Professional relationships between doctors and nurses have often been seen as problematic, a barrier to effective collaborative practice, yet little is known about the intrinsic nature of such relationships in the primary care context. This study set out to explore roles of, and relationships between, nurses and doctors currently working in New Zealand primary care settings. Using a qualitative methodology, data were collected using in-depth interviews with 18 individual nurses and doctors working in primary care settings in Wellington, New Zealand. Doctors' and nurses' perceptions of their own and each others' roles, and the perceived relationships between individuals from both disciplinary groups were explored, using principles of naturalistic enquiry in a mixed method of analysis. The study findings indicate that effective interprofessional relationships between individual doctors and nurses can, and often do, exist in New Zealand primary care settings, although they are not universal. The identification and separation of vocational and business roles, and the development of professional identity, form the basis for a theory of trust development in nurse-doctor interprofessional relationships in New Zealand primary care. Professional identity is related to demonstration of professional competence, in turn related to development of mutual interprofessional respect and enduring interprofessional trust.
The way in which many of these students approach end-of-life care has been altered through a transformative educational experience that encouraged them to draw on their own experiences and skills. Their learning was facilitated by the writing of accounts and the discussion that each group held with teaching staff at the conclusion of the programme.
BackgroundCollaborative interprofessional practice is an important means of providing effective care to people with complex health problems. Interprofessional education (IPE) is assumed to enhance interprofessional practice despite challenges to demonstrate its efficacy. This study evaluated whether an IPE programme changed students’ attitudes to interprofessional teams and interprofessional learning, students’ self-reported effectiveness as a team member, and students’ perceived ability to manage long-term conditions.MethodsA prospective controlled trial evaluated an eleven-hour IPE programme focused on long-term conditions’ management. Pre-registration students from the disciplines of dietetics (n = 9), medicine (n = 36), physiotherapy (n = 12), and radiation therapy (n = 26) were allocated to either an intervention group (n = 41) who received the IPE program or a control group (n = 42) who continued with their usual discipline specific curriculum. Outcome measures were the Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning Scale (RIPLS), the Team Skills Scale (TSS), and the Long-Term Condition Management Scale (LTCMS). Analysis of covariance compared mean post-intervention scale scores adjusted for baseline scores.ResultsMean post-intervention attitude scores (all on a five-point scale) were significantly higher in the intervention group than the control group for all scales. The mean difference for the ATHCTS was 0.17 (95 %CI 0.05 to 0.30; p = 0.006), for the RIPLS was 0.30 (95 %CI 0.16 to 0.43; p < 0.001), for the TSS was 0.71 (95 %CI 0.49 to 0.92; p < 0.001), and for the LTCMS was 0.75 (95 %CI 0.56 to 0.94; p < 0.001). The mean effect of the intervention was similar for students from the two larger disciplinary sub-groups of medicine and radiation therapy.ConclusionsAn eleven-hour IPE programme resulted in improved attitudes towards interprofessional teams and interprofessional learning, as well as self-reported ability to function within an interprofessional team, and self-reported confidence, knowledge, and ability to manage people with long-term conditions. These findings indicate that a brief intervention such as this can have immediate positive effects and contribute to the development of health professionals who are ready to collaborate with others to improve patient outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0385-3) contains supplementary material, which is available to authorized users.
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