Interprofessional education and practice guide: profiling readiness for practice-based IPE.

Practice-based interprofessional education (IPE) is both a valuable and complex model of practice education. To support educators design, deliver, and implement high-quality practice-based IPE, this guideline was developed in conjunction with a placement profile. Underpinned by educational theory, this guideline and placement profile identifies key factors to consider before, during, and after practice-based IPE. Development of the profile has involved interprofessional collaboration as well as international feedback via conference workshops. The profile has been trialed in two clinical sites involved in practice-based IPE and refined following consultation with and feedback from educators. Educators can also use the profile to track site development over time and evidence resource and support requirements. Through use additional features may become relevant and users are encouraged to add or amend as is most beneficial to their site.

A national survey to map IPE in Ireland.

Interprofessional education (IPE) in Ireland is at an early stage. Currently, there is no data to reflect the amount and type of IPE occurring across the Island of Ireland. To support IPE implementation, data is needed on existing IPE which will identify gaps and foundations on which to build. We designed a cross-sectional, online, anonymous survey to map geographical IPE locations, IPE setting, and type of IPE offered. Results were analyzed by exporting raw data to Microsoft Excel. The survey was completed by 21 participants. Over half of participants (n = 12) came from two professions: physiotherapy and speech and language therapy. Participants were from 4 counties (from a potential 32): Cork, Dublin, Galway, and Limerick. There were twice as many university educator participants (n = 14) as compared to clinical educators (n = 7). Shared modules and guest lectures from other professions were frequent methods of shared learning. At university level the most frequent IPE activity was interprofessional problem-based learning/case study. At clinical sites students interact with a range of qualified professionals and have limited opportunities to work with students from other professions. This may impact the range of collaborative work skills developed and thus readiness for workforce entry.

Inside-out: normalising practice-based IPE.

Practice-based interprofessional education (IPE), a key feature in developing a collaboration-ready workforce, is poorly integrated in healthcare curriculums. This study aimed to synthesise educator perspectives on implementing practice-based IPE and develop recommendations to inform sustainable practice-based IPE. An ethnographic case study was carried out at a school of allied health. Data collection involved six observations, 11 interviews and a review of eight documents. Reflexive thematic analysis, informed by Normalisation Process Theory, established two key themes. First, we found that strategic planning is needed, with a coherent implementation agenda and planned reflection on activities. Second, building partnerships with placement partners was identified as essential. This can be achieved by supporting and championing practice-based IPE activities developed by placement sites and establishing how university and clinical educators can work collaboratively to deliver sustainable practice-based IPE. These conditions create a favourable environment for normalising practice-based IPE in healthcare curriculums, benefitting students, patients, and the overall healthcare service.

COVID-19 healthcare policies in Ireland: A rapid review of the initial pandemic response.

AIMS: Healthcare systems urgently required policies to guide the response to the COVID-19 pandemic. The aim of this review was to document the healthcare policies developed during the initial wave of widespread COVID-19 transmission in Ireland. We further sought to determine the key focus and impact of these policies. METHODS: We conducted a rapid review of COVID-19 healthcare policies published from 28 January to 31 May 2020. Key information including the focus of the policy, target population and impact on service delivery was extracted from included policies. During analysis, data was grouped under descriptive categories and narrative summaries were developed for each category. RESULTS: We identified 61 healthcare policies relating to COVID-19. We developed six category headings to describe the focus and impact of these policies: infection prevention and control (n = 19), residential care settings (n = 12), maintaining non-COVID-19 healthcare services and supports (n = 12), testing and contact tracing (n = 7), guidance for healthcare workers concerning COVID-19 (n = 6), and treating COVID-19 (n = 5). CONCLUSIONS: This review has identified lessons for policy development and implementation to help prepare for future healthcare emergencies. Factors to consider include support of vulnerable groups during and in the aftermath of the pandemic, providing psychological supports for healthcare workers and investment in public healthcare services such as contact tracing for future emergencies. While pandemic conditions necessitate the speedy development of policies, effective communication and adequate resourcing is required to ensure policy implementation.

Why shouldn't we do that on placement if we're doing it in the real world? Differences between undergraduate and graduate identities in speech and language therapy.

Healthcare graduates are often characterised as ill-prepared for workplace entry. Historically, research on health professional's work preparedness has focused on the quality of graduates' clinical knowledge, skills and problem-solving. This ignores the role of professional identity formation in determining readiness for clinical practice. Yet, professional identity defines graduate self-perception, how others perceive them and informs clinical behaviour. The scholarship of identity formation at the transition from undergraduate to graduate is characterised by individual (cognitive) rather than relational (sociocultural) perspectives. Yet there is growing recognition that identity formation is not just individually mediated, but is also constructed between individuals and social context. The aim of this study was to explore professional identity formation among undergraduates and graduates from one healthcare profession (speech and language therapy-SLT) using a sociocultural theoretical standpoint. A qualitative descriptive methodology was used. Final (4th) year SLT undergraduate students and graduate SLTs with less than 2 years' clinical experience participated in individual semi-structured interviews. Thematic analysis was used to describe patterns in the data, which were subsequently subjected to interpretation informed by the constructs of Figured Worlds. Data analysis revealed that undergraduate professional identity was characterised by dependency, self-centredness (as opposed to patient-centredness), and a naïve role concept. Graduate identity on the other hand included expectations of self-sufficiency, patient-centredness and a more nuanced perception of the professional role. Undergraduates have naïve, prototypical understandings of what it is to be a graduate practitioner. The nature of undergraduate clinical placement hinders meaningful identity development. This suggests that curriculums should facilitate undergraduates to act with meaningful autonomy and to be positioned in more patient-centred roles, e.g. involvement in the decision-making process for patients. Graduates may then feel more authentic as autonomous professionals in their early graduate posts. This leads to better graduate, patient and service outcomes.

'It benefits patient care': the value of practice-based IPE in healthcare curriculums.

BACKGROUND: Practice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE are integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge generated important insights into how practice-based IPE is perceived. This learning can be applied, both locally and further afield, by those seeking to embed practice-based IPE in their placement curriculums. METHODS: A qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede's cultural dimensions, informed data analysis and interpretations. RESULTS: Participants are grappling to establish the value of practice-based IPE, illustrated in three themes: clarifying the concept of practice-based IPE, mapping IPE activities and diversifying interprofessionalism. First, ambiguous conceptualisation of why and how to implement practice-based IPE was identified. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve high-quality practice-based IPE. Second, the positioning of practice-base IPE in the placement curriculum was unclear. Overt mapping of practice-based IPE activities onto learning outcomes within assessment tools enhanced its value within practice education. Third, varying levels of professional engagement were noted, perpetuating stereotypes. Creating diverse educator networks and embedding practice-based IPE in organisational strategy may incentivise engagement across a greater range of professions. CONCLUSIONS: Implementing these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally.

Organization and system theories in interprofessional research: a scoping review.

In recent years, there has been an increasing impetus to define and develop theoretical foundations for interprofessional research. Currently, the theories cited in such research have often focused on individual and group learning. By comparison, organization and systems theories (OST) enable consideration of system and organization level factors. A scoping review was conducted to explore the use of OST in interprofessional research published between 2013 and 2019. Thirty-two studies were included and 13 OST were identified. Activity theory and complexity theory were the most commonly used OST. OST are relatively well integrated into data analysis and reporting of research findings, with less consideration given to how OST can support research designs. A primary reason researchers cited for selecting OST was that such theories could best reflect the complexity of interprofessional activities. OST provide a mechanism for understanding the nuances and multifactorial issues impacting interprofessional research. OST can thus address some of the challenges of introducing and sustaining interprofessional initiatives and should be further utilized within interprofessional research.

Doing interprofessional research in the COVID-19 era: a discussion paper.

The COVID-19 pandemic, and ensuing physical distancing measures, poses challenges for researchers in the field of interprofessional care. Pandemic management has highlighted the centrality of interprofessional working to effective healthcare delivery during crises. It is essential to find ways to maintain interprofessional research that has commenced, while also designing research to capture important learning from pandemic management and response. However, it also creates opportunities for new research projects and novel research designs. This discussion paper explores ways of adapting existing research methodologies and outlines potential avenues for new research. Specifically, considerations to bear in mind when designing interprofessional research during the pandemic include research ethics and integrity, research design, data collection methods, research opportunities, implications and limitations. Interprofessional research can continue to make a valuable contribution in informing global responses to COVID-19 and in planning for future global health crises. We call for, insofar as possible, for interprofessional research to continue to be developed during this time.

'Bumping along': a qualitative metasynthesis of challenges to interprofessional placements.

CONTEXT: Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. OBJECTIVES: This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. METHODS: A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage-process-product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). RESULTS: We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. CONCLUSIONS: In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice-ready workforce. This in turn will enhance service user outcomes and safety.