastructure for facilitation of such efforts, independent of the focus.
To cope with alignment and ambiguity, a core activity of the Center is to conduct an ongoing study of its progress and direction. The study of progress is more about organizational learning around the unique case than identifying minimal progress for reports to funding agencies. The process of self-assessment is a means of constantly performing internal institutional realignments so as to make sure the project stays on course. By making assessment a part of the Center's organization, it attempts to learn from its efforts and become a learning organization.25, 26
To assist in this, social scientists who specialize in the study of interdisciplinarity have been recruited to analyze and advise the Center and relevant disciplines in their efforts. This self-study entails observation and recording of meetings, yearly interviews with faculty and students and collection of curriculum vitae and writings (grants, publications and presentations). The social scientists analyze these materials using social network analysis (links), computational linguistics (text), as well as traditional forms of qualitative and quantitative analyses. The general goal of their analyses is to learn where intellectual, relational and institutional bridging occurs,27
and which programmatic efforts succeed or not in accomplishing those processes.
To address challenges and solve them, a distinctive organizational chart is needed, as are strong, committed leaders who meet often, corral the multiplicity of research efforts, work to garner resources, present the effort to various constituencies and buffer the research from bureaucratic problems. illustrates the organization of the Center that has been constructed to embody the principles of transdisciplinary research and generate a new kind of science. It is a network form of organization28
where the core leadership facilitates and mediates a variety of distributed efforts (for example, the areas and data groups) so as to keep them focused on the goal of knowledge integration and translation.
Cycles of discovery and application.
The Center's Core has an important role. Initially, the leadership committee directs its activities, but over time, control becomes distributed among a broader array of highly involved Center members. The core members are involved in almost every aspect of the Center. They distribute resources, set inquiry agendas, call and arrange Center meetings and subcommittees, form external partnerships, give visibility to area findings and seek external resources. The Core Members also guide data acquisition and are closely involved in the meetings to compile such information. The Core conducts a general meeting where all investigators and trainees interact and explore each other's disciplines, research paradigms and objectives. The Core also insures that translation and testing structures are poised to take advantage of discoveries, reducing the time to effective bedside intervention.
Over time, the Center builds internal and external networks and deepens the quality of ideas that interrelate their efforts. shows this expanded, integrated end state for the current groups, albeit other groups will likely emerge. As such, the Center grows more integrated and expands outward so as to form a distinctive (trans)discipline well beyond its initial location. It is not hierarchical in the sense that the groups have a great deal of autonomy, nor is it perfectly flat and loose like multidisciplinary and interdisciplinary projects.
The end product of a transdiscipline is a new thought community and integrated knowledge system that has a degree of independence. A medical transdiscipline is a system of ideas that are interrelated in a way that affords a more holistic understanding of a medical problem. This new, holistic knowledge affords a challenge and opportunity for translational science. The challenge is that holistic understandings may not cleanly fit current delivery apparatuses. Instead of offering a single drug as treatment, transdisciplines will offer multiple agents and suggest their use in a targeted and staged manner. Traditional means of translation will still apply, but it may be more beneficial to develop new forms of translation that take better advantage of transdisciplinary knowledge. To facilitate this, the Center has commenced a dialog on clinical practices that involve both bench and bedside researchers. Much of this discussion has focused on new tools for quickly implementing research findings as treatments at the bedside, or for creating faster cycles in evaluation/ medical trials. However, other discussions focus on how synoptical understandings of preterm birth can be used to derive better means of prevention, diagnosis and treatment.
Most likely, new forms of translation are needed to fully take advantage of transdisciplinary, synoptic forms of knowledge. Rather than using a single piece of knowledge or diagnostic test, practitioners may be armed with a set of diagnostic markers that form a risk profile: for example, income, race, diet and stress, in addition to the presence of certain bacteria, toxic metals, genetic markers and even placental developmental markers (as per sonogram) that may indicate an increased likelihood of preterm birth. This in turn may lead to a new program of bedside treatment. Rather than leaving patient care to a single clinical department, the patient may be treated more holistically by teams spanning departments (for example, a nutritionist and physical trainer, psychologist, as well as prescribing physicians in obstetrics and pediatrics). This likely will require changes in medical training of physicians so that they will know how to view health problems in a more holistic way.
The Center envisions that some of the most dramatic returns to health may stem from policy and social scientific solutions capable of altering lifestyles. In many regards, the integration of the inquiry areas prime factors into a multilevel model will likely identify where the Center and transdiscipline can have the greatest chances of reducing rates of preterm birth. This will likely entail social education and prevention measures targeted at pregnant mothers in certain communities and engaging in certain lifestyles. The point again is not that a particular solution has been found, but that the Center is rendering such discussion of integrated, preventive, holistic treatments a point of repeated focus and concern.
The current opportunity
Although focused disciplinary approaches will continue to be essential, they alone are not likely to provide comprehensive solutions to the problem of preterm birth or other complex medical problems. It is our hope that new discoveries will emerge more quickly by focusing transdisciplinary, translational science on the complex problem of preterm birth. True transdisciplinary approaches may be better suited than current focused methods to capturing the complex interactions inherent in preterm birth, including those rooted in inherited risk and the web of exposures that envelop childbearing in a diverse and highly dynamic society. Such research strategies will first need to respect the complex nature of health issues such as preterm birth, and to move beyond traditional narrow definitions of such phenomena, such as defining preterm birth solely based on gestational age at delivery. In addition, these efforts will require the collaborative engagement of diverse disciplines, including basic and social scientists, as well as clinicians and public health practitioners. The challenge lies in creating the new conceptual and investigative structures that will ensure that these collaborations prove sufficiently creative and powerful to address a public health problem that remains largely untouched by traditional research strategies. We cannot be sure that an attempt at a new research paradigm will work, but we recognize the need for such a new paradigm and its study.