The provision of interprofessional learning (IPL) in healthcare and education promotes interprofessional teamwork which will enhance patient care quality and in turn improve health outcomes.
The World Health Organisation (WHO) Framework for Action on Interprofessional Education and Collaborative Practice (2010), states that “Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes”(World Health Organization, n.d.).
IPL can be incorporated into large group learning sessions, small group tutorials, simulations and also in a clinical setting. This write-up will be discussing IPL in a diabetes management clinic setting. In this interprofessional team model of care, different health professionals work closely together in the management of diabetes in a clinical setting.
The team includes an endocrinologist or clinical specialist in internal medicine or a family medicine physician, diabetic nurse, pharmacist, dietician and physiotherapist (Szafran et al., 2019). This setting is chosen for my write-up as it is the central tenet to optimising diabetes care which is a great challenge for both practitioners and patients who suffer from the condition.
Diabetes is a non-communicable and chronic disease that is among the priorities of the healthcare system across countries. Diabetes mellitus is a metabolic disorder, in which the metabolism of carbohydrates, fats, and proteins is disrupted due to deficiency or lack of insulin that causes various chronic complications (Kharroubi, 2015).
The roles of health professionals in this team may be exclusive or at times overlap with one another.
Clinical practitioner
The clinical practitioner acts as a consultant in bringing together input from other health professionals in the team to provide a meaningful approach to managing diabetes. Learning here takes place when one takes a role of a facilitator to mediate group dynamics and facilitate knowledge exchange between the team members.
Physiotherapist
The physiotherapist provides effective guidance in weight loss measures and increasing fitness levels in diabetic patients who most of the time are overweight or obese. The dietician plays a crucial role in drawing a practical dietary plan tailored to the patient’s lifestyle, routine and available resources.
Pharmacist
The pharmacist educates patients on adherence to therapy and revising medication lists in a timely manner to avoid medication-related complications which could be fatal.
Diabetic nurse or educator
A diabetic nurse in the team assesses the patient’s understanding of self-blood glucose monitoring and data recording. This information will be key to the joint decision which will be made at the end of the consultation session.
Promoting IPL during the learning situation
As a health professions educator and a physician running the diabetic clinic, I will promote IPL in this setting among a small group of junior doctors in the diabetic clinic in 2 ways as follows;
Role-modelling
Demonstration of interprofessional leadership by the facilitator, hereby me, can promote trust and acceptance between all the stakeholders in the setting. Role-modelling also facilitates learning through scaffolding, whereby I can highlight the various complex scenarios we encounter in diabetic care to scaffold clinical reasoning amongst junior doctors (Hall & Zierler, 2014). Apart from improving the understanding of learners, as a role model, it is important to demonstrate the importance of trust and respect for every other health professional who is involved in the clinical encounter. In the same setting, I can facilitate the encounter by clearly drawing the boundaries and stating role descriptions to the patient before beginning the clinical encounter (Suter et al., 2009).
Conduct small group teaching
Small group teaching serves as an effective method to facilitate IPL in a clinical setting by increasing the interaction between different professionals in the encounter. I can encourage IPL through small group learning by facilitating problem-solving discussions which we are encountering with the patient’s diabetic control. I can encourage active participation and engagement of team members by asking their opinion and valuable suggestions which could assist in achieving our goals with the patient. I can further extend my role here even though post-consultation periods, where we could find a moment to reflect on the case and discuss ways to improve our joint decision-making skills. As a health professions educator here, I can make the interprofessional concepts explicit at the end of the session to help learners recognise the outcomes and their achievements.
Based on the reflection I have done on the ways I would promote IPL stated above, the area in which I can improve is defining roles. ‘Role blurring’ and confusion over boundaries and responsibilities occurs often which poses a challenge in IPL. This is because the job scopes and responsibilities can seemingly overlap as all the healthcare professionals present in the encounter share the duties of providing care to the patient (Elisabeth et al., 2011). Apart from that, providing awareness and education to patients on the importance of joint decision making in their care is another area that requires much more emphasis than it already receives. The general mindset that a doctor will be leading the entire consultation process has to be changed and this requires a constant promotion of roles and responsibilities of other healthcare professionals through media and direct encounters with patients.
References:
Elisabeth, C., Ewa, P., & Christine, W. H. (2011). The team builder: The role of nurses facilitating interprofessional student teams at a Swedish clinical training ward. Nurse Education in Practice, 11(5), 309–313. https://doi.org/10.1016/j.nepr.2011.02.002
Hall, L. W., & Zierler, B. K. (2014). Interprofessional Education and Practice Guide No. 1:
Developing faculty to effectively facilitate interprofessional education. Journal of
Interprofessional Care, 29(1), 3–7. https://doi.org/10.3109/13561820.2014.937483
Kharroubi, A. T. (2015). Diabetes mellitus: The epidemic of the century. World Journal of
Diabetes, 6(6), 850. https://doi.org/10.4239/wjd.v6.i6.850
Suter, E., Arndt, J., Arthur, N., Parboosingh, J., Taylor, E., & Deutschlander, S. (2009). Role
understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care, 23(1), 41–51. https://doi.org/10.1080/13561820802338579
Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. I. (2019). Interprofessional collaboration in
diabetes care: perceptions of family physicians practising in or not in a primary health care team. BMC Family Practice, 20(1). https://doi.org/10.1186/s12875-019-0932-9
World Health Organization. (n.d.). Framework for action on interprofessional education and
collaborative practice. Retrieved 2010, from http://apps.who.int/iris/handle/10665/70185