What have you learnt from working within your team and throughout this module?
Introduction 174/125 words
I attended the interprofessional (IP) conference and worked on a table team consisting of 3 adult nurses, 3 medical students, an occupational therapist, a social worker, a midwife and myself (a children's nurse). This essay will discuss my learning as a result of attending the conference and interacting with the other student professionals. In order to demonstrate my learning from the conference I will discuss why IP learning in education is important. I will discuss what I have learnt about the importance of communication in health and social care, why I have learnt it is important to be aware of the different values, roles and perspectives of other professions and why stereotyping and power imbalance can affect the group working process. The purpose of the conference was to explore interprofessional working (IPW), so it is useful to have an understanding about what this means. IPW involves communicating and interacting with more than two members from different professions in a purposeful way to reach an agreement about goals, plans and evaluations (Barrett and Keeping, 2005).
IP importance in education of healthcare professionals 323/200 words
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In order for professionals to work interprofessionally the skills must be learnt during their training. The importance of joint learning has been highlighted by the Government in The NHS Plan (DoH, 2000). During the recent conference I learnt the value of interprofessional education (IPE) in enhancing the confidence of pre-registration health care professionals when they enter the workplace (Miers, 2010). This may be especially important for some students who enter practice placement areas where the IPW ethos is poor, so the student's opportunity for participating in interprofessional interactions will be determined by their own confidence level to create opportunities for themselves (Pollard, 2009). Personally, I feel my confidence in interacting with doctors will have been enhanced by the conference due to my interactions with medical students. I hope that I am able to approach medical teams and ask them more questions about their role and whether I can spend some time shadowing them, as I have done on previous placements with physiotherapists, play workers and other members of the interprofessional team. Some of my increased confidence has been gained from informal conversation with the medical students about hobbies and interests outside of work and making the realisation that medical students are the same as any other health care student body. It is suggested by Hoffman et al (2008) that the informal interactions between students of different professional groups can help to strengthen the IPE experience when moving into clinical practice because friendships may be formed. I feel my IPE experience could also have been strengthened by including the patient's perspective which is often not included in IPE and helps to forge links between theory and practice (Cooper and Spencer-Dawe, 2006). It was intended that a service user group would present a play to the whole conference, however they were unable to attend, although I feel that even if the group had presented at the conference, the IPE experience could be enhanced by having a service user join the individual table team for a short while to discuss issues with the students.
Communication within health and social care 458/265 words
From working within my team I have learnt that communication in health and social care underpins everything that professionals do and can determine the quality of service that patients receive. Poor communication between members of interprofessional teams effects the quality of care patients receive and can result in any number of bad experiences for the patients, from being a major cause of patient complaints to contributing to deaths, for example the tragic case of Victoria Climbie (Priest and Roberts, 2006). Following discussion in our table team, we were all in agreement that there are some factors which we felt contribute to poor communication and that, as students, we are in a position to have some control over them. As a team we felt that the use of professional jargon, abbreviations and poor handwriting are contributing factors to poor communication and we developed our first statement to personally all try and avoid these behaviours (see statements in appendix 1). As a group our rationale to avoid jargon was developed because we found that even as students, we were using words and phrases learnt from practice that our interprofessional colleagues did not understand. Thistlewaite (2008) also states that different professions and teams develop their own jargon and methods of working which becomes a barrier to the successful working of the team. Using jargon can also become a barrier to effective communication with patients, who should never be forgotten as the most important member of the interprofessional team and the reason for its being (Fitzgerald, 2008).
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Jargon and abbreviations should be avoided in conversation as well as written records. Our table team identified patient records as a key tool in interprofessional communication and felt that the records must therefore be 'appropriately accessible' (see sentences in appendix 1). By this we meant that the records should be available to be accessed by those members of the team with a genuine need to see the records. Keeping central case notes as a method of record-keeping which is accessible to all members of the interprofessional team and which has avoided staff having to duplicate records was described by Molyneux (2001). However, keeping central case notes would not work in all situations, for example, in my experience it would be difficult in community situations where professionals are not often working from the same office base. It has been shown in studies that when teams are able to have the same office base that communication becomes easier and the team have better relationships with each other (Molyneux, 2001). I believe in certain situations, for example child protection issues, where multiple agencies are involved the development of new computer systems to allow a central-case note system could benefit the patient and possibly contribute to saving lives (reference).
Contrasting professional perspectives/ values 308/265 words
In addition to interprofessional teams having good, effective communication pathways the team must also understand each others roles in order to work efficiently together (Pellatt, 2007). Our team discussed each other's roles at length and the value of the opportunity to do this which the conference has given us. This discussion lead our team to produce statement 3 (appendix 1) to respect and understand each others roles. The occupational therapist (OT) in our team felt more clarity was needed surrounding the OT so posted a role summary on BlackBoard, which is a useful and concrete reference which can be related to a 'real person'. In addition to ensuring professional members of the team understand each others roles, it is also important to ensure the patient understands the role each member of the interprofessional team plays (Pellatt, 2007). There are also benefits to individual professionals in learning about other team members roles, such as the ability this has to enhance your own professional identity (Frost and Robinson, 2007). However, learning about other peoples roles and working in an interprofessional way can also threaten an individuals professional identity (Frost and Robinson, 2007).
Understanding the roles of team members also leads to an understanding about the unique qualities and skills that different professionals bring to the team. This skill mix is crucial to patient care as a single professional is highly unlikely to posses all of the requisite skills to meet that patients needs (Freeth, 2001). In order to meet patient needs Irvine et al (2002, cited by Fletcher, 2010) suggests that for this reason professionals have a moral obligation to collaborate with others. However, some professionals posses anxieties that individual expertise may be lost when working in interprofessional teams but these can be overcome by gaining an understanding about each others precise roles, skills and responsibilities (Frost and Robinson, 2007).
Stereotyping, power imbalances and group processes 505/265 words
When entering a team to work it is important to be aware of our own stereotypes about other professionals as this can hinder the process of IPW and potentially affect patient care. Before attending the conference I held a stereotype of the medical students that they would be controlling and hold all of the power in the team. I was made to question this stereotype before attending the conference, when I was advised that previous cohorts of medical students had felt marginalised due to course differences and differences in practical experience from the majority of other students at conference. I was open-minded when meeting them, and found the medical students to be exactly like the other students on our team, which was friendly, willing to engage with the group and work and genuinely interested in our perceptions of interprofessional working. As a team we developed statement 6 (see appendix 1) because we all agreed that to work to overcome stereotypes we must first recognise when we hold them. However, even if professionals recognise that they hold stereotypes, there can still be conflict between team members (Junger et al, 2007). Our team were fortunate to get along well and we did not experience any irresolvable conflicts because when there were differing opinions we listened to what was being said and acknowledged the valid points of the other team members.
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With regard to power imbalance, my initial stereotype was that the medical students would dominate and hold the majority of power within the group. I had no preconceptions that other professionals, such as midwives, social workers or OT's would dominate the groups with power. This may be because I perceive our status in the workplace to be similar, whereas I perceive medics to be of higher status which could cause interprofessional jealousy and affect the team working (Molyneux, 2001). In terms of IPE Hoffman et al (2008) suggest that the power difference between students is less, as students can relate more easily to their student peers.
The group, however, must overcome any stereotypes or power imbalances in order to focus on the aim of the group meeting. Our team in statement 5 (appendix 1) suggested that the group must have a purpose for meeting and a goal to achieve. In addition to this the literature suggests the team must also have a philosophy in order to work together as a successful team (Junger et al, 2007). When the team has a shared philosophy and give the interprofessional meetings equal priority the experience can be a success. Molyneux (2001) describes a weekly case conference which was successful because all professionals attended the meetings and allowed sufficient time to discuss individual work with patients and plan, as a team. Our team worked well together despite not setting any ground rules, or having them laid down for us, and I feel this was beneficial because we all inputted roughly equal amounts into the group work and despite a dominating and opinionated midwife we all contributed freely to group discussions (Molyneux, 2001).
Conclusion 270/125 words
In conclusion this essay has discussed some of the aspects of IPW which have been raised on the conference and I have explained what I have learnt from them. The essay has discussed the importance of IPE in enhancing the confidence of health and social care practitioners ready for professional practice. I discussed how I found the conference had especially enhanced my confidence in interacting with medical students and how I hope to take this into future practice by shadowing doctors. I felt that my IPE could have been further enhanced by including patients as part of the table team as they are the central member of any interprofessional team. The impact poor communication has on patient care was also discussed and considered in respect of the difficulties in communication when professionals are located at different bases. From the conference I have learnt about the importance of professionals understanding each others roles and the importance of professionals ensuring the patient is clear on everybody's roles. I also learnt that learning about other professionals roles can enhance your own professional identity and how some professionals posses anxieties that they may become de-skilled when working in interprofessional teams. Some professionals hold stereotypes which affect their ability to achieve IPW and I discussed my own stereotype of medical students and how I overcame this. In addition I learnt that a team having a shared purpose and philosophy can aid the team to meet it's outcomes, which should be utilising all members of the teams skills to provided the highest level of service to the most important member of the interprofessional team, the patient.