Norwegian nursing and medical students’ perception of interprofessional teamwork: a qualitative study

BMC Medical Education

Karina Aase¹  Britt Sæthre Hansen²  Ingunn Aase¹ 

[1] Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway;Department of Health Studies, University of Stavanger and Stavanger University Hospital, Stavanger N-4036, Norway

关键词: Students’ perceptions;    Healthcare;    Content analysis;    Professional role;    Interprofessional education;    Interprofessional teamwork;   

Others  :  1091892
DOI  :  10.1186/1472-6920-14-170

 received in 2013-08-07, accepted in 2014-08-08,  发布年份 2014

【 摘 要 】

Background

Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts.

Methods

The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students).

Results

The results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure.

Conclusions

This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies.

【 授权许可】

   
2014 Aase et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 3.

【 参考文献 】

• [1]World Health Organization [WHO]: Patient Safety Curriculum Guide Multi-professional Edition. Switzerland: S& B Graphic Design; 2011. ISBN 978 92 4 150195 8
• [2]Barr H, Koppel I, Reeves S, Hammick M, Freeth D: Effective Interprofessional Education: Argument, Assumption and Evidence. London: Blackwell Publishing; 2005.
• [3]Thistlethwaite J: Interprofessional education: A review of context, learning and the research agenda. Med Educ 2012, 46:58-70.
• [4]World Health Organization [WHO]: Framework for Action on IPE & Collaborative Practice. Switzerland: S& B Graphic Design; 2010.
• [5]Clark PG: The devil is in the details: The seven deadly sins of organizing and continuing interprofessional education in the US. J Interprof Care 2011, 25(5):321-327. 10.3109/13561820.2011.578223
• [6]Broers T, Poth C, Medves J: What’s in a Word? Understanding Interprofessional Collaboration from the Students’ Perspective. J Res Interprof Pract Educ 2009, 1:1.
• [7]Lapkin S, Levett-Jones T, Gilligan C: A systematic review of the effectiveness of interprofessional education in health professional programs. Nurse Educ Today 2013, 33:90-102.
• [8]Aase I, Aase K, Dieckmann P: Teaching interprofessional teamwork in medical and nursing education in Norway: A content analysis. J Interprof Care 2013, 27:238-245.
• [9]Reeves S, Lewin S, Espin S, Zwarenstein M: Interprofessional Teamwork for Health and Social Care. UK: Wiley- Blackwell; 2010.
• [10]Ministry of Health and Care Services: National health plan for Norway (2007–2010). Oslo, Norway: Ministry of Health and Care Services; 2007.
• [11]Norwegian Ministry of Education And Research: St.m. nr. 13: Utdanning for Velferd. Samspill I Praksis, (Education for Welfare. Cooperation in Practice.). Oslo; 2012–2013. [Governmental White Paper]
• [12]Clark PG: Examining the interface between interprofessional practice and education: Lessons learned from Norway for promoting teamwork. J Interprof Care 2011, 25(1):26-32.
• [13]Kyrkjebø JM, Brattebø G, Smith-Strøm H: Improving patient safety by using simulation training in health professional education. J Interprof Care 2006, 20:507-516.
• [14]Bjørke G: Collaboration across professional boundaries [Samarbeid på tvers av profesjonsgrenser. Kvalifisering for tverrprofesjonelt samarbeid i helse- og sosialsektoren ]. Høgskolen i Oslo, HiO-rapport nr 1. Oslo: Høgskolen i Oslo; 2009. ISBN: 9788257946524
• [15]Almås S, Barr H: Common curricula in Norway: Differential implementation and differential outcomes in undergraduate health and social care education. J Interprof Care 2008, 2(6):650-657.
• [16]Bjørke G, Haavie NE: Crossing boundaries: Implementing an interprofessional module into uniprofessional Bachelor programmes. J Interprof Care 2006, 20(6):641-653.
• [17]Saroo S, Boet S, Kitto S, Reeves S: Interprofessional simulated learning: the need for “sociological fidelity”. J Interprof Care 2011, 25:81-83. 10.3109/13561820.2011.5565514
• [18]West M, Markiowicsz L: Building Team-Based Working. Cornwall: The British Society and Blackwell Publishing Ltd; 2004.
• [19]Petri P: Concept analysis of interdisciplinary collaboration. Nurs Forum 2010, 45(2):73-82.
• [20]D’Amour D, Oandasan I: Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept. J Interprof Care 2005, 19(Suppl.1):8-20.
• [21]Reeves S, Zwarenstein M, Goldman J, Barr H, Freeth D, Hammick M, Koppel I: Interprofessional education: Effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2008, (1):CD 002213. doi:10.1002/14651858.CD002213.pub2
• [22]Polit DF, Beck CT: Nursing Research: Generating and Assessing Evidence for Nursing Practice. Philadelphia Lippincott: Williams & Wilkins; 2008.
• [23]Morgan DL: Focus Groups as Qualitative Research [vol. 16]. Thousand Oaks: Sage Publication; 1997.
• [24]Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 2004, 24:105-112.
• [25]Manias E, Street A: Nurse-doctor interactions during critical care ward rounds. J Clin Nurs 2001, 10:442-450.
• [26]Fougner M, Horntvedt T: Students’ reflections on shadowing interprofessional teamwork: A Norwegian case study. J Interprof Care 2011, 25:33-38.
• [27]Zaccagnini ME, White K: The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice. USA: Jones and Bartlett Publishers; 2011.
• [28]Pollard K: Student engagement in interprofessional working in practice placements settings. J Clin Nurs 2009, 18:2846-2856.
• [29]Thistlethwaite J: Guest editorial: Interprofessional education. J Clin Nurs 2008, 20:425-426.
• [30]Vaismoradi M, Salsali M, Ahmadi F: Nurses’ experiences of uncertainty in clinical practice: adescriptive study. J Adv Nurs 2011, 6:991-999.
• [31]Street A: Nursing Replay: Researching Nursing Culture Together. South Melbourne: Churchill Livingstone; 1995.
• [32]Atwal A, Caldwell K: Do all health and social care professionals interact equally: A study of interactions in multidisciplinary teams in the United Kingdom. Scand J Caring Sci 2005, 19:268-273.
• [33]Weber H, Støckli M, Nubling M, Langewitz WA: Communication during ward rounds in Internal Medicine: An analysis of patient–nurse–physician interactions using RIAS. Patient Educ Couns 2007, 67:343-348.
• [34]Nikendei C, Kraus B, Schrauth M, Briem S, Junger J: Ward rounds: how prepared are future doctors? Med Teach 2008, 30:88-91.
• [35]Williamson GH, Callaghan L, Whittlesea E, Mutton L, Heath V: Placement development teams and interprofessional education with healthcare students. J Clin Nurs 2011, 20:2305-2314.
• [36]Nørgaard K, Ringsted C, Dolmans D: Validation of a checklist to assess ward round performance in Internal medicine. Med Educ 2004, 38:700-707.
• [37]Caldwell K, Atwal A: The problems of interprofessional healthcare practice in hospitals. Br J Nurs 2003, 12(20):1212-1218.
• [38]Stew G: Learning together in practice: A survey of interprofessional education in clinical settings in South-East England. J Interprof Care 2005, 19:223-235.