Abstract:To embed interprofessional education in practice-based professions' curricula and clinical placements requires active, supportive structures and local facilitation. Structures such as Placement Development Teams can help to achieve this where organisational cultures are influenced by committed staff. Students require persuasion concerning the benefits of interprofessional education.
“…A total of 41 studies were included in the final synthesis . Study characteristics are summarised in Tables .…”
Section: Resultsmentioning
confidence: 99%
“…This engagement would ensure widespread support provision for greater numbers of students across the professions and sector. (Placement development team members, varied placement sites)…”
Section: Resultsmentioning
confidence: 99%
“…This engagement would ensure widespread support provision for greater numbers of students across the professions and sector. (Placement development team members, varied placement sites) 67 In such a climate, IPP leadership is developed across organisational levels and becomes more securely integrated into placement culture.…”
Section: Support From Individual Managers Alone Was Not Robust Enoughmentioning
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.
“…A total of 41 studies were included in the final synthesis . Study characteristics are summarised in Tables .…”
Section: Resultsmentioning
confidence: 99%
“…This engagement would ensure widespread support provision for greater numbers of students across the professions and sector. (Placement development team members, varied placement sites)…”
Section: Resultsmentioning
confidence: 99%
“…This engagement would ensure widespread support provision for greater numbers of students across the professions and sector. (Placement development team members, varied placement sites) 67 In such a climate, IPP leadership is developed across organisational levels and becomes more securely integrated into placement culture.…”
Section: Support From Individual Managers Alone Was Not Robust Enoughmentioning
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.
“…The students’ reasoning on this point is supported by Nikendei et al [34] and Williamson et al . [35] who concluded that ward rounds training was urgently required. Nørgaard et al .…”
BackgroundLittle is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts.MethodsThe study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students).ResultsThe results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure.ConclusionsThis study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies.
“…Practice-based, rather than classroom-based, collaborative learning has been commended as an effective application of IPL. [2][3][4][5][6][7] However, it can be cumbersome to arrange and supervise. 8 In rural Australia with its relative workforce shortage, sustainable, practice-based IPL can be particularly challenging.…”
INTRODUCTIONInterprofessional learning (IPL) in health professional education is based on the notion that learning together will support more effective ways of working together. 1 IPL has the potential to improve interprofessional collaboration and the effectiveness and quality of patient care. Practice-based, rather than classroom-based, collaborative learning has been commended as an effective application of IPL. [2][3][4][5][6][7] However, it can be cumbersome to arrange and supervise. 8 In rural Australia with its relative workforce shortage, sustainable, practice-based IPL can be particularly challenging.
9In this paper, we describe a model of IPL -the Health 'Hubs and Spokes' (HHS) Project -which was based in rural towns and organised around locally-relevant priorities. HHS involved small teams of students from different disciplines, working together on a project identified by the host organisation. It was designed to be a sustainable model of interprofessional education using service learning -a type of practice-based learning where students engage with a community partner to collaborate, reflect and develop outcomes of real world benefit. 10 Although service learning is relatively new to Australian higher education settings, it is increasingly being adopted and is particularly well suited to students in the health professions.
11-12In theory service learning can lead to mutual benefits and outcomes for community organisations, universities and students, as a result of engaged scholarship and partnerships focused on clearlyarticulated local needs and service gaps. 13 A risk of university-community partnerships is that university needs may be prioritised over those of the community. 14 To avoid this, HHS focused on aspects of social capital that are particularly relevant for rural communities: the Project worked within networks of trusted agents in the community (community-based facilitators, and clinical supervisors) 15 and through its projects attempted to support the service-capacity of essential health institutions in the community. 16 Thus social capital was both an integral factor in the working of HHS and in the outcome of the individual team projects. Students' reactions, change in perceptions, and the impact of HHS on their behaviour have been described elsewhere. 17,18 In this paper, we describe the outcomes of the HHS at the level of the rural health service or community, and discuss potential programmatic tensions between focusing on service level outcomes, and outcomes that relate to individual attitudinal and behavioural characteristics.
METHODSThe Health 'Hubs and Spokes' Project is described in Box 1.Study type. This was a qualitative study using semi-structured interviews with 43 local facilitators, academic staff and health professionals (ascertainment, 80% of those involved in delivering the project), and 14 representatives of local health or community services (Table 1).Setting. Six rural towns in South East NSW, the location for 37 IPL teams of 89 students (82% of the 108 students who ...
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