Table of Contents
Methods of educational learning.
Process of developing an Inter-professional learning program..
Inter-professional learning in healthcare education-evidence base.
Inter-professional learning and education is a process of education through which the students are provided with opportunities for “shared learning”. It is a well-structured and balanced learning opportunity that combines the knowledge base of two or more distinct professions. It aims at enabling the learners and students to gain knowledge, skills and professional attitudes that they will not be able to gain effectively by using any other means (Reeves, 2016). The idea of inter-professional learning entails approaches to learning that are essentially about integration and synthesis of knowledge from the different professions for solving problems and issues. It provides the students with the opportunity to come together to learn and develop the necessary required skills for working collaboratively. Most commonly utilized method of developing education program and approach in healthcare is inter-professional learning mostly focusing on patient care and improved quality of care for the patient.
Inter-professional learning in healthcare is said to improve patient health outcomes and help in establishing collaborative competencies and practice in healthcare. It also helps in developing the required skills to become ready for provision of safe patient care and collaborative, multi-professional approach (IPE, 2017). Changes at educational, organizational and professional level are being incorporated in order to incorporate and infuse inter-professional learning and education in the realm of health and social care programs of education. Regulatory bodies and organizational policies are also changing to accommodate inter-professional learning into the curriculum as well. IPE centers for education are being created as higher institutions for education in many countries like USA, Australia, Canada and UK (WHO, 2015). A lot of research and thought process goes into developing an inter-professional learning pedagogy for education (Barwell et al., 2013). Various barriers exist in the way of development of the inter-professional learning curriculum especially in healthcare setting. This essay will explore the concept and idea behind inter-professional learning and its application and development in the health professions education pedagogy.
The need for IPE arises directly from the unpredictability and multifaceted nature of patients' wellbeing and social consideration needs which requires powerful coordination of services (Fallatah, Jabbad & Fallatah, 2015). It likewise comes from research exhibiting that viable coordinated effort among different medicinal and healthcare services’ suppliers is fundamental for the arrangement of viable and far reaching care. Undoubtedly, issues with correspondence and joint effort among various health and social care experts keep on being a worry as it can contribute to a compromise in healthcare delivery to the patients (Reeves, 2016).
Inter-professional Education (IPE) has been an academic technique which has included more than one expert order. For in the course of recent years health professions and disciplines have had an objective to improve the nature of patient consideration by teaming up with one another ((Fallatah et al., 2015). The execution of IPE has progressed the instructive improvement of learners and students in healthcare sciences and medicinal services past that of customary educational plans. The outcome being a more prominent comprehension with respect to every student from various disciplines of healthcare of the quality parts of patient care. Other than a more noteworthy comprehension of value persistent and quality care while still being a student, IPE has cultivated more prominent regard and uplifting perspectives among the collaborative colleagues for improving patient results and outcomes (Alinier et al., 2014).
It is an inter-professional cooperation of various healthcare disciplines which manages to provide customers or patients a chance to get quality and valued care that has been affected by other healthcare orders and aptitude. A key fundamental of the IPE approach is more prominent correspondence between healthcare and wellness experts. More prominent correspondence builds the decent variety and diversity of care alternatives, hence giving a higher consideration to patient quality. IPE unites students, learners, and health care personnel in an intelligent, group situated, collective discussion (Alinier et al., 2014). The cooperative perspective places all members on a comparable contributory level. This contrasts from the more conventional approach of healthcare, which commonly has a pioneer from a healthcare calling in control.
There is a need for improving teamwork and increased cooperation in the healthcare services today (IPE, 2017). Inter-professional collaboration and IPE has been pointed out by the World Health Organization as an important step in the preparation of a healthcare cadre which is ready for collaborative practice and is efficiently prepared to respond to the local health needs. It has become a focal point of healthcare especially in terms of improving quality and safety of patient-centered care, especially in the case of chronic diseases (WHO, 2015). It helps in the reduction of the costs of healthcare and decrease the intervention outdatedness as well. This training process based on inter-professional learning should begin at the earliest in the higher education setting, especially in the healthcare setting.
There have been debates and discussions around when should the IPE way of learning be incorporated and implemented within the organizations- both clinical and educational. The most useful time to do the so has been debated upon and research indicative of students entering the first year, in their pre-qualification program, since they already have a pre-conceived, previously established set of notions and stereotypes about the other healthcare courses and professional groups (Talwalkar et al., 2016). This leads to the argument that that any kind of IPE or IPL delivered at this instant will be helpful in playing a critical role to reduce the negative notions and any kind of animosity between the various professional groups (IPE, 2017). Contrastingly, the other suggestion is to provide this IPE after the completion of qualification because then, a more credible and clear understanding would have been effectively established amongst the participants based on their professional role and identity.
Suggestions have also come stating that IPE should become a part of the student’s continuous and ongoing development – while pursuing the qualification in a professional manner. This way it can start from the pre-qualification stage and throughout their careers as well. Assuming that the nature and the aims and goals of the IPE education will vary basis the stage of learning, this approach seems most appropriate and accurate (IPE, 2017). IPE can initially be used in the preparation of students for collective and collaborative practice and later be used as a reinforcement tool for early experiences in learning and also provide further guidance in collaborative practice. Methods of learning that involve and enable interaction and interactivity are a primary feature of IPL (Talwalkar et al., 2016). A variety of ways exist that can be used to promote interactive learning such as the following- leaning based on observation and shadow learning; problem-solving approach, seminar-based approach; using simulation models; practicing clinical placements and settings; discussions on the web(e-learnings) and blended method of learning where the web based learning is combined with the traditional methods.
The specific method of learning which will be employed in different situations will be dependent on the initiative, basis, objectives and aims of the IPE along with the resources that are available and the type and nature of participants as well. Some students might and some might not have familiarity or experience with specific learning methods, such as simulation or web based learning, and maintain this variation , even though found to be very effective could become a challenge in the implementation of the IPE program (Henderson et al., 2016).
Another method used quite effectively is the method of informal learning scenarios where team meetings and collaborations take place between the different team members in informal settings, such as outside the realm and purview of a classroom. It is observed that the discussions carried out henceforth, become imperative to improve the inter-professional learnings and are effective ways of improving inter-professional learning as a learning strategy (Nisbet et al., 2015).
Getting support from the professional leaders and recruitment of educators, showing high-quality expertise in teaching may help improve the condition of IPE. Flexible scheduling of IPL classes along with compulsion in attendance will also help in the instruction of effective IPE. Continuous credit based system of education for IPL as well might help in elevating its status and encourage more active participation especially for post-qualification learners and students(IPE, 2017).
The preparation and development of the curriculum for IPL can be a challenge in terms of requirements of commitments from the administration of the universities, including the faculty, teachers, instructors and deans from the multiple disciplines and professions involved. Specific time, resources and knowledge must be committed by the schools, colleges, programs and departments to engage in the process and course for IPL. An organization format or map needs to be agreed upon by the various departments involved to help in the facilitation of the curricular activities. There should be sufficient space to include and accommodate a large number of faculty, students, staff and community members as well. For example, a space in the community can be used for the initial purpose of introductions and ice-breaking (Richardson & Potter, 2012). Internet and information technology can be used to conduct e-learning sessions and web-based conferences and lectures along with distance learning as well. It will help in reaching more participants. A learning system for the administration of the course material along with the process of evaluation for measuring the progress of students should also be incorporated as a part of the process of developing the IPL curriculum.
The various types of interactive learning processes are based on the principles of experimental, reflective, collaborative and egalitarian activities as well. Efficient practice in healthcare which is oriented towards patient-care includes principles of mutual trust, coordination, collaboration, communication, cooperation, responsibility and accountability as well. Therefore, the concepts taught in IPL curriculum should include these principles where the students of health care can learn and experience them (Richardson & Potter, 2012). Developing an understanding and comprehension of the values of the variety of professions and disciplines is a core component of the IPL curriculum. As the students gain more knowledge, understanding and competence in their own field of education, a greater insight develops in them about the significant role they will play in a health care team. This will lead to the students being able to understand the connections between their healthcare program and other professions as well as within their own profession as well (IPE, 2017). As a consequence of this, there should be an implementation of an IPE curriculum that includes in itself a uniform framework and a effective model of inter-professional collaboration as well.
The development of the IPL curriculum can be made more attractive and effective by having a list of disciplines that should or could have contact with the patients. It will also help attract a greater variety of disciplines of healthcare towards IPL (Hoods et al., 2014). Each of the disciplines and fields would be able to describe their patient contact- directly or indirectly. Conduction of this inventory will help increase the interest of the various healthcare disciplines into the opportunities for contact with patients and therefore, might generate more interest in being represented as a part of the effort for teamwork and collaboration (Graves et al., 2016). This listing of the potential patient contacts might also help in improving the variety and diversity of approach towards healthcare and help improve the patient outcomes eventually.
For more development of the planning of curriculum of IPL, initial idea should only include and inculcate short-term patient goals because if log-term goals are incorporated in the approach towards learning in the early stages, it overly complicates the situation for the students and loses track of the objective and aim setting process. It becomes especially important for the students pursuing their undergraduation or are in the initial year of their healthcare curriculum and syllabus. This activity of focusing initially on the short –term goals will also help the students in developing professional insight for establishing practical long term goals (Reeves, 2016).
The Readiness for Inter-professional Learning Survey (RIPLS) is a tool used for over-all evaluation of the IPE curriculum, in both the, pre and post participation phases. It is a 19 item questionnaire and it measures the various attributes like collaboration, teamwork, roles, professional identity and responsibilities as well (Mahler et al., 2015).
Inter-professional learning in healthcare education involves the use of a large number of settings such as primary care, tertiary care, acute and community care. It addresses a large number of conditions, diseases and settings such as chronic diseases- diabetes, hypertension or acute conditions as well (Olson et al., 2014). Research in this field about the impact, ways or methods and the pedagogy of imparting IPL is quite new. It involves discussions around the methods, duration, timings, impacts and barriers to IPL in healthcare settings.
Focusing on the type of techniques used in the provision of IPL, it was found that communication and IPL strategies based on simulation were effective strategies to inculcate teamwork and collaboration (King et al., 2016; Scherer et al., 2013; Sigalet et al., 2015). Another systematic review done to measure the effectiveness of IPL and simulation communication strategies showed that communication and IPL have a positive impact on developing students´ skills in communication and collaboration (Granheim et al., 2018).
A systematic review conducted in 2014 showed that IPE when imparted in a university based setting in pre-licensure stage as a part of allied health curriculum, it is more effective and feasible. Group work based interventions involving small teams and practical patient oriented approach in comparison to lecture –based imparting of education, can be more effective and cause improvement in attitudes and approach towards interaction in an IPL setting. It also leads to better teamwork and effective comprehension of the roles of the health professionals. Findings around durations of the IPL interventions are limited, but participants described that interventions that lasted less than 2.5 hours were not too useful and very brief (Olson et al., 2014).
Even though IPL is being hailed as important pedagogical technique, and the presence of an international definition that is accepted worldwide, the idea of infusing IPL into the standard curriculum of the health profession is a very significant challenge (Reeves et al., 2016). There still exist a number of constraints and barriers to its inclusion and practice in the healthcare profession. Most commonly quoted reasons include cultural and logistical factors such as costs, constraints of the time table, the particular requirements and needs of the individual professional bodies or disciplines and the culture of the departments which are averse to taking any risks (Sunguya et al., 2014; Meleis et al., 2016; Rogers et al., 2017).
Looking at the outcomes, it was observed that there was a need for specific and more profound set of tools that can be utilized as measures for specific and easily assessable outcomes of learning. They can be used to apply across all health professions and become effective competencies for measuring inter-professional learning (O’Keefe et al., 2017).
A systematic review done in 2016 showed that the principles for quality improvement were based upon the IPE programs administered post-qualification. Generally, the IPE programs used the style of formative assessment, in the form of joint/team/group presentations or written assignments or accounts on an individual basis which helped in the provision of a collaborative and collective account of the views of the students and learners’ experience in inter-professional learning. Also, observed was the lack of discussion around the limitations associated with the methodology employed in their research. Hence, it became difficult to comprehend the nature of their biases in the studies and the quality of research as well. Also, a number of studies offered only a partial or limited description of the specific IPL program, which made it difficult to check if the changes that were reported could be directly attributed to the IPE program that was imparted (Reeves, 2016).
Also, another study suggested that there existed a substantial lack of proper research in the field of IPL in terms of researching and understanding the processes involved in IPL instead of just measuring evaluation (Olson et al., 2014). Although it can be concluded that IPE works, the understanding of the relationships between different modes of IPE and its outcomes is very limited.
As described above, aggregating proof of issues with coordination and cooperation inter-professionally between the various healthcare providers and social consideration suppliers, and the subsequent effect on the nature of healthcare services, has led to the decision makers in policy, training, human services, strategy, research and healthcare to put resources into IPE. It is foreseen that IPE will give health care suppliers the abilities, skill and information required to work adequately with other medicinal services suppliers within the healthcare framework. Accordingly, IPE activities for pre and post-capability students are being created and executed over the globe.
Evidence of research of more than thirty years has given helpful understanding into IPE, as talked about above. Through these examinations we have a comprehension about the estimation of IPE at both pre-and post-capability learning stages. For instance, students can profit by a pre-capability activity about the jobs of various health care experts comparable to a specific clinical zone being studied in a class room and additionally position setting, while a post-capability activity can address correspondence issues with other experts in health care with whom they work, and backing changes in the practical sense and practice. The various sorts of interactive learning strategies that can be utilized in IPE were also discussed. The open door for intuitiveness is a fundamental component of IPE, however the specific strategies utilized will rely upon the goals and available assets. Strong leadership from schools, affiliations, and associations, is subsequently fundamental to energize and uphold students and specialists who are completely indulging in IPE programs.
Future interest in IPE must be founded on thorough proof however, concerning the results accomplished, and this proof is slowly gathering. As the blend of IPE audits uncovered, this sort of instruction can have positive results comparable to members' responses, perspectives, information/aptitudes, practices, and, patient benefits as well. In any case, as observed, there are methodological impediments to these investigations. With the extending number of studies here, and the expanding center around the methodological nature of such investigations, it is hoped that the proof of this field will be progressively more powerful.
Exploration has assisted with demonstrating the job of IPE in improving inter-professional cooperation and upgrading the nature and quality of care imparted to patients. Health care and social care instruction schools and relationships over the world have underlined the significance of their students and specialists being powerful associates and communicators, and are utilizing IPE as a key system to the advancement of such capacities. As the proof for IPE keeps on advancing, more prominent information will be developed on how it can most viably be arranged, executed and implemented, and its relationship to creating community oriented capabilities that can decidedly influence the conveyance of patient care and wellbeing outcomes.
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