Boundary-crossings among health students in interprofessional geropsychiatric outpatient practice: Collaboration with elderly people living at home

Abstract

This qualitative research explores interprofessional learning among health students within a mental health outpatient setting. The focus is on how they manage to establish a boundary-crossing community of practice. Six final year students from medicine, occupational, and physical therapy, divided into two groups, visited elderly clients living at home on two occasions. Based on an assessment of the client, they had to consider suitable health and social initiatives to enhance quality of life, health outcomes, and wellbeing. The students then had to produce a jointly written health record documenting their professional and interprofessional evaluations. Two facilitators participated in the home visits and documented them through field notes. Focus group interviews conducted before and after the home visits and at the final seminar, together with health record documents, were audio-taped, coded, and thematically analyzed. Iterative reflexive analysis combined the findings with relevant research and theory from social and experiential learning. The findings show how boundary-crossing strengthened client-centeredness and students' knowledgeability, and how the intervention became more beneficial and qualitative. New insights were obtained from reflecting on and discussing professional stereotypes, identity, and roles. Writing the health record together enabled the students to reach a common ground.

Students’ interprofessional workplace learning in clinical placement

“…Patient-focused interprofessional workplace activities combined with facilitated dialogues and reflections have previously been associated with increased awareness of other professions' competencies (Kent et al, 2017), understanding of professional work in practice (Baerheim & Raaheim, 2020) and seeing the value in working in interprofessional teams (Lingard et al, 2017;Reeves, Xyrichis & Zwarenstein, 2018). In the group interviews, the students' reflections on their professional differences and complementary knowledge of the patient's need for care provided expanded perspectives on what and how their own and others' professional knowledge contributed to the patient's care (Jentoft, 2020). The notions of habilitation and rehabilitation was used to verbalise and express both similarities and differences in occupational and physiotherapy practices, and while acknowledging profession-specific knowledge they also opened up the boundaries between the professions (Christiansen, Taasen, Hagstrøm, Hansen & Norenberg, 2017).…”

“…Students' learning at professional boundaries and bridging boundaries to other professions can be confusing and blurred. Conflict-filled professional boundaries arise out of the differences in knowledge of medicine and caring, as well as inequalities in professional roles and attitudes (Jentoft, 2020). There is often a strong desire to defend the interests of the particular professional group (Hall, 2005;Santy, 1999) and a lack of understanding of other professional roles (Fox & Reeves, 2015).…”

Boundary Objects as Dialogical Learning Accelerators for Social Change in Design for Health: Systematic Review

“…Jentoft [ 89 ] described in her research boundary-crossing activities among physical therapy and medical students in interprofessional geropsychiatric outpatient practice. In the study, the students visited older clients living at home on 2 occasions.…”

Boundary Objects as Dialogical Learning Accelerators for Social Change in Design for Health: Systematic Review (Preprint)

“…Operational Clinical vocabulary as a boundary object in multidisciplinary care management of multiple chemical sensitivity, a complex and chronic condition Sampalli et al, 2011 [86] • Coordination Operational Boundary objects in the multidisciplinary care management of chronic conditions: multiple chemical sensitivity Sampalli et al, 2009 [87] • Coordination Postimplementation analysis Boundary objects, social meanings and the success of new technologies Fox, 2011 [88] • Transformation Project Boundary-crossings among health students in interprofessional geropsychiatric outpatient practice: collaboration with elderly people living at home Jentoft, 2020 [89 a IT: information technology.…”