‘Bumping along’: a qualitative metasynthesis of challenges to interprofessional placements

Abstract

Context Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. Objectives This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. Methods A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage‐process‐product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). Results We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. Conclusions In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice‐ready workforce. This in turn will enhance service user outcomes and safety.

Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature

“…The full search strategy is available in an additional word file [see Additional file 1]. In addition, we included articles found in the reference lists of previous reviews on IPE, discovered as a result of the search for IPE interventions [4,6,9,[14][15][16][17][18][19][20][21][22].…”

Developing new possibilities for interprofessional learning- students’ experience of learning together in the ambulance service

“…The students are active participants, and they learn with and from each other in authentic activities [ 5 ]. The groups often consist of nursing and medicine students overlapping with physiotherapy and occupational therapy students [ 2 , 6 , 7 ]. IPE can consist of a wide range of activities depending on the aims, educational setting, and availability of participants.…”

“…Researchers have systematically mapped IPE [ 2 , 6 – 8 ], and have shown that setting and context matters [ 8 ] and contextual factors influence IPE [ 9 ]. Therefore, in each activity developed and implemented in different contexts the students’ experiences should be considered.…”

‘It benefits patient care’: the value of practice-based IPE in healthcare curriculums

“…Geographical [ 21 ] and specific healthcare needs and resources [ 22 ] likely influenced the approach taken in these regions. Globally, long-term funding for practice-based IPE is an on-going challenge [ 23 ] and many practice-based IPE projects do not extend beyond pilot or short-term initiatives [ 24 ]. This has stimulated growing interest in relatively low resource activities such as case-based tutorials [ 25 – 27 ].…”