2. Setting off Impetus and opportunity The art of the possible From shared learning to IPE “[There was] maybe an external driver, team work, but at the same time we introduced a common course architecture – everything went into modules, some of which could be shared across courses … so we tried for shared learning - a natural extension along with the natural environmental situation… There was also an opportunity to get funding …. Unfortunately they didn’t fund us but we decided to go ahead anyway …”

3. Keeping going “In a [faculty] board meeting, IPE sits as an agenda item so you update etc. but when you come to a sticky bit the chair will say well you need to link with programme leads to make that happen, … when you try to contact them it’s not a direct “No” but it’s as though it’s fudged to the extent that they have used their professional knowledge of their programme to be able to justify why ‘we’re already doing it’ or some other excuse – like treacle.” Getting ‘buy in’ from staff and managers Listening to students Marriages, separations, hard work (and money)

4. Shoehorning and squeezing “from uni perspective we are going from 20, 40, 80 to a 15, 30, 60 credit system to bring us in line with other unis. This is being used as a reason to examine curricula again, N&M being done first, AHPs and SW will go though this in the next 4 years” “Trying to keep going, when you’ve got so many drivers and revalidation at different points, keeping an ipe thread is problematic. You need IP champions in the curriculum, by default the module leaders become the IP champions, but you have to keep banging the ipe drum.”

5. Vulnerabilities 1: Research “We have put in some HEA bids for IPL – not successful. Got some internal funding … but other demands taken precedence over research and publications” “No one [here] doing any research into IP working” “I have been told my IP stuff won’t be entered in faculty REF because IP is not a priority for the faculty... there’s no educational research included in faculty priorities, money for our previous research came from workforce development money”

6. Vulnerabilities 2: Practice “In 2001 … we started with 5 week placements – couldn’t sustain this” “The training ward collapsed after 3 years – not sustainable from staff perspective and for students …” “It hasn’t been possible to provide IPE in practice, we want to try again, but without putting an added burden on overworked mentors” “The context out there: a very varied workforce and workers who cannot guarantee the importance of IP working; very variable quality of IP for students to learn from; complex cultural issues in work setting” “We could equip students with IP frameworks, e.g. capabilities and work with that in practice, but …managed by uni rather than practice … our documents are not that far ahead to have mentors facilitating student experience” IP practice learning:

7. Misalignments (Re)validation: “We went through every disciplines’ documents, and [IPL] is in every one but may need translating for the educators [and] … you are competing with all the other requirements in the documents.” “I’m uncomfortable in saying this but effect of staying in same revalidation process is that it was another year and a half of meetings etc to make sure validation and QAA happened …“ Assessment of students: “For some courses IPE is mandatory [re attendance] …. Each course has different approaches, different sanctions…” “OTs have competency statements re multi-disciplinary practice …but not other students, medicine have a different placement management process…”

8. Lining up Professions and faculties Regulatory requirements – Assessment – Practice learning Validation procedures and revalidation cycles Recognition (and reward) for IP facilitation Policies promoting the conditions for IPE across the UK

9. Creating, recreating and listening hard “Learning from lives shut down a few years ago due to curriculum development in the medical school. Everyone loved it but it was a fixed module that took everybody, medical students had rotations of 30, plus 200 sw twice per year. GMC increased exams and these needed to be end of 1st semester. Wanted to drop the disability content into other parts of the curriculum. But we lost it and all those involved in practice got involved in newer bits of ipe. Now looking at community hospitals for other students to join up with medics there.” An example of adapting creatively to changing curricula