Undergraduate interprofessional learning in clinical practice: A collaborative approach to creating a sustainable learning environment.

Location:

When did you first introduce the innovation?

More than 24 months ago

Please describe the innovation you have developed

The project is a collaborative development between the United Lincolnshire Hospitals NHS Trust (ULHT) and eight universities across in the East Midlands Deanery. The aim of this project is to develop interprofessional learning (IPL) opportunities for undergraduate students in Pilgrim Hospital, Boston. Central to the success of this project was establishing a network of healthcare professionals from the Trust and academics from several universities across the NHS Midlands and East Deanery. This steering group promoted engagement with IPL and set the strategic direction of the project.

The project involves students from nursing, midwifery, physiotherapy, dietetics, occupational therapy and medicine. The clinical areas involved in the project are gynaecology, midwifery, stroke unit, and gastroenterology. Using the themes of dignity, communication and safeguarding, mentors and clinical supervisors have identified opportunities to facilitate IPL between different undergraduate students within the practice setting. Patient-centred learning activities were developed with opportunities for reflective discussions for students from different health professions.

Building on the success of these area clinical areas, we would like to expand the learning opportunities to other clinical areas. Other professions such pharmacy and social work students will be joining this academic year. As the project expands we have continued to maintain the support of the Director of Medical Education, the Chief Nurse and Clinical Educational Leads across the Trust.

What prompted you to develop this innovation?

IPL is an essential component of the pre-registration education of all healthcare professionals. Whilst the benefits of IPL have been widely endorsed in the literature, few studies have been implemented within the practice setting.

United Lincolnshire Hospitals NHS Trust offers placement provision for students from different professions from several universities in the NHS Midlands and East Deanery. A review of IPL provision at Pilgrim Hospital identified that no framework existed to support students from different professions to learn together whilst in clinical practice. To enable students from all healthcare professions to share the benefits of IPL this collaborate project was established.

In your view, what is it about this innovation that makes it different/important?

Literature reveals that interprofessional learning in clinical practice has not been widely implemented. It is an area which needs to be encouraged to help students to learn collaboratively whilst in practice. Collaborative practice promotes good communication and decision making that enables healthcare professionals to work together in a creative, innovative and effective manner. This project is based on the themes of dignity, communication and safeguarding. These themes are important to all healthcare professionals and have particular significance in contemporary practice as failures in communication, safeguarding and promoting patient/client dignity have been the focus of a number of recent United Kingdom Government reports e.g. Francis (2013). Fostering a culture of interprofessional working can ensure patient dignity is upheld and there is consistent agreement that effective collaboration is crucial for improving patient safety.

To what extent does your innovation make use of existing approaches, resources or technologies?

Establishing a collaborative network of academics, clinical staff and students remains one of the main strengths of the project. This network provides the opportunity to share existing resources and e-learning materials between universities and across disciplines. Examples include TIGER (2014) and other open educational resources (UoN, 2015). Through the on-going development of a learning hub on the Trust website these resources have been made available to facilitators and students. The opportunity to share e-learning materials between institutions avoids duplication of training resources and provides students with equitable access to high quality e-learning resources across the region.

To what degree has this innovation led to changes in education or clinical practice?

Within this project we have continued to build on areas of good practice and provide interprofessional learning opportunities for a range of undergraduate students allocated to Pilgrim Hospital for practice placements. The project has created an appropriate learning environment for students to develop the knowledge, skills and attitudes of collaborative interprofessional working. In addition, facilitators have demonstrated a greater awareness of the value of IPL and a renewed enthusiasm for engaging actively in IPL activities. A significant number of IPL activities have been developed and implemented in practice. Empowering facilitators and creating a culture of interprofessional learning within the clinical area has ensured the success of the project.

What evidence do you have of the impact of the innovation?

Evaluation of the project has been based on student feedback during the reflective discussion following patient-centred IPL activities. Feedback has been received from medical, physiotherapy, occupational therapy, dietetic and nursing students.

Students were asked to identify what they had learned from the IPL activities. Whilst students made specific comments that were related to their learning tasks such as positioning stroke patients and the role of the occupational therapist in patient care, they also commented on these activities from an IPL perspective. Knowledge of the roles of other healthcare professionals and the need for collaborative working to meet patients’ needs were identified as important. Students also highlighted the need for good communication between healthcare professionals and patients. Relating interprofessional approaches to issues of dignity and safeguarding enabled the students to see and value how future collaborative working practice would enhance the quality of patient care. A full evaluation of the project has been submitted for publication (Journal of Interprofessional Care).

To what degree has the innovation been disseminated in your organisation or elsewhere?

During the early stages of this project it was crucial to gain the support of stake holders within the Trust. This included all the professional leads in clinical practice and the Director of Interprofessional Learning at the co-ordinating universities. As the project developed it become clear that whilst clinical staff remained enthusiastic about the project there were some anxieties around meeting the needs of students from different professions. To address these concerns a series of facilitation workshops were planned and implemented. These workshops served as a forum to provide continued support for facilitators. Promotional materials were also produced to raise awareness of the project disseminate the finding and IPL resources.

This project won a Lord Dearing Award for Teaching and Learning from the University of Nottingham (Dearing Awards, 2014). The project was also recognised as an example of good practice and innovation by Health Education East Midlands (HEEM) in their outcomes report for healthcare education and training at Pilgrim Hospital.

Presentation and publications

  • Networking for Education in Healthcare conference (2014) Churchill College, University of Cambridge, UK
  • Royal College of Nursing (2015) Nurse Education International Forum, University of Nottingham, UK

Please provide details of any plans you have to disseminate the innovation in the future.

This continues to be an ambitious and complex project due to the number of higher education institutions involved in the project. Through the continued development of the eLearning resource hub we will continue to share open education resource with our partner institutions. Regular meetings with the Director of Medical Education, the Chief Nurse and Clinical Educational Leads across the Trust ensure key stakeholders maintain engagement with the project. Indeed, continued support from the Trust has enabled the planned expansion of the project to include Lincoln County Hospital.

A one-day conference has been planned for May 2016. The focus of the conference will be: ‘Improving patient care through interprofessional learning and collaborative practice’. This event will consist of keynote speakers, interactive seminars and plenary panel discussions. It will enable participant to share experiences of developing IPL within the practice setting and provide opportunities to expand the project to other hospitals.