Learning with, from and about each other

For decades, the World Health Organisation has emphasised the need for interprofessional education, not because interprofessional education is an end in itself, but as a means of ensuring that different types of health professions can work together to meet the needs of the people. Flemming Bandholm Jakobsens ph.d fra 2011 (afhandlingen er på engelsk).



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Introduction af Flemming Bandholm Jakobsen

For decades, the World Health Organisation has emphasised the need for interprofessional education, not because interprofessional education is an end in itself, but as a means of ensuring that different types of health professions can work together to meet the needs of the people.

Danish authorities, professional societies and universities have called for interprofessional collaboration as a means of achieving better care and treatment and shorter hospital stays, thereby creating the possibility that patients can return to work more rapidly.

The higher education system in Denmark has also recently put a stronger emphasis on interprofessional education and collaboration by explicitly mentioning the necessity of all students’ ability to participate independently in uniprofessional and interprofessional collaborations.

Interprofessional education for health professional students can take place in Interprofessional Training Units. This dissertation, with the support of five articles, describes results from a Danish Interprofessional Training Unit (ITU).

Methods

Study I: This study included focus group interviews of the following: one head nurse and two superintendent physiotherapists; two students from occupational therapy, two students from physiotherapy, two students from medicine and two students from nursing; three deans from occupational therapy, physiotherapy, and nursing; three clinical tutors and one associate professor. Furthermore, interviews were conducted with an external observer and the project manager. We chose a qualitative approach for this project and performed a transverse analysis as a Systematic Text Condensation.

Study II: In this study, 162 students from occupational therapy, physiotherapy, medicine, and nursing completed the Attitudes to Health Professionals Questionnaire before they started in the ITU and again on their last day in the ITU. Data were collated by measuring the 10 cm scale with a conventional ruler. Data was inputted in Epidata and analysed using Excel and SPSS 13.0.

Study III: This study included patients admitted for primary hip or knee replacement surgery. We included 72 patients from the ITU and 62 patients from the conventional ward (COW). We estimated the daily costs in the ITU and in the COW. We calculated the effect of the intervention from change in self-reported health-related quality-of-life from the preoperative inpatient visit to the three-month
 postoperative control visit.

Study IV: In this study, we distributed a fifteen-item questionnaire to 55 medical students on their last day in the ITU and supplemented this questionnaire with a group interview with 22 of the students. We chose a qualitative approach for this project. The interview was analysed using Systematic Text Condensation. The results from the analysis of the interview were used to elaboration and validation of the questionnaire completed by all 55 students.

Study V: In this study, we asked on two occasions a cohort of 428 students studying occupational therapy, physiotherapy, and nursing to write three short statements describing what they perceived as the most important learning outcome that resulted from their stay in the ITU. The first time we asked for these statements was on the students’ last day in the ITU; the second time we asked them was after their graduation. We performed a qualitative analysis of the statements. After the analysis, we counted the statements addressing different themes from both data collections and obtained a quantitative distribution of the statements. Finally, we controlled for differences in perceived learning outcome from students and alumni.

Results

Study I: The goals of the ITU were fulfilled because the students learned interprofessional teamwork, strengthened their own professional role and worked together in an organisation for the benefit of the patient. All this took place in a secure learning environment, in which new methods of coordinating and integrating clinical and theoretical interprofessional learning were developed and tested.

Study II: After the ITU experience, students viewed most professions as more “caring” and less “subservient” (apart from physicians who were seen as being more “subservient” after the ITU experience). This study indicates that an IPE initiative, such as the ITU, can have a positive impact on students’ attitudes.

Study III: The patients in the two intervention groups were comparable at baseline. The ITU was found to be more cost-effective than the COW.

Study IV: Results show that a stay in the ITU with a safe learning environment can increase both uniprofessional and interprofessional learning for medical students. The students stressed the importance of supervision before and after carrying out a hospital task.

Study V: The study showed, that over time, students differ in their perceptions of the outcome of the learning experiences in an ITU. Whereas students state uniprofessional outcome more frequently, alumni in retrospect see professional identity and interprofessionalism as more important.

Conclusion

A two-week stay in an ITU helps students obtain uniprofessional and interprofessional learning and aids the formation of professional identity. What alumni remember most clearly after graduation is the interprofessional learning and the formation of professional identity. Furthermore, these studies found that the ITU was cost-effective compared to the conventional ward.
 

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