Effective Interprofessional Education: Argument, Assumption and Evidence

204 Pages·2005·1.3 MB·English

by  Hugh Barr

Barr/EffectiveInterprofessionalEducation:Argument,AssumptionandEvidence FinalProof 28.5.2005 2:27am pagei
promoting partnership
for health
Effective Interprofessional
Education
Argument, Assumption and Evidence
Hugh Barr
Ivan Koppel
Scott Reeves
Marilyn Hammick
Della Freeth
Series editor: Hugh Barr
Barr/EffectiveInterprofessionalEducation:Argument,AssumptionandEvidence FinalProof 28.5.2005 2:27am pageii
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Effectiveinterprofessionaleducation:argument,assumption,andevidence/byHughBarr ... [etal.].
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ISBN-13:978-1-4051-1654-1(hardback:alk.paper)
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1. Medicaleducation.2. Socialworkeducation.3. Interprofessionalrelations.4. Interdisciplinary
approachineducation.
I. Barr,Hugh.II. Series.
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3. InterdisciplinaryCommunication.4. InterprofessionalRelations.W18E2682005]
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Barr/EffectiveInterprofessionalEducation:Argument,AssumptionandEvidence FinalProof 30.5.2005 11:40am pageiii
Contents
Contributors vi
The Series viii
Foreword byDr Gerard Majoor x
Foreword byProfessor MadelineSchmitt xi
Preface xv
Acknowledgements xx
Glossary xxi
Chapterone Rising to theChallenge 1
Chaptertwo Learning to Work underPressure 10
Chapterthree Capturing Interprofessional Education in Essence 29
Chapterfour Reviewing the Evidence Base 40
Chapterfive DistinguishingbetweenSixDomains 58
Chaptersix RelatingOutcomesto Foci 74
Chapterseven Approaching Learningand Teaching 95
Chaptereight Reconciling Values 105
Chapternine Thinking Theory 120
Chapterten Drawing theThreads Together 139
List of Boxes
2.1 Community coalitionsto improve care for olderpeople 12
2.2 Learning to respond together to theneeds of chronically
disabled people 13
2.3 Supporting staff and patients in hospice care 14
2.4 Facingup to child abuse 16
2.5 Learning how to protect children 17
2.6 Learning to work together with the whole family 19
2.7 Joint action onpoverty 21
2.8 Learning to work with rural poverty 22
2.9 Recruiting professionals ina deprived ruralcommunity 25
3.1 Canada asa case study 30
4.1 Arandomised controlled trial 53
4.2 An actionresearch study 53
4.3 Astudy focusingon the patient’s perspective 55
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iv Contents
5.1 Saturday school 62
5.2 A graduate entry programme for medical and nursing students 63
5.3 Beginning together 64
5.4 Embedding uniprofessional and interprofessional
in multiprofessionalcurricula 64
5.5 Joint observation 65
5.6 A process map for interprofessional learning 65
5.7 Lunch breaks together during placements 66
5.8 Acuteclinical placementin Sweden 67
5.9 An award bearing community mentalhealth course 68
5.10 Systemicinterprofessional education 69
5.11 A college coursefor staff workingin spinal cord injury units 70
5.12 A collaborative assignment 70
5.13 Action learning with doctorsand counsellors 71
5.14 Quality improvement in a children’s hospital 72
5.15 Interprofessional education for sexualhealth practitioners 73
6.1 A study reporting level2aand 2b outcomes 75
6.2 A study reporting level1outcomes 76
6.3 A study reporting level3outcomes 78
6.4 A study reporting level4aoutcomes 79
6.5 A study reporting level4b outcomes 80
6.6 Breaking bad news 81
6.7 Exposing perceptions and prejudices 82
6.8 Developing collaborative competencies for nursing
and medical students 85
6.9 Managing challenging behaviour –an inter-agency approach 88
6.10 Coping with the logistics 90
6.11 Interprofessional education and clinical governance 91
6.12 Supervising the child protection process 92
7.1 Narrative-basedlearning 98
7.2 Problem-based learning 99
7.3 Observation-based learning 101
7.4 Video conferencing 101
7.5 Computer-mediated interdisciplinary teams 102
8.1 Involving students in course planning and review 110
8.2 Involving seven professions in formulating ethical curricula 112
8.3 Identifying coretopics in health care ethics 113
8.4 Ethical consequencesof advancesin genetics 113
8.5 Religious and spiritual issues in health care 114
9.1 Understanding underlying feelings 126
9.2 Coping with anxiety, loss and change 127
9.3 Establishing a learning team 131
9.4 TQM inthreehospital departments 134
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Contents v
List of Figures
2.1 Achain reaction 27
3.1 Three foci of interprofessionaleducation 34
5.1 Extra-curricula model 61
5.2 Crossbarmodel 62
5.3 Cross-curriculamodel 69
6.1 Interlinking relationship of the three foci of interprofessionaleducation 94
9.1 Relating theories to foci 137
List of Tables
4.1 The JET classification of interprofessional education outcomes 43
4.2 Details ofsearches, abstractsand papers obtained 44
4.3 Distribution of countries 48
4.4 Publication year 49
4.5 Duration of interprofessional education initiatives 49
4.6 Qualification for interprofessional education 50
4.7 Caresector 50
4.8 Clinical sector andcondition 50
4.9 Pre-and post-qualifying interprofessional education 51
4.10 Professional participation 51
4.11 Evaluation design 52
4.12 Data collection methods 54
4.13 Sourceof data 55
4.14 Identifying methodological limitations 56
4.15 Ethical considerations 56
5.1 Interprofessional education andlead institution 60
5.2 Stage of interprofessional education and lead institution 60
6.1 Reported outcomes 75
6.2 Coincidenceof reported outcomes 75
6.3 Focusof interprofessional education 80
6.4 Focusand outcomes ofinterprofessional education 92
7.1 Approachesto interprofessional learning and teaching 103
9.1 Underpinning theory 121
Appendices
1 SearchStrategies 146
2 Abstraction of Studies 148
3 Higher Quality Studies 151
References 157
Index 175
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Contributors
Hugh Barr is Emeritus Professor of Interprofessional Education in the School of
Integrated Health at the University of Westminster, Visiting Professor in Inter-
professionalEducationintheSchoolofHealthandSocialCareattheUniversityof
Greenwich,PresidentoftheUKCentrefortheAdvancementofInterprofessional
Education(CAIPE)andEditor-in-ChiefoftheJournalofInterprofessionalEducation.
HewasformerlyanAssistantDirectorofthethenCentralCouncil forEducation
and Training in Social Work.
IvanKoppelisseniorpartnerinaninner-citygeneralpracticeinLondon,whose
work is based on close collaboration between different professional and occupa-
tionalgroups.HealsoholdsapostofPrincipalLecturerattheSchoolofIntegrated
Health,UniversityofWestminster,whereheisinvolvedinteachingontherangeof
interprofessional courses. His research interest is in analysis of discourses in
continuingandinterprofessionaleducation.
Scott Reeves is a Research Fellow in the Health Care Education Development
Unit,St Bartholomew’sSchool of Nursing andMidwifery, CityUniversity.He is
also a Senior Research Fellow at the Faculty of Health and Social Care, London
South Bank University. Scott is a sociologist who collaborates with colleagues
from a range of health and social care backgrounds. His work focuses on the
evaluation of interprofessional education and collaboration. Scott isanAssociate
Editor of the Journalof Interprofessional Care.
Marilyn Hammick is an education and research consultant, Visiting Professor of
Interprofessional Education, School of Health Care Practice, Anglia Polytechnic
University;AssociateEditorofJournalofInterprofessionalCare;Vice-chairofCAIPE
and Consultant to Best Evidence Medical Education. Her international work in-
cludesmentoringsystematicreviewgroupsandsheisexternalevaluatortonation-
allyfundedinterprofessionaleducationprojects.Marilynwas previously aSenior
Lecturer,CentreforResearchinMedicalandDentalEducation,UniversityofBir-
mingham,andReaderinInterprofessionalEducation,OxfordBrookesUniversity.
Della Freeth is Reader in Education for Health Care Practice at City University,
London,based in theHealth CareEducation Development Unitatthe St Bartho-
lomew’s School of Nursing and Midwifery. She is an educationalist who works
alongsidea wide range ofhealth professionals, supporting thedevelopment and
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Contributors vii
evaluation of educational initiatives. Her personal research interests have two
overlapping foci, interprofessionalcollaboration and learning through simulated
professionalpractice.SheisaBoardMemberofCAIPEandanAssociateEditorof
the Journal of Interprofessional Care.
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The Series
Promoting Partnership for Health
Health is everybody’s responsibility: individuals, families, communities, profes-
sions, businesses, charities and public services. It is more than prevention and
cureofdisease.Itislife-fulfillingforthewell-beingofall.Eachpartyhasitsrole,
but effective health improvement calls for partnership, more precisely for many
partnerships,whichbringthemtogetherininnovativeandimaginativeways.The
scopefor this seriesiscorrespondingly wide.
Successive books will explore partnership for health from policy, practice and
educationalperspectives.Allthreedrivechange.Policypressesthepaceofreform
everywhere, but change is also driven by the demands of practice, triggered by
economicandsocialtrends,technologicaladvanceandrisingpublicexpectations.
Education responds, but alsoinitiates, as a change agentin its own right.
Progressivehealthcareisclientcentred.Theserieswillwholeheartedlyendorse
that principle, but theclientis alsorelative, citizen,client andconsumer:
. Relative sustaining,and sustained by, family
. Citizen working for, and benefiting from, community, country and comity of
nations
. Clientof countlessprofessions
. Consumerof health-enhancing or health-harming services
A recurrent theme will be the roles and responsibilities of professions, indi-
viduallyandcollectively,topromoteandsustainhealth.Thefocuswillbeonthe
healthandsocialcareprofessions,buttakingintoaccountthecapabilityofevery
profession to improve or impair health. The responsibility of the professions in
contemporarysocietywillresonatethroughouttheseries,startingfromtheprem-
ise that shared values of professionalism carry an inescapable obligation to
furtherthe health andwell-being of all.
Each book will compare and contrast national perspectives, from developing
andso-calleddevelopednations,setwithinaglobalappreciationofopportunities
andthreatstohealth.Eachwillbedriven,notsimplybyself-evidentscopeforone
nation to learn from another, but also by the need to respond to challenges that
paynorespecttonationalbordersandcanonlybeaddressedbyconcertedaction.
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The Series ix
Partnership has become so fashionable that it is tempting to assume that all
reasonable men and women will unite in common cause. Experience teaches
otherwise: best laid plans too often founder for lack of attention to differences
whichcan bedevilrelationshipsbetweenprofessionsandbetweenorganisations.
Thisserieswillnotbestarry-eyed.Itwillalertreaderstothepitfallsandtoways
to avoid them.
The three books introducing the series focus on collaborative working and
learning between services and between professions in health and social care. In
the first, Meads & Ashcroft et al. (2005) find collaboration critical to effective
implementation of health care reforms around the world. In the second, this
book makes the case for interprofessional education as a means to promote
collaborative practice, corroborated by emerging evidence from systematic
searches of the literature. In the third, Freeth et al. (2005) marry evidence with
experience, to assist teachers to develop, deliver and evaluate interprofessional
education programmes. All three books transcend professional, organisational
andnationalboundariestoshareexperienceaswidelyaspossibleforthecommon
good, as they set thetoneforthe series.
HughBarr
SeriesEditor
October2004
List of other books in this series
Freeth, D., Hammick, M., Reeves,S., Koppel,I.& Barr, H.(2005) EffectiveInterprofessional
Education:Development,DeliveryandEvaluation.BlackwellPublishing,Oxford.
Meads,G.&Ashcroft,J.withBarr,H.,Scott,R.&Wild,A.(2005)TheCaseforInterprofes-
sionalCollaboration.BlackwellPublishing,Oxford.
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Foreword by Gerard Majoor
The quality of health care suffers everywhere from fragmentation between ser-
vices and between professions. Barriers are erected, not only between public
health, primary care, social care and hospital-based services but also between
medical, nursing, social work, allied health, management and other professions.
Each student identifies with his or her future profession, learning from its
esteemedseniormembersandreinforcedbyallegiancetoitsassociations.Valuable
thoughthisprocessundoubtedlyisinbuildingmutualsupportanddiscipline,itall
too easily results in rigid and protective demarcations between professions who
need to work closely together to respond effectively to the needs of the same
patients,familiesandcommunities.
‘Ifeducationispartoftheproblem,itmustalsobepartofthesolution’,asHugh
Barrandhisco-authorsassertintheopeningchapterofthisbook.Fragilethough
it may be, interprofessional education is a laudable attempt to deal with the
downside of the professionalisation process and, more positively, to prepare
healthandsocialcarestudentsforcollaboration.Thekeytosuccessliesinensur-
ing that future interprofessional education programmes are grounded in best
practice based on the evidence. This book offers an invaluable source of such
information, following an exhaustive and systematic search of the literature
worldwide for the most rigorous examples of interprofessional education so far
reported. At the same time, it exposes conventional wisdom about interprofes-
sional education to critical review in the light of the evidence assembled and
provides a baseline for the future development of interprofessional education
beforeandafter qualification inthe classroom andthe workplace.
Persuasive though the case for interprofessional education is, it is difficult to
establish partnerships between different institutions educating different types of
health professionals and practice agencies. It is hard to harmonise curricula, to
attune time schedules for teaching in college and practice and sometimes to
surmountdifferencesbetweenteachers.Butwemust.Interprofessionaleducation
is one of the much needed strategies to reduce compartmentalisation and to
improve the quality of health care.
Educational institutions all over the world are now introducing interprofes-
sionaleducationanddocumentingtheirexperience.Iamconvincedthatthisbook
willbeof great help to allthosewho are ready to take up that challenge.
GerardMajoorPhD,Chairman
TheNetwork:TowardsUnityforHealth
FacultyofMedicine
MaastrichtUniversity,TheNetherlands