Health and social care professionals' attitudes to interprofessional working and interprofessional education: A literature review.
Summary (2 min read)
Introduction
- The relationship between attitudes and behaviour is considered within the field of social psychology (Azjen & Fishbein,1977; Bem, 1970; Festinger, 1957).
- It can be argued that investigating the attitudes of health and social care teams to IPW and IPE, may provide an understanding of the value that is placed on IPW and IPE for students learning in healthcare settings.
- It is important that these issues are studied directly, within a relevant context, and from the perspective of staff working within these settings.
Methods
- A systematic search was carried out using The Cochrane Database of Systematic Reviews, Education Resources Information Centre (ERIC), MEDLINE, and the Cumulative Index to Nursing and Allied Health Literature .
- Relevant papers were also identified from a hand search of the Journal of Interprofessional Care and by interrogating references from relevant papers.
- As the turn of century was a significant turning point for IPE and IPW (Barr, Helme & D’Avray, 2011), the search focused on literature published between 2000 and 2014 .
- Table 1 provides a summary of the search strategy, including the inclusion and exclusion criteria.
- The full texts of relevant studies were accessed and interrogated using Hawker, Payne, Kerr, Hardy, and Powell’s (2002) framework for appraising research and to reviewing IPE studies where mixed methodologies were used (Ireland, Gibb, & West, 2008).
Results
- A total of 35 studies met the inclusion criteria for this review, and no studies were excluded on the basis of poor quality.
- Fourteen of these studies included health and social care staff as research participants (Table 2).
- This review was valuable in identifying two main common themes which included the effect of: professional background on attitudes to IPW and IPE previous experience of IPE on attitudes to IPW and IPE Table 2. 2012 Australia Healthcare IPE & IPW Braithwaite et al.
- Health & social care IPW Herbert et al.
Effect of Professional Background on Attitudes to IPW and IPE
- The effect of professional background on attitudes to IPW and IPE, and differences in attitudes among different professional groups was discussed by a number of studies.
- These studies were carried out in a number of different countries (Table 2), and their findings highlight that although there may be cultural differences across global healthcare teams, professional background may be a common influence on attitudes.
- The study by Wittenberg-Lyles, Oliver, Demiris, and Regehr (2010) compared health and social care professionals’ perceptions of collaboration from questionnaire responses with their observations of these professionals working together.
- In two studies in particular, IPE interventions provided during undergraduate training were assessed as a positive influence on attitudes to IPW (Pollard & Miers, 2008; Pollard et al., 2012).
Assessment of the quality of the studies
- Hawker et al., (2002) described the assessment of methodological rigor as the third and final stage of systematically reviewing research.
- By using only quantitative methods the researchers’ ability to investigate participants’ responses to questionnaires was restricted.
Discussion
- Two main common themes where identified in relation to the factors effecting attitudes to IPE and IPW from the 35 eligible studies in this review: the effect of professional background on attitudes to IPW and IPE, and the effect of previous experience of IPE on attitudes to IPW and IPE.
- Boundaries between professionals impacts on the provision of effective healthcare (Powell & Davies, 2010), and this review highlights the need for further research to investigate how professional boundaries influence attitudes to IPW and IPE.
- This further reinforces the need for further high quality research to assess the impact of different types of IPE interventions on practice (Reeves et al., 2013).
- A lack of clarity and understanding around the true concept of IPE and IPW remains in healthcare and education (Reeves, Goldman, Gilbert, Tepper, Silver, Suter and Zwarenstein, 2011) and as reported by Egan-Lee et al., (2006), experience of facilitating IPE can assist with providing this clarity.
- Two main limitations are noted in relation to the search strategy employed in this review.
Concluding comments
- There is limited evidence related to staff attitudes to IPW and the value placed on IPE for students learning in healthcare setting.
- In relation to all of the studies reviewed, professional background and prior experience of IPE were identified as two of the main factors effecting attitudes to IPW or IPE.
- Other possible influencing factors such as age, gender, professional experience and income were considered in some of the studies, although the strength of these correlations were varied and inconsistent.
- Health and social care staff play a primary role in ensuring the provision of safe, quality care to patients and carers.
- It is important that this research is carried out within a relevant context and that the chosen research design suits this context.
Declaration of interest
- The authors report no declarations of interest.
- The authors were responsible for the writing and content of this paper.
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Citations
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...18 recognised that such studies generally restricted the discussion to the impact of IPE on students’ attitudes, rather than extending the inquiry into potential mechanisms of how any recorded attitude change occurred, although more recently there has been some exploration of the cognitive, emotional and behavioural elements of attitudes (Gould et al., 2017; O’Carroll et al., 2016; Domac et al., 2015)....
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...…rather than extending the inquiry into potential mechanisms of how any recorded attitude change occurred, although more recently there has been some exploration of the cognitive, emotional and behavioural elements of attitudes (Gould et al., 2017; O’Carroll et al., 2016; Domac et al., 2015)....
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...During the process of constructing the questionnaire for this study, and considering the implications of the results, a broad selection of articles using, or reviewing, such instruments had been studied (O’Carroll et al., 2016; Kururi et al., 2014; Hayashi et al., 2012; Ateah et al., 2011; Hojat et al, 2015; Hammick et al., 2007; Mc Fayden et al., 2007; Lindqvist et al., 2005; Mc Fayden et al., 2005; Tunstall-Pedoe et al., 2003; Bronstein, 2002)....
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...I identified that although a questionnaire would not facilitate a detailed level of understanding, it might provide some initial quantitative data (O’Carroll et al., 2016)....
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References
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...(2011) adds to the body of research and builds on the findings from other studies within the field (Stake, 2005; Yin, 2003), investigating a number of different departments and using quantitative and qualitative methods of data collection is essential if the working environment is to be investigated as a variable....
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...…by Baxter and Brumfit (2008) and Egan-Lee et al. (2011) adds to the body of research and builds on the findings from other studies within the field (Stake, 2005; Yin, 2003), investigating a number of different departments and using quantitative and qualitative methods of data collection is…...
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Frequently Asked Questions (8)
Q2. What is the role of the integration of health and social care in the United Kingdom?
This integration combines the services of health boards and local councils to reduce the numbers of unecessary admissions to hospitals by providing a more coordinated, cost effective approach to the provision of quality health and social care.
Q3. What did the authors find to be the significant effect of prior IPE experience on staff?
These studies highlighted that prior uncertainties, doubt and ambiguity related to the value of IPE for students, decreased once staff experienced IPE as a facilitator.
Q4. What is the effect of previous experience of IPE on staff attitudes to IPW?
These findings suggest that a greater sense of professional identity and professional culture as well as a lack of understanding of roles and responsibilties may influences attitudes to IPW and IPE.
Q5. What is the effect of previous experience of IPE on staff?
As qualified healthcare professionals, staff with experience of IPE in their pre-qualifying training felt more prepared for IPW and had increased self-awareness of positioning in a team, compared to those without prior IPE experience (Pollard & Miers, 2008).
Q6. What other variables were considered to influence attitudes to IPE?
The effects of othervariables such as professional experience, income, job satisfaction, gender on attitudes were considered briefly by some researchers.
Q7. What influences were considered as possible influences on attitudes?
The differences in attitudes between regions and locality of hospitals was also considered as a possible influence on attitudes, although researchers acknowledged that this relationship would need to be further explored (Jové et al., 2014).
Q8. What factors were considered in some of the studies?
Other possible influencing factors such as age, gender, professionalexperience and income were considered in some of the studies, although the strength of these correlations were varied and inconsistent.