Gillian Nisbet

Interprofessional education: what's the point and where we're at…

I n its broadest sense, medical and indeed all health education is still essentially conducted in silos, although there is now a growing recognition that medical education needs to be contextualised within the needs of the health workplace and co-ordinated across the education/training/practice continuum ... the growing provision of health care by teams rather than individuals, particularly for the aged and chronically ill, has presented the as yet largely unrealised challenge of interprofessional education and learning. Interprofessional education

Informal interprofessional learning: an untapped opportunity for learning and change within the workplace.

Abstract In this paper, we explore the educational and workplace learning literature to identify the potential and significance for informal interprofessional learning within the workplace. We also examine theoretical perspectives informing informal workplace interprofessional learning. Despite numerous studies focusing on formal interprofessional education programs, we suggest that informal interprofessional learning opportunities are currently unrealized. We highlight reasons for a focus on learning within the workplace and the potential benefits within an interprofessional context.

Marginalisation of dental students in a shared medical and dental education programme

Objectives  Internationally, there are a number of universities at which medical and dental education programmes share common elements. There are no studies about the experiences of medical and dental students enrolled in different programmes who share significant amounts of learning and teaching.

Interprofessional Education in Australasia

In April 2006 at the ‘‘All Together Better Health 3’’ conference in London a small group of health professionals from Australia and New Zealand took the opportunity to meet face-toface and share their experiences of IPL (interprofessional learning). The irony was that these people were meeting half the world away from their institutions. They had heard each other’s names before but few had talked face-to-face. It took an international meeting to launch the idea of AIPPEN – the Australasian Interprofessional Practice and Education Network. Since my own move to Australia almost four years ago I have been stimulated by the increasing interest in IPE ‘‘down under’’. In 2005 in an editorial for this journal I wondered where the teamwork approach to health care was hidden in my new home (Thistlethwaite, 2005). Similarly I had trouble finding IPE initiatives within local universities. I realize now that there were in fact many projects going on, particularly in rural and remote areas, but that there was a lack of promotion of these. RIPEN (the Rural Interprofessional Education Network) was and is going strong but there was less focus on initiatives in other areas – hence the decision to form AIPPEN. AIPPEN is a network of individuals, groups, institutions and organizations committed to researching, delivering, promoting and supporting IPE and IPP (interprofessional practice). Its primary objective is to promote better health care outcomes and enhance IPE and IPP in Australia and New Zealand by developing a network to promote communication and collaboration among members. We also aim to influence workforce policy and practice change and disseminate information on IPL throughout the region (Nisbet et al., 2007). The steering group members are involved in a range of activities and meet regularly by teleconference. In line with international trends, IPL activity within Australia and New Zealand is rapidly expanding. Results of a 2005 survey of Australian universities (Thistlethwaite and Nisbet, unpublished) indicated that 19 of the 38 Australian universities offered campus-based IPL opportunities, particularly in undergraduate programs run by Faculties of Health, rural clinical schools and Departments of Nursing. These, however, tended to focus on content rather than specific IPL objectives, e.g., Indigenous studies; research methodologies. There was minimal indication that IPL was an embedded component of curricula. However, close to 60% of respondents indicated they aimed to increase the amount of IPE offered in the future, with 40% suggesting no change. Although two thirds of the courses had been evaluated, only three evaluations had been published, highlighting the need for more formal evaluation of programs and dissemination of findings. There is also a dearth of sociological and critical papers or monographs about IPE and IPP. To meet this need for scholarship the production of a critical text in the field is high on the agenda of the Monash University Department of Rural and Indigenous Health. Journal of Interprofessional Care, August 2007; 21(4): 369 – 372

Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders

OBJECTIVE A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. METHODS Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. RESULTS Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. CONCLUSIONS The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

Interprofessional team meetings: Opportunities for informal interprofessional learning

Abstract This study explores the potential for workplace interprofessional learning, specifically the learning that occurs between health professionals as part of their attendance at their regular interprofessional team meetings. While most interprofessional learning research to date has focused on formal structured education programs, this study adds to our understanding of the complexities of the learning processes occurring between health professionals as part of everyday practice. Through observations of team meetings and semi-structured interviews, we found that the interprofessional team meeting provided a practical, time-efficient, and relevant means for interprofessional learning, resulting in perceived benefits to individuals, teams, and patients. The learning process, however, was influenced by members’ conceptions of learning, participation within the meeting, and medical presence. This study provides a basis for further research to assist health professionals capitalize on informal learning opportunities within the interprofessional meeting.

Interprofessional developments in Australia - L-TIPP (Aus) and the Way Forward

In 2007 a partnership of academics, educators and health professionals from the University of Sydney and the University of Technology Sydney (UTS) was awarded an Australian Learning and Teaching Council grant to undertake a scoping and development study to establish a national research and development agenda for interprofessional education (IPE) within higher education with the aim of enhancing collaborative health care delivery. The project was titled ‘Learning and Teaching for Interprofessional Practice in Australia (L-TIPP, Aus)’. The project had two major foci: an international/national literature review and qualitative interviews with stakeholders across education and health to explore perspectives on IPE and its integration into health professional training. We wished to involve stakeholders, in particular Australian higher education institutions, in a debate about the future development and delivery of health care, and how health and social/community care professionals are educated. A goal was to agree on how IPE may be taken forward as a central and enabling element of contemporary health and education reform. This project was timely as the new Labor government, elected in late 2007, promised significant health and social/community care reform, through health and social care professionals with well-developed interprofessional practice capabilities. In October 2008, the federal Department of Health and Ageing (DOHA) published Towards a National Primary Health Care Strategy, which contained references to ‘‘multidisciplinary teams’’ and ‘‘interdisciplinary learning’’ (Australian Government – DOHA, 2008). One recommendation was that ‘‘the current and future primary health care workforce is provided with high quality education (undergraduate, postgraduate and vocational) and clinical training opportunities that support interdisciplinary learning’’ (p. 40) and moreover that ‘‘. . .concerns have been raised regarding whether standards for training and education are keeping pace with . . . the importance of interdisciplinary learning opportunities given the growing importance of team work in the community setting’’ (p. 41). Later that year the Bennett report (National Health and Hospitals Reform Commission, 2008) into health service reform included a proposal that aimed ‘‘to make more efficient use of the health workforce through a new education framework to facilitate the development of high functioning, multidisciplinary teams’’ (p. 25). At a state level, these important documents are echoed (or reinforced) by the Garling Report (2008) into acute care services in NSW (New South Wales) public hospitals. This report announced guiding principles to be adopted, including interdisciplinary team-based care. Recommendation 37 stated that ‘‘clinical education and training should be undertaken in a multi-disciplinary environment which emphasises inter disciplinary team based patient centred care’’ and that ‘‘the education and training be delivered by the most appropriate and suitable person regardless of the profession or specialty of the individual, and including, where appropriate, non-clinically trained personnel’’ (Garling, 2008). Journal of Interprofessional Care, July 2009; 23(4): 315–317

Development and initial validation of the interprofessional team learning profiling questionnaire

ABSTRACT Informal workplace interprofessional learning occurs as health professionals interact with each other as part of everyday work practice. Participation in interprofessional team meetings is a practical way to foster learning. However, a gap exists in the availability of a reliable and valid instrument that adequately captures the nuances of informal workplace interprofessional learning in this setting. The purpose of this study was to develop a questionnaire to measure the different components of interprofessional learning that contribute to the quality of interprofessional learning within the interprofessional team meeting. Questionnaire items were developed from a review of the literature and interviews with health professionals. Exploratory factor analysis was used to determine the underlying factor structure. Two hundred and eighty-five health professionals completed a 98-item questionnaire. After elimination of unreliable items, the remaining items (n = 41) loaded onto four factors named personal and professional capacity; turning words into action—“walk the talk”; the rhetoric of interprofessional learning—“talk the talk”; and inclusiveness. Internal consistency was high for all sub-scales (Cronbach’s alpha 0.91, 0.87, 0.83, and 0.83, respectively). Content, construct, and concurrent validity were assessed. The instrument developed in this study indicated consistency and robust psychometric properties. Future studies that further test the psychometric properties of the questionnaire will help to establish the usefulness of this measure in establishing evidence for the perceived effectiveness of interprofessional learning in a healthcare setting.

Scrutinising Our Assumptions of the Other Professions

The reader might wonder which profession these quotes refer to. In fact it could be any number of professions. These are just some of many assumptions heard within healthcare. We make assumptions about our own profession in relation to others: where we sit in the pecking order; our relationship with patients; whether or not we are respected by others.

Content validation of an interprofessional learning video peer assessment tool

BackgroundLarge scale models of interprofessional learning (IPL) where outcomes are assessed are rare within health professional curricula. To date, there is sparse research describing robust assessment strategies to support such activities. We describe the development of an IPL assessment task based on peer rating of a student generated video evidencing collaborative interprofessional practice. We provide content validation evidence of an assessment rubric in the context of large scale IPL.MethodsTwo established approaches to scale development in an educational setting were combined. A literature review was undertaken to develop a conceptual model of the relevant domains and issues pertaining to assessment of student generated videos within IPL. Starting with a prototype rubric developed from the literature, a series of staff and student workshops were undertaken to integrate expert opinion and user perspectives. Participants assessed five-minute videos produced in a prior pilot IPL activity. Outcomes from each workshop informed the next version of the rubric until agreement was reached on anchoring statements and criteria. At this point the rubric was declared fit to be used in the upcoming mandatory large scale IPL activity.ResultsThe assessment rubric consisted of four domains: patient issues, interprofessional negotiation; interprofessional management plan in action; and effective use of video medium to engage audience. The first three domains reflected topic content relevant to the underlying construct of interprofessional collaborative practice. The fourth domain was consistent with the broader video assessment literature calling for greater emphasis on creativity in education.ConclusionsWe have provided evidence for the content validity of a video-based peer assessment task portraying interprofessional collaborative practice in the context of large-scale IPL activities for healthcare professional students. Further research is needed to establish the reliability of such a scale.