The role of collaborative learning in resilience in healthcare—a thematic qualitative meta-synthesis of resilience narratives

Abstract

Background To provide high quality services in increasingly complex, constantly changing circumstances, healthcare organizations worldwide need a high level of resilience, to adapt and respond to challenges and changes at all system levels. For healthcare organizations to strengthen their resilience, a significant level of continuous learning is required. Given the interdependence required amongst healthcare professionals and stakeholders when providing healthcare, this learning needs to be collaborative, as a prerequisite to operationalizing resilience in healthcare. As particular elements of collaborative working, and learning are likely to promote resilience, there is a need to explore the underlying collaborative learning mechanisms and how and why collaborations occur during adaptations and responses. The aim of this study is to describe collaborative learning processes in relation to resilient healthcare based on an investigation of narratives developed from studies representing diverse healthcare contexts and levels. Methods The method used to develop understanding of collaborative learning across diverse healthcare contexts and levels was to first conduct a narrative inquiry of a comprehensive dataset of published health services research studies. This resulted in 14 narratives (70 pages), synthesised from a total of 40 published articles and 6 PhD synopses. The narratives where then analysed using a thematic meta-synthesis approach. Results The results show that, across levels and contexts, healthcare professionals collaborate to respond and adapt to change, maintain processes and functions, and improve quality and safety. This collaboration comprises activities and interactions such as exchanging information, coordinating, negotiating, and aligning needs and developing buffers. The learning activities embedded in these collaborations are both activities of daily work, such as discussions, prioritizing and delegation of tasks, and intentional educational activities such as seminars or simulation activities. Conclusions Based on these findings, we propose that the enactment of resilience in healthcare is dependent on these collaborations and learning processes, across different levels and contexts. A systems perspective of resilience demands collaboration and learning within and across all system levels. Creating space for reflection and awareness through activities of everyday work, could support individual, team and organizational learning.

Backstage researching resilience researchers – dilemmas and principles for data collection in the resilience in healthcare research program

“…By being informed by the diverse perspectives on resilient healthcare from the different included projects and associated researchers, the RiH research program has resulted in new theoretical perspectives that have significantly expanded the understanding of resilience in healthcare (e.g. Haraldseid-Driftland et al. , 2022; Lyng et al.…”

“…By being informed by the diverse perspectives on resilient healthcare from the different included projects and associated researchers, the RiH research program has resulted in new theoretical perspectives that have significantly expanded the understanding of resilience in healthcare (e.g. Haraldseid-Driftland et al, 2022;Lyng et al, 2021Lyng et al, , 2022a. Future research should focus on how guidelines, reflection tools and literature in the resilience field need continuous improvement to handle potential methodological challenges to advance the field.…”

The patient representation struggle during the COVID‐19 pandemic: Missed opportunities for resilient healthcare systems

“…Recent literature increasingly recognizes the dynamic and mundane practical nature of resilience in healthcare and the roles that community groups play in resilient responses to crises 27 ; patient representatives most certainly have a role to play here, for instance in fostering reflexivity and learning. 13,18 The ability of patient representatives to play this role can also be seen in the case of the recognition and care for Long-COVID. By sharing stories on social media about long-term complaints after an infection they succeeded in the recognition for this condition.…”

“…17 Reflexivity and being open to learn from different perspectives and types of knowledge are considered crucial aspects for fostering the adaptive practices in healthcare needed to foster resilience. 13,18 In this paper we dive further into the potential contribution of patient representatives for healthcare system resilience.…”

Learning does not just happen: establishing learning principles for tools to translate resilience into practice, based on a participatory approach

“…This occurs when an organization adapts its enterprise by assimilating new knowledge, while simultaneously exploiting existing knowledge to change and improve their systems, routines, rules and procedures [ 27 ]. Given the complexity of healthcare, resilient performance depends on high levels of collaboration and interconnection across different system levels (individuals, teams and organizations), and between different stakeholders (including healthcare professionals, patents, and families) [ 28 – 30 ]. The learning element within the resilient healthcare literature therefore builds on the importance of collaborative learning - that is learning through work and learning together [ 31 , 32 ].…”