Graduate entry doctors and nurses sharing a family study – learning, teamwork and professional identity
N.B. The information below is authored by the mini-project applicants, not by staff of the subject centre. This text represents the views and opinions of the mini-project team only, not those of the subject centre or its affiliates.
Principal investigator
Dr Paul Garrud, University of Nottingham
Full list of project partners
Chris Simpson, School of Nursing, Midwifery & Physiotherapy, University of Nottingham; Penny Furness, School of Nursing, Sheffield Hallam University; Richard Pitt, Centre for Interprofessional Education and Learning, University of Nottingham; Sharon Conroy, School of Graduate Entry Medicine and Health, University of Nottingham; Martin von Fragstein, School of Graduate Entry Medicine and Health, University of Nottingham; Julie McGarry, School of Nursing, Midwifery & Physiotherapy, University of Nottingham; Fiona Sheppard, School of Nursing, Midwifery & Physiotherapy, University of Nottingham
Topic
Graduates for the 21st century, Interprofessional education in practiceBackground
Establishment of a new graduate-entry nursing programme (GEN), based at the Derby Centre adjacent to the Graduate Entry Medicine & Health School, provided the opportunity to develop interprofessional learning and collaborative working between students of the two courses (GEM, GEN). The first fruit of this collaboration, commended by the GEN validation panel, is a Shared Family Study that extends for one year, with objectives that include teamwork,
interprofessional learning, and learning about family and community health needs, experience and health promotion. The challenge is to develop and deliver a module that reflects the needs of the students and not be tokenistic to either
professional group.
The Shared Family Study comprises the attachment of trios of students (2 GEM, 1 GEN) to families with a member who has an ongoing health condition. Over 12 months students visit their family several times, learn about the health needs and experiences of health and social care of the family and their community, research
the health statistics and services available, and develop a health promotion intervention targeted at needs in that community. There are a number of group seminars where they can share and reflect on their experiences, analyse the characteristics and needs of different families and communities, and plan subsequent visits. They will also be able to research and prepare assessed group
coursework.
This project comprises a piece of action research that will evaluate the success of this innovation and identify its strengths and shortcomings in order to aid the evolution of this and other interprofessional learning between medicine and
nursing students. Potential lessons learnt will influence the development of similar initiatives across the faculty and wider academic community. It plans to do this as a cohort study, testing and monitoring learning, personal and professional
attitudes and behaviour at three points over 12 months – at the start (autumn 2009), in the midst of the student work (spring 2010), and at the completion of the student study (autumn 2010). The approach to be employed is mixed methods, using a small number of validated questionnaires, interviews, discussion and reflection about interprofessional working as part of the course
seminars, and the formally assessed outcomes of the Shared Family Study. In more detail:-
• Questionnaires: Readiness for Interprofessional Learning (Parsell & Bligh, 1999); Demographics (Coster et al, 2008); Professional Identity (Brown et al, 1986).
• Group interviews: Sample of consenting participant families; GPs; and course tutors.
• Individual interviews: sample of consenting participant GEM & GEN students
• Seminars: reflection and evaluation of interprofessional team working during the shared family study
• Assessed learning outcomes: coursework for Shared Family Study
The research questions that this evidence will address are:-
1. How do readiness for interprofessional learning and professional identity change as a function of interprofessional learning between graduate entry medicine and nursing students?
2. What are the salient experiences, personal gains and shortcomings for students and families participating in this curricular project?
3. What characteristics (demographic, curricular, familial, community) are associated or identified as aiding or detracting from achieving its planned
outcomes?
Proposed activities
• Establishment of Centre for Interprofessional Education & Learning, University of Nottingham www.nottingham.ac.uk/ciel
• Trent Universities Interprofessional Learning In Practice project, £560k Trent Multiprofessional Deanery funded project in collaboration with Nottingham and Sheffield Hallam Universities to develop sustainable models of interprofessional learning in practice
• Development of Interprofessional Practice Learning Teams £15k funded Learning-in-Practice Nottingham Unit
• Working with GP Practices in Nottingham on the £15k EMHCWD funded Multi-Professional Learning Organisation project to create capacity for increased interprofessional learning for undergraduate health and social care groups.
• Establishment of undergraduate Interprofessional Learning sets for dietetic;
medicine, midwifery, nursing, pharmacy, physiotherapy and social work students.
• Development of Interprofessional Facilitator Training workshops
• Development and validation of GEN (Graduate Entry Nursing) Diploma, March 2009
Sept 2009
• Enrolment and induction of GEM and GEN students
October-November 2009
• 1st study point (questionnaire-based), (family visits 1 & 2; 1st shared seminar)
April-May 2010
• 2nd study point (interviews), (family visit 3; community health research; 2nd shared seminar; production of assessed coursework)
September-October 2010
• 3rd study point (questionnaires, interviews, assessment results)
October-December 2010
• Final analyses & report writing
Spring/Summer 2011
• Report, HEA Dissemination workshop, conference papers, publication of shared materials.
Proposed outcomes
The project will produce the following outcomes:-
• Curricular materials (study guide, seminar plans, assessment criteria, logistic and financial outline) for sharing with other GEM and GEN schools.
• An evaluation report to be used within the institution to guide future interprofessional developments.
• Dissemination of project results via report to HEA Centre, HEA dissemination workshop, conference presentations & posters, and journal publication.
• Evidence about the development and efficacy of shared learning, teamwork, and learning about population and family health. This will
inform the evolution of interprofessional training and how best to facilitate the learning of public health and health promotion.
• Enhanced interprofessional working and understanding of the roles and boundaries of different health and social care professionals will enhance quality of care
• Focus of patient and family centred health and social care to maximise health and health promotion
Expertise of grant holder and project team
Similar work
Relevant projects reported in the literature include Roberts et al (2000) study of shared community learning between 4th year medical students and nursing students on a community placement, Coster et al’s recent (2008) study of change in attitudes to interprofessional learning amongst students in 8 different health
professional training programmes, and Priest et al’s (2008) paper on evidence about IPL in mental health trainees. Key factors identified in this work are that the largest change in attitudes about interprofessional learning occur in the first year as a healthcare student, that clinical placements comprise one of the most important motivators, and that differences in academic level can compromise effective working together and learning from each other. Higher age has also
been reported as associated with more positive attitudes and experiences of interprofessional learning (eg Tunstall-Pedoe et al, 2003).
The Shared Family Study builds on this work by placing the project at the start of the GEM and GEN courses, basing the experience around a community placement, and, with graduate entry, involving older students and substantially greater similarity in past academic level between the students undertaking the two courses.
The University of Nottingham has recently collaborated with Sheffield Hallam University on the TUILIP (Trent Universities Interprofessional Learning in Practice) project, £560k funded by Trent Multiprofessional Deanery. This project aimed to promote interprofessional learning opportunities for students of different health
professions within a variety of practice settings. The evaluation suggested that those pilot sites in which the service users were central to the students' learning were particularly successful in meeting their objectives. For more details about this project see http://tuilip.hwb.shu.ac.uk and Armitage et al. (2008). This supports the anticipated importance of the family focus for the student groups in the proposed project.
References
Armitage, H., Pitt, R., & Connolly, J. (2008) Developing Sustainable Models of
Interprofessional Learning in Practice - The TUILIP Project. Nurs Educ Pract, 8: 276-82;
Armitage, H, Pitt, R & Jinks, A (2009) Initial findings from the TUILIP Project’, J Interprof Care, 23:1,101-3
Coster S, I. Norman, T. Murrells, et al (2008) Interprofessional attitudes amongst undergraduate students in the health professions. Int J Nurs Stud, 45: 1667-81
Jinks, A, Armitage, H, & Pitt, R (2009) A qualitative evaluation of an interprofessional learning project, Learn Health Soc Care, iFirst]
Priest H, Roberts P, Dent H, et al (2008) Interprofessional education and working in mental health: in search of the evidence base. J Nurs Man. 16:474-85.
Roberts C, Howe A, Winterburn S, Fox N. (2000) Not so easy as it sounds: a qualitative study of a shared learning project between medical and nursing undergraduate students. Medical Teacher, 22: 386-91.
Tunstall-Pedoe S, Rink E, Hilton S. (2003) Student attitudes to undergraduate interprofessional education. J Interprof Care, 17: 161-72.
Contact details
Grant holder: paul.garrud@nottingham.ac.uk,
University of Nottingham
Amount awarded: £4,987