Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Chapter 6 Interprofessional learning within a practice environment 1

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Learning outcomes Discuss the developments in interprofessional learning. Understand situated learning theory. Create a learning environment within which effective interprofessional learning can take place. Critically appraise the concept of interprofessional mentorship. 2

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Drivers for interprofessional learning 1.The voice of the patient 2.Policies and initiatives 3.Poor collaborative practice 1.Professional developments 2.Technological developments 3

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Policies and initiatives The NHS Plan – A Plan for Investment, a Plan for Reform (Department of Health, 2000) Collaboration between the NHS, HEI’s and regulatory bodies to make preregistration training more flexible and a core curriculum for common foundation programmes Designed to promote partnership at all levels, to ensure seamless patient-centred care Core curriculum to include communications skills, and the NHS principles and organization. Commitment to providing pre-registration interprofessional education programmes for health and social care professionals 4

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Policies and initiatives Working Together, Learning Together: A Framework for Lifelong Learning for the NHS (Department of Health, 2001) All universities in England offering preregistration professional education programmes should include common learning by

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Policies and Initiatives The Knowledge and Skills Framework (NHS KSF) and the Development Review Process (Department of Health, 2004) Creating an Interprofessional Workforce: An Education and Training Framework for Health and Social Care in England (Department of Health, 2007) The Creating an Interprofessional Workforce: An Education and Training Framework for Health and Social Care in England (Department of Health, 2007) High Quality Workforce: NHS Next Stage Review (Department of Health, 2008) 6

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Regulatory bodies and interprofessional learning Programme providers must ensure that students have the opportunity to learn with, and from, other health and social care professionals NMC (2010, p. 75) Successful interprofessional learning can develop students’ ability to communicate and work with other professionals, potentially improving the environment for service users and professionals HPC (2009, p. 40) Demonstrate that all students undertake specific learning and assessment in partnership working and information sharing across professional disciplines and agencies Department of Health (2002, p. 4) Medical schools must ensure that students work with and learn from other health and social care professionals and students. GMC (2009, p. 52) 7

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Learning theories and interprofessional education Two categories: 1.Those that focus on the individual, for example constructivist and behaviourist approaches. 2.Those that view learning as a collective process, for example social constructivism. 8

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Social constructivist theories Activity theory In this theory the learner is not simply socialized into the knowledge held by the community or activity in a passive manner. The learner’s participation acts as a disturbance to an already unstable system that offers collaborative knowledge production over a period of time. 9

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Engeström’s (2001) Activity Theory 10

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Engeström’s (2001) activity theory Relationship between and within each activity system that makes this learning theory ideal to use in interprofessional education. This model of learning tells us how new knowledge is produced and held collaboratively in inherently unstable, complex systems, such as those found in health and social care. 11

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Social constructivist theories Situated learning Lave and Wenger (1991) are key proponents in the field of situated learning. Evolved from the historical forms of apprenticeship, whereby students spent a considerable period of time, usually five years, learning their craft from a ‘master’. This form of training focuses on the gradual acquisition of craft knowledge through demonstration and practice, with feedback. 12

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Situated learning Central to Lave and Wenger’s (1991) theory is a process called ‘legitimate peripheral participation’. Complex term and best understood by considering the three components of this phrase separately. All three components depend on each other: 1.It is legitimate because everyone involved accepts the position of learners/new team members/newly qualified practitioners as potential members of the community of practice. 2.Peripheral because the ‘potential’ members of the community of practice are initially observing practice from the periphery on the edge, before gradually becoming more and more involved with the practices of the community. 3.Participation because it is through ‘doing’ that they acquire knowledge. Knowledge is situated within the community of practice, rather than something that exists in textbooks. 13

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Situated Learning Key features of a community of practice are: Communities of practice are everywhere – at home, at work, at university. We all belong to a number of them. Communities of practice are informally bound by what they do together and by what they have learned through their mutual engagement in these activities. Communities of practice develop around things that matter to people. The practices of a community reflect the members’ own understanding of what is important. Communities of practice are defined by what the community is about; how it functions and what capability it has produced. 14

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Frameworks for learning Critical appreciation Cooperative learning Collaboration Coaching Reflection Narratives 15

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Key Points of a situated learning environment Fosters the development of lifelong learning skills. Situated learning and teaching strategies include: critical appreciation; cooperative learning; collaboration; reflection; coaching and narrative. Learning takes place in the zone of proximal development through interactions between a newcomer and an old-timer. Learner and the facilitator are actively involved in and jointly manage the responsibility for learning. Situated learning techniques take more time and effort for both the learner and facilitator. 16

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 What is mentoring? The process whereby an experienced, highly regarded, empathic person (the mentor), guides another individual (the mentee) in the development and re-examination of their own ideas, learning and personal and professional development. The mentor, who often, but not necessarily, works in the same organization or field as the mentee, achieves this by listening and talking in confidence to the mentee. Oxley (1998, cited in BMA, 2004, p. 3) ….. listening with empathy, mutually sharing experiences, professional friendship, developing insight through reflection and being a sounding board. Clutterbuck (2004) 17

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 What is the role of a mentor? 18 Role model Teacher Guide/supervisor Assessor

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 What is interprofessional mentorship? Occasions when a health or social care professional facilitates interprofessional learning and supervises and assesses students in the practice setting. Marshall and Gordon (2005, p. 39) Learning that takes place between providers and students, who are from different disciplines or health professions. Lait et al. (2011, p. 211) 19

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 What is the role of an interprofessional mentor? The primary roles of an interprofessional mentor are the same as those of a uniprofessional mentor. These are: facilitation of learning supervision and assessment. The application of these roles, however, would be related to the learner’s interprofessional learning outcomes. 20

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Interprofessional Learning Outcomes Interprofessional Capability Framework (CUILU, 2004) Framework is divided into four domains: 1.collaborative working 2.reflection 3.cultural awareness and ethical practice 4.organizational competence. Each domain contains three levels of learning that lead incrementally to achieving the capability. 21

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 Interprofessional learning outcomes Interprofessional Competency Framework (CIHC, 2010) Framework has six domains: 1.Role clarification 2.Patient/client/family/community-centred care 3.Team functioning 4.Collaborative leadership 5.Interprofessional communication 6.Interprofessional conflict resolution These six domains emphasize the knowledge, skills, attitudes and values that are essential for interprofessional collaborative practice. 22

Jane Day, Interprofessional Working: An Essential Guide for Health & Social Care Professionals 2/e Nursing and Health Care Practice Series © Cengage Learning EMEA 2013 What have you learnt? Try answering the following questions: 1.What are the key features of a community of practice? 2.List the key points of situated learning theory. 3.What are the key features of a situated-learning environment? 4.What is the role of an interprofessional mentor? If you can’t answer any of the above read Chapter 6 and/or review this PowerPoint presentation. 23