Skip to main content

Advertisement

Log in

Inside-out: normalising practice-based IPE

  • Published:
Advances in Health Sciences Education Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adler, P. A., & Adler, P. (1994). Observation techniques. In N. K. Denzin & Y. S. Lincoln (Eds.), Handbook of Qualitative Research (pp. 377–392). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Agreli, H., Barry, F., Burton, A., Creedon, S., Drennan, J., Gould, D., & Hegarty, J. (2019). Ethnographic study using normalization process theory to understand the implementation process of infection prevention and control guidelines in Ireland. British Medical Journal Open, 9, e029514.

    Google Scholar 

  • Anderson, E. S., & Kinnair, D. (2016). Integrating the assessment of interprofessional education into the health care curriculum. Journal of Taibah University Medical Sciences, 11(6), 552–558.

    Google Scholar 

  • Bazeley, P. (2009). Analysing qualitative data: More than identifying themes. The Malaysian Journal of Qualitative Research, 2(2), 6–22.

    Google Scholar 

  • Bhaskar, R. (2008). A realist theory of science. New York: Routledge.

    Google Scholar 

  • Boshoff, K., Murray, C., Worley, A., & Berndt, A. (2020). Interprofessional education placements in allied health: A scoping review. Scandinavian Journal of Occupational Therapy, 27(2), 80–97.

    Google Scholar 

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

    Google Scholar 

  • Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597.

    Google Scholar 

  • Brewer, M. L., & Barr, H. (2016). Interprofessional education and practice guide No. 8: Team-based interprofessional practice placements. Journal of Interprofessional Care, 30(6), 747–753.

    Google Scholar 

  • Centre for Advacement in interprfoessional education. (2017). Interprofessional education guidelines. Retrieved 4 December 2019 from: https://www.caipe.org/resources/publications/caipe-publications/caipe-2017-interprofessional-education-guidelines-barr-h-ford-j-gray-r-helme-m-hutchings-m-low-h-machin-reeves-s.

  • Dalhousie University. (2020). Interprofessional education: Curriculum requirements. Retrieved 10 October 2020 from: https://www.dal.ca/faculty/interprofessional-education/programs---initiatives/curriculum-requirements.html.

  • Davis, J. M., Janczukowicz, J., Stewart, J., Quinn, B., & Feldman, C. A. (2018). Interprofessional education in dental education: An international perspective. European Journal of Dental Education, 22(S1), 10–16.

    Google Scholar 

  • de Brún, T., O’Reilly-de Brún, M., O’Donnell, C. A., & MacFarlane, A. (2016). Learning from doing: The case for combining normalisation process theory and participatory learning and action research methodology for primary healthcare implementation research. BMC Health Services Research, 16, 346–346.

    Google Scholar 

  • Domac, S., Anderson, E. S., & Smith, R. (2016). Learning to be interprofessional through the use of reflective portfolios? Social Work Education, 35(5), 530–546.

    Google Scholar 

  • El-Awaisi, A., Anderson, E., Barr, H., Wilby, K. J., Wilbur, K., & Bainbridge, L. (2016). Important steps for introducing interprofessional education into health professional education. Journal of Taibah University Medical Sciences, 11(6), 546–551.

    Google Scholar 

  • Fenwick, T., Nerland, M., & Jensen, K. (2012). Sociomaterial approaches to conceptualising professional learning and practice. Journal of Education and Work, 25(1), 1–13.

    Google Scholar 

  • Fletcher, A. J. (2017). Applying critical realism in qualitative research: Methodology meets method. International Journal of Social Research Methodology, 20(2), 181–194.

    Google Scholar 

  • Fraher, E., & Brandt, B. (2019). Toward a system where workforce planning and interprofessional practice and education are designed around patients and populations not professions. Journal of Interprofessional Care, 33(4), 389–397.

    Google Scholar 

  • Gear, C., Eppel, E., & Koziol-Mclain, J. (2018). Advancing complexity theory as a qualitative research methodology. International Journal of Qualitative Methods, 17, 1–10.

    Google Scholar 

  • Gillespie, B. M., Harbeck, E., Lavin, J., Gardiner, T., Withers, T. K., & Marshall, A. P. (2018). Using normalisation process theory to evaluate the implementation of a complex intervention to embed the surgical safety checklist. BMC Health Services Research, 18(1), 170.

    Google Scholar 

  • Herath, C., Zhou, Y., Gan, Y., Nakandawire, N., Gong, Y., & Lu, Z. (2017). A comparative study of interprofessional education in global health care: A systematic review. Medicine, 96(38), e7336.

    Google Scholar 

  • Holtrop, J. S., Potworowski, G., Fitzpatrick, L., Kowalk, A., & Green, L. A. (2016). Effect of care management program structure on implementation: A normalization process theory analysis. BMC Health Services Research, 16(1), 386.

    Google Scholar 

  • Institute of Medicine. (2015). Measuring the impact of interprofessional education on collaborative practice and patient outcomes. Washington, DC: National Academies Press.

    Google Scholar 

  • Kawulich, B. (2005). Participant observation as a data collection method. Forum: Qualitative social research, 6(2), Art. 43.

  • Khalili, H., Thistlethwaite, J., El-Awaisi, A., Pfeifle, A., Gilbert, J., Lising, D., . . . Xyrichis, A. (2019). Guidance on global interprofessional education and collaborative practice research: Discussion paper. Retrieved on 29 December from: www.research.interprofessional.global.

  • Kreuter, M. W., De Rosa, C., Howze, E. H., & Baldwin, G. T. (2004). Understanding wicked problems: A key to advancing environmental health promotion. Health Education & Behavior, 31(4), 441–454.

    Google Scholar 

  • May, C., & Finch, T. (2009). Implementing, embedding, and integrating practices: An outline of normalization process theory. Sociology, 43(3), 535–554.

    Google Scholar 

  • May, C., Finch, T., Mair, F., Ballini, L., Dowrick, C., Eccles, M., & Heaven, B. (2007). Understanding the implementation of complex interventions in health care: The normalization process model. BMC Health Services Research, 7(1), 148.

    Google Scholar 

  • McHugh, S. K., Lawton, R., O’Hara, J. K., & Sheard, L. (2020). Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? A systematic review and narrative synthesis. BMJ Quality & Safety, 29(8), 672–683.

    Google Scholar 

  • Morphet, J., Hood, K., Cant, R., Baulch, J., Gilbee, A., & Sandry, K. (2014). Teaching teamwork: An evaluation of an interprofessional training ward placement for health care students. Advances in Medical Education and Practice, 25(5), 197–204.

    Google Scholar 

  • Novak, R. E., Cantu, A. G., Zappler, A., Coco, L., Champlin, C. A., & Novak, J. C. (2016). The future of healthcare delivery: IPE/IPP audiology and nursing student/faculty collaboration to deliver hearing aids to vulnerable adults via telehealth. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 1(1), 1–11.

    Google Scholar 

  • O’Leary, N., Salmon, N., Clifford, A., O’Donoghue, M., & Reeves, S. (2019). ‘Bumping along’: A qualitative metasynthesis of challenges to interprofessional placements. Medical Education, 53(9), 903–915.

    Google Scholar 

  • O’Leary, N., & Boland, P. (2020). Organization and system theories in interprofessional research: A scoping review. Journal of Interprofessional Care, 34(1), 11–19.

    Google Scholar 

  • Olenick, M., Allen, L. R., & Smego, R. A., Jr. (2010). Interprofessional education: A concept analysis. Advances in Medical Education and Practice, 1, 75–84.

    Google Scholar 

  • Parker-Jenkins, M. (2018). Problematising ethnography and case study: Reflections on using ethnographic techniques and researcher positioning. Ethnography and Education, 13(1), 18–33.

    Google Scholar 

  • Rees, C. E., Crampton, P., Kent, F., Brown, T., Hood, K., Leech, M., & Williams, B. (2018). Understanding students’ and clinicians’ experiences of informal interprofessional workplace learning: An Australian qualitative study. British Medical Journal Open, 8(4), e021238.

    Google Scholar 

  • Reeves, S. (2008). Planning and implementing a collaborative clinical placement for medical, nursing and allied health students: A qualitative study. Medical Teacher, 30(7), 699–704.

    Google Scholar 

  • Reeves, S., Fletcher, S., Barr, H., Birch, I., Boet, S., Davies, N., & Kitto, S. (2016). A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical Teacher, 38(7), 656–668.

    Google Scholar 

  • Roberts, C., & Kumar, K. (2015). Student learning in interprofessional practice-based environments: What does theory say? BMC Medical Education, 15(1), 211.

    Google Scholar 

  • Salsberg, J., Parry, D., Pluye, P., Macridis, S., Herbert, C. P., & Macaulay, A. C. (2015). Successful strategies to engage research partners for translating evidence into action in community health: A critical review. Journal of Environmental and Public Health, 1–15.

  • Sargeant, J. (2009). Theories to aid understanding and implementation of interprofessional education. Journal of Continuing Education in the Health Professions, 29(3), 178–184.

    Google Scholar 

  • Skinner, K., Robson, K., & Vien, K. (2020). Interprofessional education: A unique approach to addressing the challenges of student assessment. Journal of Interprofessional Care. https://doi.org/10.1080/13561820.2020.1780202.

    Article  Google Scholar 

  • Smith, B., & McGannon, K. R. (2018). Developing rigor in qualitative research: Problems and opportunities within sport and exercise psychology. International Review of Sport and Exercise Psychology, 11(1), 101–121.

    Google Scholar 

  • Steven, K., Howden, S., Mires, G., Rowe, I., Lafferty, N., Arnold, A., & Strath, A. (2017). Toward interprofessional learning and education: Mapping common outcomes for prequalifying healthcare professional programs in the United Kingdom. Medical Teacher, 39(7), 720–744.

    Google Scholar 

  • Taylor, C., Angel, L., Nyanga, L., & Dickson, C. (2017). The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students. Journal of Clinical Nursing, 26(19–20), 3099–3110.

    Google Scholar 

  • Thistlethwaite, J. E. (2015). Interprofessional education: Implications and development for medical education. Educación Médica, 16(1), 68–73. https://doi.org/10.1016/j.edumed.2015.04.007.

    Article  Google Scholar 

  • Varpio, L., Aschenbrener, C., & Bates, J. (2017). Tackling wicked problems: How theories of agency can provide new insights. Medical Education, 51(4), 353–365.

    Google Scholar 

  • Varpio, L., Paradis, E., Uijtdehaage, S., & Young, M. (2020). The distinctions between theory, theoretical framework, and conceptual framework. Academic Medicine, 95(7), 989–994.

    Google Scholar 

  • Weiss, K. B., Passiment, M., Riordan, L., & Wagner, R. (2019). Achieving the Optimal Interprofessional Clinical Learning Environment: Proceedings from an NCICLE symposium. Retrieved 25 September 2020 from: https://nexusipe-resource-exchange.s3-us-west-2.amazonaws.com/1071%20NCICLE%20IP-CLE%20SymPro%20Booklet-DIGITAL%20FINAL.pdf?Eyg9apfDm7B0dnhB_vK53sVbonpDkcm5.

  • World Health Organisation. (2010). Framework for Action on interprofessional Education & Collaborative Practice. Geneva: World Health Organisation.

Download references

Acknowledgements

The authors would like to thank Dr Louise Larkin, Dr Jon Salsberg and Ms Joanne Mannion for reviewing earlier drafts of this paper.

Funding

Scholarship held by the first author at the School of Allied Health, University of Limerick, Ireland.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Noreen O’Leary.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 16 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

O’Leary, N., Salmon, N. & Clifford, A.M. Inside-out: normalising practice-based IPE. Adv in Health Sci Educ 26, 653–666 (2021). https://doi.org/10.1007/s10459-020-10017-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-020-10017-8

Keywords

Navigation