Abstract
BackgroundTo identify facilitators and barriers that residents, medical and nursing students perceive in their Interprofessional Education (IPE) in a clinical setting with other healthcare students.MethodsA systematic review was carried out to identify the perceptions of medical students, residents and nursing students regarding IPE in a clinical setting. PubMed, CINAHL, ERIC and PsycInfo were searched, using keywords and MeSH terms from each database’s inception published prior to June 2014. Interprofessional education involving nursing and medical students and/or residents in IPE were selected by the first author. Two authors independently assessed studies for inclusion or exclusion and extracted the data.ResultsSixty-five eligible papers (27 quantitative, 16 qualitative and 22 mixed methods) were identified and synthesized using narrative synthesis. Perceptions and attitudes of residents and students could be categorized into ‘Readiness for IPE’, ‘Barriers to IPE’ and ‘Facilitators of IPE’. Within each category they work at three levels: individual, process/curricular and cultural/organizational. Readiness for IPE at individual level is higher in females, irrespective of prior healthcare experience. At process level readiness for IPE fluctuates during medical school, at cultural level collaboration is jeopardized when groups interact poorly. Examples of IPE-barriers are at individual level feeling intimidated by doctors, at process level lack of formal assessment and at cultural level exclusion of medical students from interaction by nurses. Examples of IPE-facilitators are at individual level affective crises and patient care crises situations that create feelings of urgency, at process level small group learning activities in an authentic context and at cultural level getting acquainted informally.These results are related to a model for learning and teaching, to illustrate the implications for the design of IPE.ConclusionsMost of the uncovered barriers are at the cultural level and most of the facilitators are at the process level. Factors at the individual level need more research.
Highlights
To identify facilitators and barriers that residents, medical and nursing students perceive in their Interprofessional Education (IPE) in a clinical setting with other healthcare students
The categories we distinguished in the data were Readiness for IPE, Facilitators of IPE and Barriers to IPE, which were at 3 levels – cultural/ organizational, process/curricular and individual
Readiness for IPE implies the degree of willingness for team-working and team-learning, the significance students give to acquiring their professional identity, the power of their professional culture and the view students hold of professional boundaries or overlap in roles and responsibilities [15]
Summary
To identify facilitators and barriers that residents, medical and nursing students perceive in their Interprofessional Education (IPE) in a clinical setting with other healthcare students. Interprofessional Education (IPE) has been defined as situations “where two or more professions learn with, from and about each other to improve collaboration and the quality of care“ [1]. IPE is considered important to prepare students for successful Interprofessional Collaboration, which is critical for patient safety and quality of care [2, 3]. Numerous IPE initiatives are launched every year all across the globe, but till there is no generalizable theory which can explain how, why or when learning through IPE is successful [4, 5]. The theory of social capital suggests that creating sociable relationships between students of different professions during IPE activities leads to trust in other professional groups during practice [6].
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