Government calls for enhanced collaboration amongst practitioners frequently leads to IPE that is then developed and delivered by educators, practitioners or service managers. Staff development is a key influence on the effectiveness of IPE for learners who all have unique values about themselves and others. Authenticity and customization of IPE are important mechanisms for positive outcomes of IPE. Interprofessional education is generally well received, enabling knowledge and skills necessary for collaborative working to be learnt; it is less able to positively influence attitudes and perceptions towards others in the service delivery team. In the context of quality improvement initiatives interprofessional education is frequently used as a mechanism to enhance the development of practice and improvement of services.
Over the past decade systematic reviews of interprofessional education (IPE) have provided a more informed understanding of the effects of this type of education. This paper contributes to this literature by reporting an update of a Cochrane systematic review published in this journal ten years ago (Zwarenstein et al., 1999 ). In updating this initial review, our current work involved searches of a number of electronic databases from 1999-2006, as well as reference lists, books, conference proceedings and websites. Like the previous review, only studies which employed randomized controlled trials, controlled-before and-after-studies and interrupted time series studies of IPE, and that reported validated professional practice and health care outcomes, were included. While the first review found no studies which met its inclusion criteria, the updated review located six IPE studies. This paper aims to add to the ongoing development of evidence for IPE. Despite some useful progress being made in relation to strengthening the evidence base for IPE, the paper concludes by stressing that further rigorous mixed method studies of IPE are needed to provide a greater clarity of IPE and its effects on professional practice and patient/client care.
This paper outlines the essential aspects of conducting a systematic review of an educational topic beginning with the work needed once an initial idea for a review topic has been suggested through to the stage when all data from the selected primary studies has been coded. It draws extensively on the wisdom and experience of those who have undertaken systematic reviews of professional education, including Best Evidence Medical Education systematic reviews. Material from completed reviews is used to illustrate the practical application of the review processes discussed. The paper provides practical help to new review groups and contributes to the debate about ways of obtaining evidence (and what sort of evidence) to inform policy and practice in education.
Despite the growing literature that collaboration is a 'good' thing, there are calls emphasising the need for evidence of its effectiveness. However, the nature of the evidence to assess effectiveness is less clear. This paper examines the components that contribute to the challenges that confront evidence on collaboration. It considers the differing interpretations that have been placed on evaluation and explores how ways of determining the outcomes of collaboration and the levels of outcome measurement to assess collaborative effectiveness are influenced by the multifactorial nature of the concept. Evidence on the impact of collaboration is influenced by the diversity of perspectives and conceptual facets, and difficulty in measurement of the notions involved. Other factors discussed are the choice of macro or micro evaluation, of proximal or distal indicators, of short and long-term effects, or of individual-level or collective community-level outcomes. The suitability of randomised controlled trials for the measurement of collaborative outcomes as well as the requirement of mixed methods evaluations are highlighted. An evaluation of five community partnerships in South Africa is employed as an example to link the evaluation concepts that are discussed to a real enquiry. If collaboration is to be successful in making a difference in the lives of people, then increasing the precision and context of appraising its effectiveness will reduce the nature of inconclusive evidence and is likely to improve the practice of partnerships, coalitions and joint working in health and social care.
Learning between professions has been widely invoked in health and social care in the belief that it improves collaboration in practice. Evidence to substantiate that belief is, however, elusive. Obstacles to the rigorous evaluation of interprofessional education are formidable, but this article reports progress towards establishing an evidence base. It describes two reviews. One is subject to criteria for Cochrane Collaboration, the other less constrained. Findings are reported for the first and methodology is discussed for the second. The article begins with an overview of interprofessional education in health and social care.
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