Interprofessional Workplace Learning Research Articles

Advancing interprofessional workplace learning: Successful implementation of the ‘WILD Series©’ hybrid professional development model

BackgroundThe 2021 NCICLE Pathways to Excellence framework highlights the need for professional development opportunities promoting interprofessional learning to optimize healthcare provider and learner teaming in the clinical learning environment. Despite this priority, research shows some clinicians are not developing their collaborative practice skills. PurposeThis article describes the hybrid Workplace Interprofessional Learning and Development (WILD) Series, which was developed to promote interprofessional preceptor development through workplace learning. MethodThe WILD Series© includes four unique six-week offerings, each dedicated to one Interprofessional Education Collaborative (IPEC) competency area. Each six-week session includes five weeks of one topical, actionable independent email engagement and concludes with a structured, facilitated synchronous debriefing session. DiscussionThe WILD Series© is the first IPE program designed for independently practicing clinicians and preceptors that includes synchronous and asynchronous components. Initial feedback was positive regarding the series format, content, and outcomes. ConclusionThe WILD Series© demonstrates that workplace learning can be an effective strategy for addressing gaps in interprofessional preceptor development.

Comparing intraprofessional and interprofessional workplace learning: Similar or not?

Comparing intraprofessional and interprofessional workplace learning: Similar or not?

Students’ interprofessional workplace learning in clinical placement

Students’ learning in the workplace during their clinical placements is an important part of their education to become healthcare professionals. Despite the number of studies of student interprofessional learning in clinical placements, little is still known about the significance of interprofessional learning and how it is facilitated and arranged for to occur. This article aims to investigate interprofessional learning between students collaborating in a workplace-driven arrangement integrated into a clinical placement. A focused ethnographic research approach was applied, comprising observations of ten students participating in the arrangement organised by clinical supervisors on a medical emergency ward at a Swedish university hospital, followed by group interviews. Using a boundary-crossing lens, the article analyses the workplace arrangement, in which students’ learning across professional boundaries and their negotiations around a boundary object were prerequisites to coordinate their interprofessional knowledge and manage emerging challenges while being in charge of care on the ward.

The wolf shall dwell with the lamb: The power dynamics of interprofessional education.

Stalmeijer and Varpio 1 advise us that educational perspectives and practices we nurture will thrive whilst those we ignore will wither. Their allegory of two wolves conceptualises medical education in two ways: a conventional, intraprofessionally-led way; and a less conventional, interprofessional way, where all interdisciplinary members of healthcare teams conjointly lead clinicians' education. They ask whether it would be 'of benefit to patient care to feed both these wolves?'.

Reflexivity and expansive learning theory in interprofessional workplace learning

ABSTRACT Our aim in this article was to combine the theories of reflexivity and expansive learning theory to elucidate how they may interact in interprofessional health student teams’ learning activities in the workplace. According to Margaret Archer reflexivity is “the regular exercise of the mental ability, shared by all normal people, to consider themselves in relation to their (social) context and vice versa.” It stems from the individual’s inner dialogue. In interprofessional student teams, the participants’ inner dialogs may interplay, forming team reflexivity. We have elucidated how individual reflexivity and team reflexivity are related in the workplace. Expansive learning theory focuses on the learning possibilities in the zone of proximal development. Working through contradictions, the team may develop the object, which may be something drastically new. We regard team reflexivity as a driving force for elucidating and differentiating complex contradictions, stimulating the development of the object. Our study may inspire educators to further develop the pedagogical design of their interprofessional courses. We describe how team reflexivity may be facilitated in the student team activity, among the health-care staff, and in the administrative collaboration between educational institutions and governmental health services.

Pedagogical aspects of interprofessional workplace learning: a case study

ABSTRACTIn this article we aim to elucidate some pedagogical aspects of interprofessional workplace learning, using the learning strategies of the Centre for Interprofessional Workplace Learning, Norway (TVEPS) as a case. We find the Expansive Learning Theory well suited for a creative interaction with the learning strategies at our interprofessional training centre. The Expansive Learning Theory focuses on learning over a substantial time horizon, but also opens for micro-cycles of learning over a shorter time of hours or days, which mirrors the learning system of TVEPS. As the social premises for learning are both situated and in change, human learning as a social process is diverse and in continuous change. Expansive Learning Theory focuses the interprofessional team learning at the workplace rather than on individual learning. Thereby such team learning is regarded as situated at the workplace premises physically, interpersonally, administratively and social-historically. The interprofessional student team’s learning process creates an object, a construct within the physical, ethical, social, administrative, or theoretical domain. In the TVEPS learning system, the object is the patient care plan which the student team produces, by working on resolving contradictions in the zone of proximal development. By debriefing the object (the care plan) with the staff, the object is developed further in creative interplay. New objects may be developed, as changed care or change in administrative systems at the workplace. By linking these concepts, Expansive Learning Theory can function as an analytical tool for understanding interprofessional learning activity at the workplace.

Design of a 15-month interprofessional workplace learning program to expand the added value of clinical pharmacists in primary care

Background and purposeClinical pharmacists who work in the general practice settings bring an improvement to patient care and outcomes. Postgraduate training for an independent clinical role does not often occur in the primary health care setting. When it does, the design of the curriculum is infrequently based on interprofessional workplace learning principles and it does not always integrate practical experience with classroom-based learning activities. This could lead to situations where clinical pharmacists are insufficiently trained to apply clinical reasoning skills and direct patient care in the general practice setting. Educational activity and settingA program was designed, including competencies and learning objectives, based on results from focus group interviews with stakeholders and the literature on interprofessional workplace learning. Ten participants were selected for a pilot run of the program and were asked several times for their opinion about the program. FindingsA 15-month training program was offered to pharmacists who became clinical pharmacists with the responsibility to perform patient consultations in general practice. The program was based on interprofessional workplace learning principles and facilitated the participants’ skill in connecting the evidence, the patients’ perspective and their own professional perspective. The 10 participating pharmacists were satisfied with the program. Discussion and summaryThe training program provided increased opportunities to clinical pharmacists to add value in general practice. The training program enabled pharmacists to advance their skills in direct patient care and to improve the alignment between different professionals in the primary care domain.

Understanding students’ and clinicians’ experiences of informal interprofessional workplace learning: an Australian qualitative study

ObjectivesWhile postgraduate studies have begun to shed light on informal interprofessional workplace learning, studies with preregistration learners have typically focused on formal and structured work-based learning. The current study investigated...

Interprofessional case conference: impact on learner outcomes.

Transition to interprofessional team-based care is a quickly progressing healthcare model and requires changes in medical training approaches. The Department of Veteran Affairs (VA) has taken a lead role in creating such training experiences, one of which is the establishment of multiple Centers of Excellence in Primary Care Education (CoEPCE). These sites are tasked with developing teaching innovations to better facilitate interprofessional team-based care. The patient-aligned care team interprofessional care update (PACT-ICU) is an interprofessional workplace learning activity with the goals of simultaneously addressing educational and patient care needs. Participants of the PACT-ICU included trainees and faculty of a variety of medical disciplines (e.g., internal medicine, psychology, and pharmacy) involved in a training primary care clinic. Two medically complex patients were presented at each PACT-ICU conference with the purpose of creating a plan of care that maintained an interprofessional team-based approach. Following implementation of the PACT-ICU conference intervention, two primary outcomes were assessed. First, self-assessment of PACT-ICU attendee learner outcomes was measured using a brief questionnaire surveying knowledge gain as it related to increase in knowledge of other professions' capabilities, roles, and responsibilities. Secondly, trainee provider behavior change was evaluated by measuring number of "within PACT" consults before and after participating in PACT-ICU. There was a significant positive change in self-assessed knowledge along with an indication of trainee behavioral change, as measured by electronic medical record consult patterns. This study demonstrates that interprofessional case conferences involving trainees and staff from multiple professions can increase awareness of other professions roles in patient care as well as facilitate interprofessional collaboration.

Interprofessional Relationships for Work-Integrated Learning in Healthcare: Identifying Scope for Ongoing Professional Development

Interprofessional collaboration is an important aspect of delivering healthcare. However, helping students learn to work with other health professions continues to pose challenges. Students’ interprofessional relationships are an important aspect of learning to work with other professions. The complexity of educators’ interprofessional relationships is less easily recognised. Existing relationships between educators were the intentional foundation underpinning the development and implementation of a recent interprofessional workplace learning initiative over 18 months involving undergraduate students from speech pathology (n = 12) and nutrition and dietetics (n = 18) programs. As part of a larger collaborative inquiry, educators involved in the initiative explored the nature of interprofessional relationships involved in developing, delivering and participating in the initiative. The aim was to develop a deeper understanding of such interprofessional relationships in order to provide guidance for ongoing development of students’ and educators’ collaborative practice. Transcripts of five focus groups undertaken with students (n = 5), academic educators (n = 4) and clinical educators (n = 4) were compiled into a text set and interpreted using tools of philosophical hermeneutics. Findings of this study were iteratively dialogued with earlier findings of the collaborative dialogical inquiry to ensure “fusion of horizons” between studies. The three interpreted themes transcended professional affiliations: facilitating interprofessional mutuality, appreciating the multifaceted nature of “respect” and considering the visibility of interprofessional relationships. The themes highlighted the importance of educators’ ongoing development and understanding of interprofessional relationships as they help students learn to work with other professions. Based on a practice-based education framework, we pose reflective questions for educators to inform their ongoing development. We conclude that it is important for all those involved in healthcare education to embrace the responsibility of developing interprofessional relationships in an ongoing manner and not view the development of interprofessional relationships solely as the domain of students.

Securing intersubjectivity through interprofessional workplace learning experiences

Effective interprofessional work is premised on high levels of shared understandings (i.e. intersubjectivity) among those who are co-working. In particular, when quick or seemingly spontaneous responses are required for urgent or immediate action, what is termed as “shared intuition” is highly desirable. Much of the required intersubjectivity can arise ordinarily through everyday healthcare collaborations, such as through joint problem-solving. Yet, a concern is how best to develop these capacities in circumstances when co-working is temporary, fleeting and partial, and also when the goals to be achieved are ambiguous and uncertain, and the processes indeterminate. To achieve the kinds and levels of intersubjectivity required for these non-routine forms of care and intermittent interprofessional working, therefore, likely requires particular curriculum and pedagogic interventions within practice settings. These interventions may be used to shape the organisation and sequencing of experiences for interprofessional work through which can arise a foundation of shared understanding of concepts, procedures and values. Yet, to assist the articulation, sharing, appraising and elaborating shared disciplinary and personal-professional positions, values and procedures, specific pedagogic interventions may also be required, albeit their exercise being embedded in co-working practices in healthcare work activities.

Interprofessional workplace learning: a catalyst for strategic change?

The integrated care development programme (ICDP) was a continuing interprofessional educational programme for health and social care managers and commissioners. Multi-professional strategic teams from a single locality participated in university and workplace-based learning activities centred on the development of an integrated business plan to address a local priority for improvement. The evaluation used participant self-assessment, semi-structured interviews and group discussions to assess achievement of expected impacts on the participants, their organisations and partnerships, and patient/service user outcomes. The findings indicate that whilst those employed in management and commissioning roles had considerable experience of working across professional and agency boundaries they derived individual benefits from a workplace IPE programme. The principles of design and delivery developed in pre-registration and clinician/practitioner IPE courses also applied to those working at a more strategic level. Organisational impacts were reported, but 6 months post-programme evidence was not yet available of significant improvements in patient outcomes and /or financial efficiencies. Individual motivation, team dynamics and support from line managers all affected the extent to which individual and organisational impacts were achieved.

Patients' nursing records revealing opportunities for interprofessional workplace learning in primary care: a chart review study.

Working and learning go hand in hand during interprofessional collaborative practice. Patients' nursing records are designed to record patient care and health status. It is not known whether these records are also used to keep track of interprofessional contacts or interprofessional learning between team members. This study explored the usefulness of patients' nursing records in optimising interprofessional workplace learning for general practitioners. We utilized a descriptive retrospective chart review. All palliative home care teams of the Dutch speaking part of Belgium were involved. Throughout the year 2010, a representative sample of patient charts was selected. Characteristics of encounters between general practitioners and palliative care nurses were extracted from the charts. Detailed accounts of interprofessional contacts were found in the charts. Palliative care nurses recorded number and type of contacts, topics discussed during contacts and general practitioner's learning activities. Palliative care nurses are sensitive and open towards the general practitioners' learning needs. Patients' nursing records provide useful information for interprofessional team discussions on workplace learning. Healthcare professionals should be trained to respond to each other's learning needs.

Responding to health care complexity: suggestions for integrated and interprofessional workplace learning

This report highlights complexity in health care and the relevance of integrated and interprofessional care and learning. It is proposed that appropriate workforce training in response to complexity should be contextually relevant and workplace integrated, and should focus on building interprofessional capability for reflective practice and critical thinking. This training should be interprofessional and foster systems thinking. It is suggested that the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) is a useful integrating framework.