The experiences of pre-licensure or pre-registration health professional students and their educators in working with intra-professional teams: A qualitative systematic review
Diane Butcher, RN, MN, PhD(c); Karen MacKinnon, RN, MScN, PhD, Associate Professor, University of Victoria School of Nursing; Anne Bruce, RN, PhD, Professor, University of Victoria School of Nursing; Carol Gordon, BA, MA, MLS, PhD, Distance Education Librarian, University of Victoria; Clare Koning, RN, MN, PhD(c)
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Background: Numerous inter-professional initiatives permeate the health care landscape, requiring professionals to collaborate effectively to provide quality patient care. Little attention has been given to intra-professional relationships, where professionals within one disciplinary domain (with more than one point of entry-to-practice) collaborate to provide care. New care models are being introduced where baccalaureate and diploma students of a particular discipline (such as nursing, occupational therapy, dentistry, or physiotherapy) are working closely together in teams to deliver care. Questions thus arise as to how students and educators learn to work on intra-professional teams.
Objectives: To identify and synthesize evidence regarding experiences of pre-licensure health professional students and their educators on intra-professional teams, and to draw recommendations to enhance policy and/or curriculum development.
Types of participants: Pre-licensure students and educators, focusing on regulated health professions which have more than one point of entry into practice.
Phenomena of interest: Experiences of intra-professional team learning or teaching within various entry-to-practice categories of a particular health-related discipline.
Types of studies: The review considered qualitative studies, including but not limited to designs such as phenomenology, grounded theory, ethnography and action research.
Types of outcomes: The outcomes are in the form of synthesized findings pertaining to experiences of pre-licensure health care students and educators with intra-professional teams.
Search strategy: A comprehensive search of various databases was conducted between 2 June 2015 and 16 August 2015, and repeated in March 2016. The search considered all studies reported and published from 1 January 2001 to 7 March 2016. Only studies published in English were included in this review.
Methodological quality: Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the Joanna Briggs Institute Qualitative Assessment and Review Instrument.
Data extractio: Data were extracted using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. The data extracted included descriptive details about the phenomena of interest, populations, and study methods.
Data synthesis: Research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Study findings that were supported by the data in primary studies were organized into categories on the basis of similarity of meaning. These categories were then subjected to a meta-synthesis to produce a set of synthesized findings.
Results: Eight studies were included in the review. Sixty-eight findings were organized into nine categories based on similarity of meaning. Four synthesized findings were produced: (i) Contextual factors (including pedagogical approaches and timing of experiences) may influence experiences of intra-professional learning, (ii) Shared learning opportunities contribute to comprehensive care planning and more efficient patient care, (iii) Intra-professional learning helps to build collaborative relationships and understanding of roles, and (iv) Intra-professional learning is beneficial; however, it also created frustration for students.
Conclusions: Despite its challenges, shared learning experiences assisted students in understanding each other’s roles, develop communication and collaborative competencies, develop comprehensive care plans, provide more efficient care, and helped prepare them for their future roles as health care professionals. Various contextual elements could either hinder or facilitate shared learning experiences.
The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.
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