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Nurse Education in Practice 12 (2012) 1–2

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Nurse Education in Practice

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Guest Editorial

Interprofessional education: Innovation in action

This Editorial Review focuses on the experiences of lecturers atThe University of Nottingham in developing an interprofessionallearning (IPL) initiative jointly between graduate entry to nursing(GEN) and graduate entry to medicine (GEM) programmes. Wediscuss the underpinning rationale for the development of thisIPL initiative and reflect on our experiences and some of the chal-lenges to date.

Background

Interprofessional learning (IPL) now occupies a prominent placewithin the discourse surrounding nurse education and is perceivedas having a significant role to play in promoting collaborativeworking across health and social care professions. Whilst therehas been some recognition of the value of IPL at both nationaland international levels for some time (World Health Organisation,1978; Department of Health, 1999; Department of Health, 2000a,b;World Health Organisation, 1988) more recent documents haveraised the profile of IPL explicitly in terms of its significance forprofessionals in developing understanding of each other’s rolesand responsibilities and to facilitate skill acquisition as a foundationfor collaborative working (Morison et al., 2010) with the aim ofenhancing the quality and safety of care. For example, the WorldHeath Organisation (WHO) published a Framework for Action onInterprofessional Education (World Health Organistion, 2010)which advocates the introduction of interprofessional educationinto all health related educational programmes. Furthermore, inthe United Kingdom (UK) the Creating an Interprofessional Work-force Executive Summary Report (Department of Health, 2007)suggests IPL as providing a way forward to develop a more collab-orative patient centred approach to working in health and socialcare by making the optimum use of skills with the ultimate inten-tion of improvements in care delivery. From a practice perspectivethe drive towards improved collaboration between professions canbe attributed in part to a need to reduce serious untoward incidentsin both children (Department of Health, 2003) and adult services(The Murder of Steven Hoskins, Serious Case Review, CornwallAdult Protection Committee, 2007).

Whilst the literature highlights some confusion in defining IPL,Barr (2005 p. 7) suggests that this encompasses situations wherepeople from at least two professional backgrounds learn “with,from and about one another to improve collaboration and thequality of care”. In the UK, the development of IPL is further sup-ported by organisations such as the Centre for InterprofessionalLearning (CAIPE) and the Higher Education Authority (HEA).

In light of this growing body of literature and evidence associ-ated with promoting the inclusion of IPL in health and social care

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programmes universities are increasingly looking to introduceand improve opportunities for Interprofessional learning withinnursing curricula. However, while the theory of introducing IPLinto curricula is acknowledged, the reality is not without its chal-lenges. For example, Freeth (2001) highlights the difficulties insustaining IPL particularly with regards to funding and resources.Furthermore, we would argue that IPL is about more than merelylearning in the classroom, it requires an integrated approach whichencompasses an experiential practice focus (Morison et al., 2003)and it is this aspect that presents a greater challenge.

At the University of Nottingham the recognition and develop-ment of IPL is promoted and supported through the Centrefor Interprofessional Learning (CIEL) and a range of strategieshave been adopted in both pre and post registration nursingprogrammes.

With the development of a new pre-registration programme(the GEN programme) however came an opportunity to developfrom inception a specifically designed and embedded practice ledIPL initiative which we have called the Shared Family Study (SFS).

The opportunity to develop the SFS arose from a vision and will-ingness for collaboration between both graduate entry courseswithin the School of Medicine and the Division of Nursing withinthe School of Nursing, Midwifery and Physiotherapy. Whilst theGraduate Entry to Medicine (GEM) course already incorporateda Community Follow Up (CFU) project, which involved studentsvisiting an individual patient in their home this was based ona uni-professional initiative whereas Tomorrow’s Doctors(General Medical Council, 2009) advocate IPL as a feature ofmodern medical education. It therefore seemed timely to developa more holistic, public health and family centred approachinvolving interprofessional perspectives to working from thesetwo disciplines.

Whilst the most appropriate time to introduce interprofessionallearning into curricula is a subject of debate (Leaviss, 2000; Barrand Ross, 2006) the SFS runs over the first year of both the Univer-sity of Nottingham GEN programme and the Graduate Entry toMedicine (GEM) programme. The structure and aims of the SFSwere developed jointly between the GEN and GEM teams. Theproject aims to improve students’ understanding about the effectsof illness, develop critical thinking about care and the evidenceunderpinning that care. Integral to the initiative is the developmentof an understanding of working with other professionals andagencies and development of the core knowledge and skillsrequired to foster collaborative working and problem solving.

Morison et al. (2003) argue that students prefer a mixture oflearning in the clinical setting and in the classroom, and the SFSaccounts for this by incorporating learning opportunities in both

Guest Editorial / Nurse Education in Practice 12 (2012) 1–22

the academic and community practice setting. During the first fewweeks of their respective courses, students attend an introductorylecture inwhich an overview of the project is provided and studentresponsibilities outlined. At the end of the lecture, the students arethen teamed into interprofessional learning sets of three and eachset is assigned to a family who meets specific selection criteriaand where consent for involvement in the SFS initiative has beengiven. Suitable criteria for inclusion encompass one of the following;those families where a member has a chronic condition, life threat-ening condition but with a reasonable prognosis, complex socialproblems, or where there is multiple agency working. The studentsthenhave contactwith familymembers over a periodof theyear andmay see them in the home, hospital or other organisational setting.Resources are provided to each student in the form of a guide bookand a diary inwhich to record their anonymised contacts and reflec-tions. During the project, the students are asked towork together asa group and to complete four key tasks as an integrated learning set.

Further support is provided in the academic setting by atten-dance at two facilitated seminars during the course of the year.The aim of these is to enable students to reflect and share theirexperiences with a small group of three learning sets. The studentsare also encouraged to discuss progress with their tasks and thefacilitators are able to offer guidance in developing these.

The fourth and final task of the study requires each learning setto focus on a particular aspect of the family’s health, develop andsubmit an abstract and then to produce a poster which is assessedby members of the GEN and GEM team. The SFS culminates ina conference when the students in their learning sets present thefindings of their work in respect of a selected aspect of their family’shealth.

It is anticipated that the experience of working together willenable students to gain an in depth understanding of each other’sroles and it is intended that this will enhance communication, dia-logue and recognition of skills and respective roles and expertise(Sherwood and Drenkard, 2007) which will ultimately promoteand sustain more effective interprofessional working within thepractice setting in their future careers.

The first cohort of students have recently completed the SFS andwe are currently in the process of formally evaluating this initiative.Informal feedback from all students has been positive and theconference has provided the opportunity to see how much theyhad gained from working through the project together.

The SFS has also been a learning experience for all staff involvedfrom both nursing and medicine as we have also negotiated ourown roles and learned about working with each other acrossfaculty in a collaborative way, negotiating timetables, developingteam teaching initiatives and jointly assessing work. As academic

staff across faculty we have also identified there are challengesassociated with such an initiative in terms with developing ourown understanding of each other’s professional backgrounds andagendas as well as the policies and frameworks which guide ourrespective courses. Our experience however has been extremelypositive and wewould argue that IPL is an essential part of contem-porary nursing curricula and one which we have developedthrough a novel approach to learning with our colleagues atNottingham.

References

Barr, H., 2005. Interprofessional Education, Today, Yesterday and Tomorrow:a Review. Higher Education Academy, United Kingdom.

Barr, H., Ross, F., 2006. Mainstreaming interprofessional education: a position paper.Journal of Interprofessional Care 20 (2), 96–104.

Cornwall Adult ProtectionCommittee, 2007. TheMurderof StevenHoskins SeriousCaseReview. http://db.cornwall.gov.uk/documents/dwonload.aspx?doc¼260425(accessed 11.01.11.).

Department of Health, 2007. Executive summary of creating an interprofessionalWorkforce-an education and training framework for health and social care inEngland. Department of Health, United Kingdom.

Department of Health, 2003. The Victoria Climbie Inq uiry. Department of Health,United Kingdom.

Department of Health, 2000a. Consultation Document of the Review of WorkforcePlanning A Health Service for All the Talents. Department of Health, UnitedKingdom.

Department of Health, 2000b. The NHS Plan: a Plan for Investment, A Plan forReform. Department of Health, United Kingdom.

Department of Health, 1999. Saving Lives: Our Healthier Nation White Paper andReducing Health Inequalities: An Action Report.

Freeth, D., 2001. Sustaining interprofessional collaboration. Journal of Interprofes-sional Care 15 (1), 37–46.

General Medical Council, 2009. Tomorrow’s Doctors London. General MedicalCouncil.

Leaviss, J., 2000. Exploring the perceived effect of an undergraduate multiprofes-sional education intervention. Medical Education 34, 483–486.

Morison, S., Boohan, M., Jenkins, J., Moutray, M., 2003. Learning in Health and SocialCare 2 (2), 92–104.

Morison, S., Johnston, J., Stevenson, M., 2010. Preparing students for interprofes-sional practice: exploring the intrs-personal dimension. Journal of Interprofes-sional Care 24 (4), p412–421.

Sherwood, G., Drenkard, K., 2007. Quality ad safety curricula in nursing education:matching practice realities. Nursing Outlook 55, 151–155.

World Health Organisation, 1988. Learning to Work Together for Health Geneva.World Health Organisation.

World Health Organisation, 2010. Framework for Action on Interprofessional Educa-tion Geneva. World Health Organisation Press.

Christine Simpson*, Julie McGarryDivision of Nursing, School of Nursing, Midwifery and Physiotherapy,

University of Nottingham, Nottingham, UK

* Corresponding author.E-mail address: chris.simpson@nottingham.ac.uk (C. Simpson).