Skip to main content

Advertisement

SpringerLink
Log in

How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory

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

Abstract

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients’ health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding ‘shared contribution’, ‘patient as key information source’ and ‘time constraints’ were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients’ voice in clinical and education processes.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Australian Government Productivity Commission. (2011). Caring for older Australians: Overview, report no. 53. Canberra. Retrieved December 10, 2014, from http://www.pc.gov.au/inquiries/completed/aged-care/report/aged-care-overview-booklet.pdf

  • Australian Medical Council. (2010). Assessment and accreditation of medical schools: Standards and procedures, 2011. Australia.

  • Barr, H. (2013). Toward a theoretical framework for interprofessional education. Journal of Interprofessional Care, 27(1), 4–9.

    Article  Google Scholar 

  • Barr (2015). Interprofessional education: The genesis of a global movement. CAIPE. Retrieved November 20, 2015, from http://caipe.org.uk/silo/files/global-ipe-2015-corrected-hb-sept–2015pdf.pdf

  • Bleakley, A., Bligh, J., & Browne, J. (2011). In S. Hamstra (Ed.), Medical education for the future: Identity, power and location, Advances in Medical Education series (Vol. 1). New York: Springer.

  • CIHC. (2010). A national interprofessional competency framework. Retrieved December 10, 2014, from http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf

  • Colthart, I., Bagnall, G., Evans, A., Allbutt, H., Haig, A., Illing, J., & McKinstry, B. (2008). The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME guide no. 10. Medical Teacher, 30(2), 124–145.

    Article  Google Scholar 

  • EBSCO Publishing. (2014). MIMS abbreviated. NSW: St Leonards.

    Google Scholar 

  • Engestrom, Y. (2008). From teams to knots: Activity-theoretical studies of collaboration and learning at work. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Engeström, Y. (2001). Expansive learning at work: Toward an activity theoretical reconceptualization. Journal of Education and Work, 14, 133–156.

    Article  Google Scholar 

  • Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., & Zurayk, H. (2010). Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756), 1923–1958.

    Article  Google Scholar 

  • Haddara, W., & Lingard, L. (2013). Are we all on the same page? A discourse analysis of interprofessional collaboration. Academic Medicine, 88(10), 1509–1515.

    Article  Google Scholar 

  • Haines, T. P., Kent, F., & Keating, J. L. (2014). Interprofessional student clinics: An economic evaluation of collaborative clinical placement education. Journal of Interprofessional Care, 28(4), 292–298.

    Article  Google Scholar 

  • Hammick, M., Freeth, D., Koppel, I., Reeves, S., & Barr, H. (2007). A best evidence systematic review of interprofessional education: BEME guide no. 9. Medical Teacher, 29, 735–751.

    Article  Google Scholar 

  • Health Workforce Australia. (2011). National health workforce Innovation and reform strategic framework for action 2011–2015. Retrieved December 10, 2014, from http://www.hwa.gov.au/sites/uploads/hwa-wir-strategic-framework-for-action-201110.pdf

  • Holmqvist, M., Courtney, C., Meilli, R., & Dick, A. (2012). Student-run clinics: Opportunities for interprofessional education and increasing social accountability. Journal of Research in Interprofessional Practice and Education, 2, 264–277.

    Google Scholar 

  • Kent, F., Drysdale, P., Martin, N., & Keating, J. L. (2014). The mixed discipline aged care student clinic: An authentic interprofessional learning initiative. Journal of Allied Health, 43(1), 51–56.

    Google Scholar 

  • Kent, F., & Keating, J. (2013). Patient outcomes from a student-led interprofessional clinic in primary care. Journal of Interprofessional Care, 27(4), 336–338.

    Article  Google Scholar 

  • Kent, F., & Keating, J. L. (2015). Interprofessional education in primary care for entry level students—A systematic literature review. Nurse Education Today, 35(12), 1221–1231.

    Article  Google Scholar 

  • Lai, F., Kent, F., & Dodic, M. (2015). Student-led interprofessional clinics may improve health management in patients with chronic disease. Medical Journal Australia, 203(10), 402.

    Article  Google Scholar 

  • Leucht, R., Madsen, M., Taugher, M., & Petterson, B. (1990). Interprofessional education perception scale. Journal of Allied Health, 19(2), 181–191.

    Google Scholar 

  • Lingard, L., McDougall, A., Levstik, M., Chandok, N., Spafford, M. M., & Schryer, C. (2012a). Representing compexity well: A story about teamwork, with implications for how we teach collaboration. Medical Education, 46, 869–877.

    Article  Google Scholar 

  • Lingard, L., Vanstone, M., Durrant, M., Fleming-Carroll, B., Lowe, M., Rashotte, J., & Tallett, S. (2012b). Conflicting messages: Examining the dynamics of leadership on interprofessional teams. Academic Medicine, 87(12), 1762–1767.

    Article  Google Scholar 

  • Miles, M., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks: Sage Publications.

    Google Scholar 

  • Parsell, G., & Bligh, J. (1999). The development of a questionnaire to assess the readiness of health care students for interprofessional learning (ripls). Medical Education, 33(2), 95–100.

    Article  Google Scholar 

  • Reeves, S., & Lewin, S. (2004). Interprofessional collaboration in the hospital: Strategies and meanings. Journal of Health Services & Research Policy, 9(4), 218–225.

    Article  Google Scholar 

  • Reeves, S., Perrier, L., Goldman, J., Freeth, D., & Zwarenstein, M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update) (review). Cochrane Database of Systematic Reviews, 3.

  • The Commonwealth of Australia. (2015). 2015 Intergenerational report Australia in 2055.

  • The Interprofessional Curriculum Renewal Consortium. (2014). Curriculum renewal for interprofessional education in health. Australia: Commonwealth of Australia, Office for Learning and Teaching.

    Google Scholar 

  • Towle, A., Bainbridge, L., Godolphin, W., Katz, A., Kline, C., Lown, B., & Thistlethwaite, J. (2010). Active patient involvement in the education of health professionals. Medical Education, 44(1), 64–74.

    Article  Google Scholar 

  • Varpio, L., Hall, P., Lingard, L., & Schryer, C. F. (2008). Interprofessional communication and medical error: A reframing of research questions and approaches. Academic Medicine, 83(10 Suppl), S76–S81.

    Article  Google Scholar 

  • World Health Organisation. (2010). Framework for action on interprofessional education and collaborative practice. Geneva.

Download references

Acknowledgments

This project received funding from the Australian Government and the Department of Health, Victoria.

Author information

Authors and Affiliations

  1. HealthPEER, Monash University, Melbourne, Australia

    Fiona Kent

  2. Department of Physiotherapy, Monash University, Melbourne, Australia

    Alison Francis-Cracknell

  3. Department of Occupational Therapy, Monash University, Melbourne, Australia

    Rachael McDonald

  4. School of Nursing and Midwifery, Monash University, Melbourne, Australia

    Jennifer M. Newton

  5. Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia

    Jennifer L. Keating

  6. Peninsula Clinical School, Monash University, Melbourne, Australia

    Miodrag Dodic

  7. Aspendale Clinic, Melbourne, Australia

    Miodrag Dodic

Authors
  1. Fiona Kent
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alison Francis-Cracknell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rachael McDonald
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer M. Newton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jennifer L. Keating
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miodrag Dodic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fiona Kent.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kent, F., Francis-Cracknell, A., McDonald, R. et al. How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory. Adv in Health Sci Educ 21, 749–760 (2016). https://doi.org/10.1007/s10459-015-9663-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10459-015-9663-4

Keywords

Search

Navigation