A critical realist model of complexity for interprofessional working

A very interesting paper written by Rick Hood, Bedford Hill, 

London

, United Kingdom

Royal Holloway University of London, Criminology and Sociology, 

Egham Hill, Egham, Surrey

, United Kingdom.

This paper presents a theoretical model of complexity for considering issues relevant to interprofessional working. The need for such a model is introduced with reference to the literature on collaboration and integration in health and social care, particularly in children’s services. It is argued that interprofessional working is often seen as a response to complexity, but that current models fail to build an appreciation of complex causality into their approach to addressing needs through targeted interventions. The alternative offered here is a critical realist model based on Bhaskar’s domains of reality, focusing on the implications of open systems, complex causality and contingency. These ideas are used to examine some of the issues and dilemmas typically encountered by interprofessional networks in coming together to work on complex cases.

For more information, please see: Journal of Interprofessional Care, Early online.

Focusing on future learning environments: Exploring the role of space and place for interprofessional education

Great editorial written by Jonas Nordquist, Simon Kitto, Jennifer Peller, Jan Ygge, Scott Reeves.


While space and place have been important units of analysis in studying learning across a number of social science domains (e.g. environmental studies), there has been little research exploring these elements in either the health professions education or the interprofessional education literature (Leander, Phillips & Taylor, 2010). This editorial highlights the importance of acknowledging and beginning to understand the role of space and place in interprofessional education. Specifically, our aim is to initiate a dialogue about how space, place and learning can affect the design and implementation of this type of education. We suggest that understanding the conceptual and practical relationship between space, place and learning is necessary to the construction and reconstruction of learning spaces that aspire to follow interprofessional education principles (e.g. student-centredness, flexibility, interactivity, collaboration and communication).


Many of the points raised in this editorial will be further discussed and debated in an upcoming conference, entitled, Future Learning Environments: How Space Impacts on Learning which will take place the Nobel Forum, KI in Stockholm, Sweden from June 3–5, 2012. This conference aims to gather an interprofessional and interdisciplinary group of academics, designers, architects, clinicians, managers and policymakers to explore key dimensions and issues related conceptualizing, evaluating and theorizing about the use of space, how it impacts on professional and interprofessional learning. Additional information about the conference can be found at: www.ki.se/learningspaces
For more information, please see: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 391-393.

Continuing professional development for interprofessional teams supporting patients in healthcare decision making

Great article on interprofessional teams supporting patients in healthcare decision making   
Beth A. Lown, Jennifer Kryworuchko, Christiane Bieber, Dustin M. Lillie, Charles Kelly, Bettina Berger, and Andreas Loh.


Healthcare professionals and organizations, policy makers, and the public are calling for safe and effective care that is centered on patients’ needs, values, and preferences. The goals of interprofessional shared decision making and decision support are to help patients and professionals agree on choices that are effective, health promoting, realistic, and consonant with patients’ and professionals’ values and preferences. This requires collaboration among professionals and with patients and their family caregivers. Continuing professional development is urgently needed to help healthcare professionals acquire the knowledge, skills, and attitudes necessary to create and sustain a culture of collaboration. We describe a model that can be used to design, implement, and evaluate continuing education curricula in interprofessional shared decision making and decision support. This model aligns curricular goals, objectives, educational strategies, and evaluation instruments and strategies with desired learning and organizational outcomes. Educational leaders and researchers can institutionalize such curricula by linking them with quality improvement and patient safety initiatives.

For more information, please read: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 401-408. 

Interprofessional education about patient decision support in specialty care

Interesting article by Mary C. Politi, Arwen H. Pieterse, Tracy Truant, Cornelia Borkhoff, Vikram Jha, Laura Kuhl, Jennifer Nicolai, and Claudia Goss.

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care – aimed at providing continuous, comprehensive care – specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients’ care. Interprofessional care involves multiple professionals from different disciplines collaborating to provide an integrated approach to patient care. For patients to experience continuity of care across interprofessional providers, providers need to communicate and maintain a shared sense of responsibility to their patients. In this article, we describe challenges inherent in providing interprofessional patient decision support in specialty care. We propose ways for providers to engage in interprofessional decision support and discuss promising approaches to teaching an interprofessional decision support to specialty care providers. Additional evaluation and empirical research are required before further recommendations can be made about education for interprofessional decision support in specialty care.

For more information, please read: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 416-422.

Simulated interprofessional education: An analysis of teaching and learning processes

Interesting article written by: Mary van Soeren; Sandra Devlin-Cop; Kathleen MacMillan; Lindsay Baker; Eileen Egan-Lee; and Scott Reeves.  

Simulated learning activities are increasingly being used in health professions and interprofessional education (IPE). Specifically, IPE programs are frequently adopting role-play simulations as a key learning approach. Despite this widespread adoption, there is little empirical evidence exploring the teaching and learning processes embedded within this type of simulation. This exploratory study provides insight into the nature of these processes through the use of qualitative methods. A total of 152 clinicians, 101 students and 9 facilitators representing a range of health professions, participated in video-recorded role-plays and debrief sessions. Videotapes were analyzed to explore emerging issues and themes related to teaching and learning processes related to this type of interprofessional simulated learning experience. In addition, three focus groups were conducted with a subset of participants to explore perceptions of their educational experiences. Five key themes emerged from the data analysis: enthusiasm and motivation, professional role assignment, scenario realism, facilitator style and background and team facilitation. Our findings suggest that program developers need to be mindful of these five themes when using role-plays in an interprofessional context and point to the importance of deliberate and skilled facilitation in meeting desired learning outcomes.

For more information, please read: Journal of Interprofessional Care (November 2011), 25 (6), pg. 434-440.

Interprofessional jargon: How is it exclusionary? Cultural determinants of language use in health care practice

Interesting article written by: Carrie Marshall, Jennifer Medves, Debbie Docherty, Margo Paterson (Queen’s University, Kingston, Ontario, Canada)

Language can impact significantly on the ways in which health care professionals relate and provide clinical services, as well as the way in which patients conceptualize their role in the healthcare encounter. The aim of this project was to explore the barriers and challenges to developing a collaborative approach in health care. A hermeneutic research approach was used with a convenience sample of international key informants representing 6 disciplines. A total of 10 individual, semi-structured interviews were conducted. Findings emphasized the need to be more inclusive by avoiding the use of exclusionary jargon so that all members of the health care team, including patients and families, can adopt a collaborative practice orientation.

For more information, please see: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6, Pages 452-453.

Knowing more about the other professions clarified my own profession

Interesting article written by Jakobsen, F., Hansen, T.B., & Erika, B. 

The purpose of this study was to compare which learning outcomes relating to an Interprofessional Training Unit (ITU) experience were found to be most important by students and by alumni. A cohort of 428 students in the ITU was asked to write three short statements describing the most important learning outcomes from the ITU. Alumni from the same cohort were after graduation asked the same question. Furthermore, they were asked to fill out a 12-item questionnaire. The statements concerning learning outcome were analysed qualitatively and categorized. The number of statements in each category was counted and tested for statistical difference between students and alumni. Students stated “uniprofessionalism” as the most important learning outcome followed by “interprofessionalism”, “professional identity” and “learning environment”. Alumni on the other hand stated “professional identity” as most important learning outcome followed with “interprofessionalism”, “learning environment” and “uniprofessionalism”. The study indicated that over time the perceived outcome of learning experiences from an ITU change in priority.

For more information, please see: Journal of Interprofessional Care, September 7, 2011: Early online: http://informahealthcare.com.myaccess.library.utoronto.ca/doi/abs/10.3109/13561820.2011.595849