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Student no.

: 09018509 Briefing Paper 1

Interprofessional Module 3

This briefing paper is about the importance of professionals role differences in an interprofessional team with the constraints they have in terms of time and other responsibilities to provide quality care. The demands of patients are steadily evolving and due to this the call for flexibility and expectancy from professionals are increasing (DoH, 2010; Skills for Health, 2006). Professionals have to possess knowledge and ability to distinguish a professional from another to be able to work in a team effectively (Baxter et al, 2008). Jefferey et al (2005) emphasises this idea by expressing his belief in sharing knowledge and understandings between team members. Consequently, role delegation will be more effective thus the care that will be provided will be efficient. However, according to the research by Pethybridge (2004), there are times when professionals are pressured into providing immediate care without any proper consultation with the rest of the team. A study conducted by Davoli and Fine (2004) shows that effective interprofessional working is also about where the professionals see themselves. It can be as part of their profession or primarily as part of a team. As well as this, organisational factors such as the frequency of team meetings and the size of the team as one of the factors behind the provision of quality care (Pellatt, 2005). Equally, the exchange of knowledge and skills between professionals may alleviate any role blurriness between team members (D Amour & Oandasan, 2005). Alongside all the points that have been underlined above, the issue about power and hierarchy still pose a problem. The medical role seemed to be closely linked to this issue and decision-making (Hugman, 2003). This may be for the reason that of when a patient gets admitted, they are automatically put under the care of the consultant. But this has not always been the case with non-medical professionals reaching an agreement between themselves that might influence the decision being made. This is supported by Payne (2000) by stating that power is merely a perception not certainty. This issue might be confused with leadership. Vroman and Kovachich (2002) define a leader as the one responsible in facilitating processes, focusing the team and structuring goals. It can be argued that a properly led team is better than a hierarchy. This is supported by Entwistle & Watt (2006) by stating that the final decision would be moulded by the whole team using their own knowledge and skills 1

Student no.: 09018509

Interprofessional Module 3

given that everything was based on the best interest of the patient and the patient provided consent. In conclusion, all the elements that have been identified above have to be taken into consideration when structuring an interprofessional team. This will result to the patient getting all their needed care at a high standard of quality. This might not always seem to be the case however due to the said constraints in the beginning of the paper. Further studies about achieving an effective interprofessional team are still required. Although, getting all the features said above are vital to the success of an interprofessional team and the services that they will provide.

Briefing Paper 2 In this briefing paper, I am going to further look at the importance of professionals role differences in an interprofessional team with the constraints they have in terms of costs and other responsibilities to provide quality care. Professional practice involves complex clinical reasoning (Higgs & Jones, 2000) and encompasses implicit knowledge (Rogers, 2004). These elements are under professional differences. Professional role differences are about changing healthcare professionals traditional roles in order to promote collaborative working. This is inevitable as policies and legislations are constantly changing (Skills for Health, 2006). However, according to Baxter et al (2008), there is lack of clarity as to how these changes can affect how professionals work and provide care. They did a study about role differences in healthcare. This study showed a variety of themes. Focusing more on the aim of this paper, themes such as role substitution, professional identity within the team and role boundaries came up. This shows that every professional is different in terms of their perception of boundaries between professionals. These rooted boundaries may have most likely been formed during the socialisation process of their training which solidified their unique philosophical approaches supporting their profession (Fitzsimmons & White, 1997; and Hall, 2005). These themes may make it difficult for professionals to work effectively with the current changes the health service is undergoing giving professionals extra pressure to work more efficiently. A recent 2

Student no.: 09018509

Interprofessional Module 3

survey of the National Health Service executives showed that patient care is suffering as a result of cost-cutting (Laurence, 2006). But with the right elements in hand, it will make significant influence in staff functioning. With reference to Baxter et als (2008) study, own professional knowledge and skills and also professional role and identity may affect how successful an interprofessional team can be. Drawing from my own experience, a lot of nurses have extended roles which therefore made them relatively useful in an interprofessional team; but this has its disadvantages such as not being able to provide all of your responsibilities with regards to patient care within the set time frame the team has agreed upon. Again, this will have an impact on costs. Another aspect of professional differences is power and status. Payne (2000) defines power as an awareness not reality. This is most apparent in an acute setting when a patient is under the care of the consultant which automatically gives the medics the decision-making power. Loxley (1997) applied several theories of joint working into this and it proved to be quite difficult to identify any benefits from the abrasion of the status and power of medical professionals. A study carried out by Cook et al (2001) about decision-making in secondary care. This study showed that nurses are developing in primary care in terms of what they do and how they can influence decisions being made about their patients. This indicates that the issue of power and status in primary care is less evident. However, this study also showed that although General Practitioners (GP) appreciate the improved contribution from nurses and other professionals, some GPs had difficulties accepting the power redistribution between the team. Due to this, tensions arose between team members. But, provided that teams are able to overcome barriers with regards to power and status, it proved that they can focus on identifying patient needs and structure a patient-centred care. In association with the constraints put on professionals, trying to sway decisions about patient care can be quite difficult especially to professionals reluctant to grip the idea of joint working. Consequently, patient may receive care that they do not necessarily need or they might not even receive care that they actually need. It may also be that they are receiving all the care that they require but not in the standard that the government expects. In conclusion, the subject of role differences is an area that needs to be further studied as, basing it from this paper, will have a significant impact on the 3

Student no.: 09018509

Interprofessional Module 3

effectiveness of an interprofessional team. During this process, issues may arise that needs addressing as well. Barriers that have been identified throughout this paper has to be taken into consideration to improve joint working and to be able to achieve outcomes set within the team whilst ensuring that the services being and will be provided is in high quality. This, however, does not warrant complete success because, as stated above, cutting costs within the health service is the main problem at present. Thus may hinder any process on going or any outstanding research to carry out to better collaborative working.

Main Critique: Hannah This briefing paper provided sound knowledge regarding the decision-making process of a team and how hierarchy and shared power affect interprofessional teams. Its aims were clearly stated at the beginning of the paper which helps readers to foresee what the paper is about. It was clearly structured in terms of introducing facts into the paper. For example, when talking about decision making, it firstly defined what it is and then went into its implications to practice while reflecting it into personal experience. This was very helpful as readers may able to create their own picture of the chosen subject. Ethical implications and confidentiality were considered as no patient name was mentioned. Although, there was not an account of this but expected due to the limited word count. After this, the author went into explaining another point. This shows that the author considered the flow of topics within the paper. However, the topics that were discussed in this essay do not particularly answer the trigger question proposed. The author did not associate chosen areas of interprofessional working to the economic constraints professionals are experiencing. The author could have linked how the pressure of making decisions fast to be able to discharge patients faster; or how sharing power between professionals in a team can help alleviate constrictions put on them. The author showed skills of analysis throughout this paper. For example, when talking about shared power, the author talked about its advantages and disadvantages and then discussed factors that can hinder its process. Afterwards, the author proposed ideas that can overcome the barriers identified. The presence of

Student no.: 09018509

Interprofessional Module 3

analysis showed that the author was unbiased and tried to look at all perspectives of an area to be able to provide readers thoughts into the subject. The author did not state whether there are any further research needed or if there are any gaps in literature that can help professionals to gain better knowledge in effective team working considering the barriers that have been highlighted. If this was provided, it may make readers look if there are any available researches present to be able to expand their understanding about this subject. Although, a discussion of the findings value in practice is present in the paper. The author provided a reference list with accurate Harvard Referencing. The author also used a range of resources. However, more references and more recent resources could have been used to explore areas which may help with discussion and further analysis to provide readers better quality information. For example, the subject of transferring information between professionals in a big time was touched upon. The author could have looked further into this in terms of how professionals can overcome it and then, linking it to the economic constraints. This will then answer the trigger question. All the sections in this paper are consistently relevant to the topic of the paper. Overall, this paper provided good amount and quality information; and analysis to give its readers an adequate insight of problems and potential ways to effectively work as a team. It was definitely worth a read.

Team contract contribution: As agreed during our initial meeting with the rest of the group, the points that have been made to structure this contract were all reasonable and valid. However, I suggest adding another point and this is: getting constant support from other team members. Highlighting Cheryl's post regarding leadership and its importance, being able to see the difference between having a leader and the start of a hierarchy is important. This is because having a two-way exchange of information (effective collaborative working) rather than a top-down exchange of information (hierarchy) is more effective in interprofessional working (Fagin & Garelick, 2004; Warelow, 1996). 5

Student no.: 09018509

Interprofessional Module 3

According to the research conducted by Rice et al (2010) medical hierarchies can have a significant impact on the effectiveness of interprofessional working in terms of the quality of care given to patients. Going by this, it will be beneficial for the whole team team to get support from others regardless of the amount of engagement they will do in a particular issue. This will lead to less pressure and increased productiveness from all team members (Rice et al, 2010).

I acknowledge that sharing responsibilities can slow the decision-making process. However, this is where cost-benefit analysis comes in. Medical decision making is a frequent fact of life in our careers. It has significant costs; however, it will have a great impact on a patient's quality of life (Zikmund-Fisher et al, 2010). But would it be reasonable to decrease this quality to reduce cost? A 'leader' in an interprofessional team, as Cheryl defined, is someone that will "facilitate processes, presenting organisational structure and goals, focusing the team and managing the logistics" (Vroman & Kovachich, 2002). They do not decide what is going to happen. The final decision would be moulded by the whole team using their own perspectives of the case (Entwistle & Watt, 2006) - given that it is not an emergency situation.

I completely agree with what Cheryl is saying. I think that the difference between a leader and a hierarchy has been emphasised and explained quite well by some team members. I think that replacing the title 'leader' with 'facilitator' will lessen the confusion. This was highlighted by Pethybridge (2004) by stating that it is crucial to illuminate who will be co-ordinating the whole process. As we all agreed, instead of an individual making the final decision, we will establish a rapport and make the decision from there. We should vote for who can be the facilitator during the construction of our critiquing framework after we have submitted our first briefing papers. I will be adding the rule regarding facilitating if you all agree with it.

Student no.: 09018509 Critiquing tool contribution:

Interprofessional Module 3

According to the Higher Education Academy (2011), students that engage in peer assessment will help them learn how to evaluate learning and be able to interpret assessment criteria. However, one of its disadvantages is fear of being critical. Basing my idea on this, we all should not be afraid of criticising others' work given that the feedback that you will give is constructive. But, this is a two-way system so we should all be open-minded; take the feedback given and use it in the future to create a better piece of work. To add to the critiquing tool that we are structuring, when analysing a briefing paper, we should look at how the person organised the paper. Was it constructed clearly? Does the paper 'flow'? Was the paper supported by a contemplated conclusion? (Norton et al, 2002).

With reference to Rebecca's idea of sectioning specific questions, we could do this by, for example, knowledge and understanding - then picking a certain critiquing question that would go under it; then we could go onto to analysis and so on.

Nathan, thank you for your input. Extracting a definition from Oxford dictionary by the Oxford University Press (2011), hypothesis is a proposed explanation for further investigation whilst a conclusion is a summed-up judgement of an arguement (Oxford University Press, 2011). So going by this, hypothesis would fit best in an introduction of an essay.

Reflective writing: Prompt question 1 All the points Cheryl have made are all valid. However, looking at it in a different view - it is vitally important for other group members to give the rest a heads up on why they are not posting as much as needed or why they are not posting at all. But, obviously, referring back to the point of lacking computer skills, this might be a problem. To explore this issue further, a study conducted by Col et al (2011) about 7

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Interprofessional Module 3

shared decision-making in an interprofessional team revealed it is crucial that each team member knows their responsibilities. Adapting this to our case, if you are not computer literate, it is your responsibility to seek support or help from your colleagues or take advantage of the resources available.

Interprofessional (IP) working is about learning with from and about each other to able to develop teamwork and quality of care (Barr et al, 2005). It is apparent in our group looking through all the activities that we are doing and that have been done, some people are contributing more than others. However, I believe the team members that have more involvement do not dominate the discussion but they have more to say to prompt more discussions and debate. Saying this does not mean that we are getting out all the possible potential from the group. This is supported by Thannhauser (2010) by stating that actually engaging in collaborative practice differs from being involved in an interprofessional team. Basing it on this, every professional in an IP team will have to put forward perspectives and share their expertise to be able to effectively deliver high quality care. A research carried out by Kvarnstrom (2008) about difficulties in collaboration showed that one of the reported problems in IP working is the lack of consensus when other team members are not present so as a result, the team cannot carry on with the decision-making; which in our case, little contribution towards activities. I have been frequently witnessing this during my placements. Some professionals would not turn up during multi-disciplinary meetings so therefore it delays everything for the patient and the professional. They usually updates them over the phone or personally but there is still a chance that important information will be missed. Due to this, another theme came up in this study and it is the uneven distribution of current knowledge this is about all team members not getting all the essential current information that leads to ineffective collaborative working. In our case, not everyone is sure what needs to be done or what to write so therefore this might inhibit them from participating. I have also witnessed this in placement. The implications of this are professionals carry out same tasks which wastes time and resources. This shows the imperative significance of information sharing between team members.

Student no.: 09018509

Interprofessional Module 3

I acknowledge the difficulty in trying to engage in a discussion when other people have more to say. But, as we are all aware, every one of us has an open-mind to whatever it is other people are trying to put across. So it is sensible to voice out your opinion whenever you can. A study carried out by Baker et al (2011) showed that socialisation during training affects how professionals perceive themselves. This study revealed that nurses and other allied healthcare professionals see themselves as 'team members' in comparison to physicians who see themselves as 'leaders' and 'decision makers'! Using this as basis, we should all be perfectly capable of contributing towards discussions.

Referencing to Rebeccas post regarding mature students, I totally agree with this as I think they have more life experience, probably more clinical experience that younger students. This helps them look at things in a different perspective most of the time. Every professional will develop their rooted boundaries (Baxter et al, 2008). Hall (2005) believes that these rooted boundaries may have most likely been formed during the socialisation process of their training. This supports the fact that different professionals look at things differently and that different professionals will have different ways of learning. The learning methods that we use are all be different, if not, slightly similar. However, I think that mature students would have polished theirs so they maximise learning while younger students would be in the process of improving theirs. Bandura (1986) developed a theory called social cognitive theory. This theory describes learning as on-going dynamic interactions between individuals, their behaviour and environment (Mann et al, 2009). Applying this to interprofessional education (IPE), it could guide our development as healthcare professionals to consider factors such as learning context; factors that contribute to learners and also factors affecting teach. In our case, some people might not be as interested in this module (motivation?) which may be the reason why they are not engaging as much. With regards to factors affecting teaching, as said by Cheryl, lack of computer skills and even when Blackboard is down can affect our learning. In terms of issues that can affect learners, this can be the lack of engagement from all team members.

Student no.: 09018509

Interprofessional Module 3

I am with you with having negative stereotypes put on younger students. But I think that with lesser clinical and life experiences, we have limited resources into how we look at things. We are quite restricted with journals, books and other literature to base what we are saying. However, this come its advantages. Basing most things around evidence is good. It is in the Nursing and Midwifery Councils (NMC) code of conduct (NMC, 2008). Obviously, this is only looking at the nursing perspective. I am unsure whether other professionals have this expectation from their governing bodies (I am quite confident you have though!). Stating things with evidence to back it up ensures that what you are suggesting is credible and sound. Higgs and McAllister (2005, p 156) stated that a great deal of the success of clinical education rests on the shoulders of clinical educators, their own abilities and personal attributes, and the preparation and support they receive. Clinical educator refers to mentors in placement. This statement illustrates that what information we get from placement are the ones that stick to our minds. Therefore that is what we put forward to others. However, according to Heale et al (2009) lack of preparation, disconnection between theory and practice; time constraints and demands, etc. are factors that can hinder learning. Consequently, this will set us back from being able to engage and stimulate discussions.

Reflective Writing: Prompt Question 2 Cooperrider and Srivasta (1987) developed a framework called appreciative inquiry. This is about initiation or management that focuses on positive personal and organisation qualities that may fuel change. Dematteo and Reeves (2011) believe that appreciative inquiry promotes empowerment and can be used as a change management tool. They also consider its benefits with regards to sharing stories that can create deep connections between professionals. As a result, this forms trust between them and also a mutual vision that may contribute towards positive change (Carter, 2006). In relation to receiving and giving feedback, using the appreciative inquiry framework, professionals would be able to confidently and comfortably provide constructive feedback to colleagues given that they trust each other and that they have shared vision. These two components greatly help with being able not only to help yourself and colleagues in improving skills, but also ensuring that patients under your care will receive the best possible care. However, according to Grant and 10

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Interprofessional Module 3

Humphires (2006), for this to work there should be a good amount of self-reflection and critical evaluation from professionals, If these are not present, appreciative inquiry will not be able to give professionals an insight into the complexity of human actions.

During my nursing placements, I have worked with a range of professionals from a physiotherapist, an occupational therapist to a GP. I strongly believe that this has given me an adequate insight into collaborative working. As part of my own learning and also a requirement of my course, I asked all the professionals that I have worked with for feedback. It greatly helped me improve my practice. Giving feedback to others can be linked to practice evaluation. For example, Barr (2005) emphasises this point by stating that evaluation is a crucial part of developing an effective team. This is supported by McLellan et al (2005) by creating a 'learning team' in which they have an appraisal tool for each professional. This tool is designed to support the team's culture and ethos while taking into consideration factors that signifies good management. Linking this to our prompt question, by being able to provide and receive feedback, it will help the team evaluate how they managed a patient. This may help them in the future to be able to provide better quality care. Feedback and evaluation not only will improve your practice but also the rest of your team. Consequently, you will be able to provide patients with quality care. But obviously, it is still up to the professionals within the team how they are going to use the feedback that they have received. Some professionals might take it for granted or some of them might take it personally. Overall, however, feedback is part of health care therefore it is essential for every professional within this sector to be able to feedback's potential.

Mini-critiques: Critique for BP2: Hannah You have explained how power in decision-making can influence an

interprofessional team. However, the trigger question is about how can an IP team 11

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Interprofessional Module 3

work more effectively under the increasing economic constraints. I recognise that you have linked decision-making and how it can help an IP team to be more effective; but in order to answer the trigger question, you could have linked your focus to the economic constraints; then you could have gone into how these limitations can be overcome and if done effectively, you could consider its implications to practice. You have used a range of references but it seems that most of them are outdated. There may be updated versions of them? Overall, it is a good piece of work and you have showed good analysis and evaluation. Critique for BP2: Nathan This briefing paper has come up with valid points regarding how economic constraints affect interprofessional working. You have looked at the points you have made and explored it. However, I feel that there was not enough analysis done. For example, you said unspoken professional value systems can expose obs tacles that appear invisible to team members belonging to other disciplinarians. You could have included an account to how they are going to do this and then going onto its implications to practice to show more analysis and evaluation. I acknowledge the limited amount of words but you could have focused on a couple of things in detail. Overall, this is a good piece of work with relevant, up-to-date and range of references. Critique for BP2: Rebecca Your explanation of role blurring was very detailed. You considered things that have to go with it (e.g. professional knowledge) for it to be effective. You looked at how it can be successfully achieve and its potential implications to practice. You have also managed to look at it in a different perspective in terms of difficulties that may arise (e.g. overlap) when this process is implemented. In addition to this, suggested ways to overcome said barriers. You have included a range of resources which obviously helped to produce a great amount of analysis throughout the paper. Overall, this is a great briefing paper.

4, 397 words

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Student no.: 09018509 References:

Interprofessional Module 3

Baker, L., Egan-Lee, E., Martimianakis, MA., Reeves, S. (2011). Relationships of power: implications for interprofessional education.Journal of Interprofessional Care . 25 (1), 98-104. Bandura, A. (1986). Social foundations of thought and action. A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall. Barr, H. (2005). Evaluating Teamwork. Journal of Interprofessional Care. 19 (2), 8182. Barr, H., Koppel, I., Reeves, S., Hammick, M., & Freeth, D. (2005). Effective interprofessional education: Argument, assumption & evidence. Oxford: Blackwell. Baxter S., Brumfitt S.. (2008). Professional differences in interprofessional working. Journal of Interprofessional Care. 22 (3), 239-251. Carter, B. (2006). One expertise among many working appreciatively to make miracles instead of finding problems. Journal of research in Nursing. 11(1), 48-83. Col, N et al. (2011). Interprofessional education about shared decision making for patients in primary care settings. Journal of Interprofessional Care. 25 (6), 409-415. Cook, G., Gerrish, K., Clarke, C. (2001). Decision-making in teams: issues arising from two UK evaluations. Journal of Interprofessional Care. 15 (2), 141-151. Cooperrider, D., & Srivastva, S. (1987). Appreciative inquiry in organizational life. In W. Pasmore & R. Woodman (Eds.), Research in Organizational Change and Development (pp. 129169). Greenwich CT: JAI Press. DAmour, D., & Oandasan, I. (2005). Interprofessionality as the eld of interprofessional practice and interprofessional education: An emerging concept . Journal of Interprofessional Care, 19(Suppl. 1), 820. Davoli, G., & Fine, L. (2004). Stacking the deck for success in interprofessional collaboration. Health Promotion Practice, 5(3), 266270.

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Dematteo, D., Reeves, S. (2011). A critical examination of the role of appreciative inquiry within an interprofessional education initiative. Journal of Interprofessional Care. 25, 203-208. DoH Department of Health (2010). Equity and Excellence: Liberating the NHS.Leeds: DoH. Entwistle, V.A., & Watt, I.S. (2006). Patient involvement in treatment decisionmaking: The case for a broader conceptual framework. Patient Education and Counseling, 63, 20S3 4S. Fagin, L., & Garelick, A. (2004). The doctor-nurse relationship. Advances in Psychiatric Treatment, 10, 277286. Fitzsimmons, P., & White, T. (1997). Crossing boundaries: Communication between professional groups. Journal of Management in Medicine, 11(2), 96101. Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care. 1 (1), 188-196. Heale, R., Mossey, S., Lafoley, B., Gorham, R. (2009). Identication of facilitators and barriers to the role of a mentor in the clinical setting. Journal of Interprofessional Care. 23 (4), 369-379. Higgs, J., & Jones, M. (2000). Clinical reasoning in the health professions. Edinburgh: Butterworth-Heinemann. Higgs, J., & McAllister, L. (2005). The lived experiences of clinical educators with implications for their preparation, support and professional development. Learning in Health and Social Care, 4(3), 156171. Higher Education Academy, The. (2011). Peer Assessment. Available: Last

http://www.heacademy.ac.uk/hlst/resources/a-zdirectory/peer_assessment. accessed 1st Nov 2011.

Hugman, R. (2003). Going round in circles? Identifying interprofessional dynamics in Australian health and social care. Hove, Sussex: Brunner-Routledge.

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Jeffery, A., Maes, J., & Bratton-Jeffrey, M. (2005). Improving team decision-making performance with collaborative modelling. Team Performance Management, 11(2), 4050. Kvarnstrom S. (2008). Difculties in collaboration: A critical incident study of interprofessional healthcare teamwork. Journal of Interptofessional Working. 22 (2), 191-203. Laurence, J. (2006). NHS chiefs admit patient care is suffering because of costcutting. Available: www.independent.co.uk/life-style/health-and-families/health-

news/nhs-chiefs-admit-patient-care-is-suffering-because-of-costcutting523641.html+cost+patie. Last accessed 12 Nov 2011. Loxley, A. (1997). Collaboration in health and welfare. London: Jessica Kingsley. Mann, K.V., McFereifge-Durdle, J., Martin-Misener, R., Clovis J., Rowe, R., Bealands, H. Sarria, M. (2009). Interprofessional education for students of the health professions: The Seamless Care model. Journal of Interprofessional Care. 23(3). 224-233. McLellan, H., Bateman, H.,Bailey, P. (2005). The place of 360 degree appraisal within a team approach to professional development. Journal of Interprofessional Care. 19 (2), 137-148. NMC. (2008). The code in full. Available: http://www.nmc-uk.org/Nurses-andmidwives/The-code/The-code-in-full/. Last accessed 22 Nov 2011. Norton, L., Clifford R., Hopkins, L., Toner, I., Norton, J.C.W. (2002) Helping psychology students write better essays. Psychology Learning and Teaching. 2(2). 116-126. Oxford University Press. (2011). Oxford Dictioncary. Available:

http://oxforddictionaries.com/definition/conclusion. Last accessed 08 Nov 2011. Oxford University Press. (2011). Oxford Last

Dictioncary. Available: http://oxforddictionaries.com/definition/hypothesis. accessed 08 Nov 2011. Payne, M. (2000). Teamwork in multiprofessional care. Basingstoke: Palgrave. 15

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Pellatt, GC. (2005). Perceptions of interprofessional roles within the spinal cord injury rehabilitation team. International Journal of Therapy and Rehabilitation , 12(4), 143 150. Pethybridge, J.. (2004). How team working inuences discharge planning from hospital: a study of four multi-disciplinary teams in an acute hospital in England. Journal of Interprofessional Care. 18 (1), 29-41. Rice K., Zwarenstein, M., Conn LG., Kenaszchuk C., Russell A., Reeves, S.. (2010). An intervention to improve interprofessional collaboration and communications: A comparative qualitative study. Journal of Interprofessional Working. 24 (4), 350-361. Rogers, T. (2004). Managing in the interprofessional environment: A theory of action perspective. Journal of Interprofessional Care, 18(3), 239249. Skills for Health (2006). Delivering a exible workforce to support better health and health services The case for change. Bristol: Skills for Health. Thannhauser J., Russell-Mayhew S., Scott C. (2010). Measures of interprofessional education and collaboration. Journal of Interprofessional Working. 24 (4), 336-349. Vroman, K and Kovachich, J (2002) Computer-mediated Interdisciplinary Teams: Theory and Reality. Journal of Interprofessional Care Vol. 16 (2). Zikmund-Fisher, B.J., Couper, M.P., Singer, E., Levin, C.A., Fowler. The DECISIONS study: A nationwidesurvey of United States adults regarding 9 common medical decisions. Medical Decision Making, 30, 20S34S.

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Student no.: 09018509 Appendix Team Contract: Everyone to contribute

Interprofessional Module 3

Respect other people's opinions Ensure 'group' discussions, avoiding ongoing debates between a couple of people Explain professional jargon Check blackboard regularly (suggestion: once every three days) Reference any points made so that others can find the source Bring a positive attitude Have clear start and end points of discussions Ensure that there would be a facilitator during a discussion/process Provide support to other members if needed.

Critiquing Tool: Knowledge and understanding: Does the paper relate to/answer the trigger question? Has the author identified with the ethical implications of confidentiality and in doing so, has avoided referring to individuals by their real names? Has the author constructed their paper clearly, considering the flow of topics and by supporting it with a contemplated conclusion? Analysis: Has the author used skills of analysis by challenging the ideas they have touched upon? Is the paper balanced and unbiased and does the author discuss opposing arguments? Evaluation: Has it been acknowledged that further areas of research could be investigated; if so, what are the implications of this? 17

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Does the writer discuss the overall value of the report findings? Have the writer discussed how much literature are about which supports their arguments? Have the writer discussed gaps in the literature and what further research needs to be done?

Transferable Skills: Has the author provided an accurate reference list by encompassing Harvard Style referencing to show wide reading and to lend credibility to the arguments? Within the structure, do the sections refer to the same idea and are they consistently relevant to the topic of the paper? Are the references still relevant and is there any new research available? Is there good level of correct spelling, grammar and punctuation?

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