Multiprofessional working, interprofessional learning and primary care: a way forward?

Across all sectors of health and social care there is a growing need for collaboration between professionals, agencies, providers and above all with the people they seek to serve. The significant challenge is how to create, within the existing and future workforce, the capability to work in multi professional teams capable of effective collaboration. The intention of this paper is to explore the implications that multi- or more specifically inter-professional learning may have for collaboration within primary care. As part of this, the state of the current evidence base regarding this form of learning will be explored. However, just as this way of learning is but one element in a wider picture of health care, so the focus will also include the implications for a workforce relevant to future primary care.

Opportunities and barriers to successful learning transfer: impact of critical care skills training.

AIM: This paper is a report of a study to assess the impact on nursing practice of critical care skills training for ward-based nurses. BACKGROUND: Following a government review in the UK of adult critical care provision, new ways of working were advocated to ensure that critical care services depended on the needs of the patient, not their location in the hospital. A re-conceptualization beyond service provision in high dependency units and intensive care units was required in order to deliver an integrated service. This has ramifications for training requirements. METHODS: Semi-structured interviews were used to explore perceived learning and learning transfer from a range of courses. The data were collected from course attendees (n = 47) and line-managers (n = 19) across two sites between 2005 and 2006. FINDINGS: Learning was closely associated with the clinical application of new skills and knowledge. Commonly, course attendees and line-managers quoted increased knowledge and confidence, better assessment skills and improved interprofessional working. Time with competency assessors, availability of expanding roles, and supernumerary time were key factors for successful learning transfer. Barriers were financial pressures on hospitals, lack of perceived relevance of the course to staff or nursing practice, and lack of time to practice skills or work with clinical skills facilitators. CONCLUSION: Course design should be a collaborative activity between education providers and commissioners to ensure the impact of training on practice. Relevance of material, time to practise skills and new learning, and organizational, rather than merely individual, support are essential for successful training interventions.

Will opposites attract? Similarities and differences in students' perceptions of the stereotype profiles of other health and social care professional groups.

The extent to which health and social care (HSC) students hold stereotypical views of other HSC professional groups is of great potential importance to team working in health care. This paper explores students' perceptions of different HSC professional groups at the beginning of their university programmes. Findings are presented from an analysis of baseline data collected as part of the New Generation Project longitudinal cohort study which is assessing the impact of interprofessional education over time on a range of variables including stereotyping. Questionnaires were administered to a cohort of over 1200 students from 10 different HSC professional groups entering their first year of university. Stereotypes were measured using a tool adapted from Barnes et al. (2000) designed to elicit stereotype ratings on a range of nine characteristics. The findings confirm that students arrive at university with an established and consistent set of stereotypes about other health and social care professional groups. Stereotypical profiles were compiled for each professional group indicating the distinctive characteristics of the groups as well as the similarities and differences between groups.Midwives, social workers and nurses were rated most highly on interpersonal skills and on being a team player whilst doctors were rated most highly on academic ability. Doctors, midwives and social workers were perceived as having the strongest leadership role, whilst doctors were also rated most highly on decision making. All professions were rated highly on confidence and professional competence and, with the exception of social workers, on practical skills. A comparison of profiles for each professional group reveals that, for example, pharmacists and doctors were perceived as having very similar characteristics as were social workers, midwives and nurses. However, the profiles of nurses and doctors were perceived to be very different. The implications of these similarities and differences are discussed in terms of their potential impact on interprofessional interactions, role boundaries and team working.

Educating the future workforce: building the evidence about interprofessional learning.

This paper addresses the theme of interprofessional education for health and social care professionals as it affects the development of the workforce. The drivers for change in the UK, typified by the Bristol Royal Infirmary and Victoria Climbié inquiries and the response to these in the form of Department of Health policy, are discussed. The need for rapid development of the evidence base around this subject is evident from literature reviews of the impact of interprofessional education. Directions for future research and investment in this area are proposed, including the need for a stronger theoretical base and for longitudinal studies over extended periods of time in order to examine short, medium and long-term outcomes in relation to health care practice.

The road ahead.

THE PROVISION of health and social care is a labour intensive enterprise in which the workforce is the key to modernisation. It not only delivers services but also acts as the arbiter of its own quality.