a r t i c l e
i n f o
Article history:
Accepted 15 November 2009
Keywords:
Education, nursing
Interprofessional relations
Professional knowledge
Clinical competence
Professional development
Faculty, nursing
s u m m a r y
In this paper, the authors present the results of a study which delineated six key competencies of interprofessional collaborative practice for patient-centred care: communication; strength in ones professional role; knowledge of professional role of others; leadership; team function; and negotiation for
conict resolution. While all of these competencies are important and require special attention, this
paper examines and discusses the competency knowledge of professional role of others and its associated
behavioural indicators, especially as these relate to the interprofessional education of nursing students.
The identication of these competencies and their behavioural indicators serve two purposes. It forms
the basis for the preparation of students, preceptors, and faculty for interprofessional practice, and it
develops a tool for assessing student performance in such practice. Consequently, we believe that the utilization of this key competency and its behavioural indicators will contribute to the development of programs that include specic knowledge and skills related to interprofessional nursing education. This will
enable educators to support and evaluate students in interprofessional educational experiences more
efciently and effectively. Ultimately, as nursing students practice and become fully functioning practitioners, client care will be optimized.
2009 Elsevier Ltd. All rights reserved.
Introduction
In the current demanding healthcare environment, interprofessional team practice is being promoted as a holistic means of providing cost-effective healthcare. The literature suggests that when
healthcare professionals such as Registered Nurses, pharmacists,
occupational therapists, and physicians collaborate, a positive
and rewarding practice environment is fostered (Freeth and
Reeves, 2004; McNair et al., 2005). Registered Nurses make up a
large component of the healthcare sector and are an integral part
of the interprofessional healthcare team. The Canadian Nurses
Association (CNA, 2005) and health care professionals (Freeth
and Reeves, 2004) have identied interprofessional collaboration
as an effective means for improving healthcare outcomes within
Canadas healthcare institutions.
In order to achieve an effective level of collaborative healthcare
practice, to improve patient outcomes, and to create a holistic caring environment, healthcare educators, including nursing faculty,
must focus attention on interprofessional education (IPE) in undergraduate programs (Curran, 2004). As an educational priority for
the development of nursing curricula, IPE will support a more integrated approach to preparing nursing students for interprofessional
practice (IPP) and collaboration. To facilitate this approach, a study
* Corresponding author. Tel.: +1 306 966 6250; fax: +1 306 966 6621.
E-mail address: mary.macdonald@usask.ca (M.B. MacDonald).
1471-5953/$ - see front matter 2009 Elsevier Ltd. All rights reserved.
doi:10.1016/j.nepr.2009.11.012
Methods
In their research study, the authors utilized a Grounded Theory
approach (Glaser, 1978) to identify competencies of interprofessional collaborative practice for patient-centred care. Ethical
239
Table 1
Behavioural indicators for interprofessional competency knowledge of the professional role of others.
1.
2.
3.
4.
5.
According to the literature, understanding the role of other professionals is an acknowledged competency. Various aspects of this
6.
7.
Describes where the scope of ones own profession ends and another
begins
Open to/seeks out the contributions of other team members
Addresses misconceptions/stereotypes among team members
Respects the roles, expertise, and unique contributions of other team
members
Identies common/overlapping professional skills amongst team
members
Values the enhanced benets of the collaborative efforts of the team
Describes the different perspectives and knowledge of other professions
240
Theres no way that any one group [profession] can ... deal with
(all) the determinants of health. It has to be a group of people
with a different knowledge base, different experiences, and
who are also willing to learn from . . . the population in which
they work. (practitioner)
Interprofessional practice is professionals from different disciplines collaborating, understanding each others roles, and
working to maximize . . . Youre not trying to do it all yourself
and youre using the skills of other professionals as well . . .
The whole is always greater than the individual bit.
(practitioner)
(7) Describes the different perspectives and knowledge of other
professions: Comments included:
Theres a need to have an understanding of what other professions offer so that there can be a whole network of people helping the client. . . . When an individual has a good understanding
of another profession and how that profession can assist a client, you have the capacity to break down some barriers.
(practitioner)
Discussion
The key competency knowledge of professional role of others has
been linked to successful interprofessional practice (Holland, 2004;
Howarth et al., 2006; Nestle et al., 2004; Pullon, 2008; Suter et al.,
2009). Recognizing that interprofessional teams are established to
meet the needs of patients/clients, teams often consist of different
healthcare professionals. Regardless of the constitution of the
team, it is imperative that all team members are able to identify
and demonstrate strength in their own roles (Bronstein, 2003; Atwal and Caldwell, 2005; Pellat, 2005) as well as demonstrate
knowledge of the roles of the other healthcare team members
(Caldwell and Atwal, 2003). Other authors (Dempsey and Larson,
2004; Insalaco et al., 2006; McCloskey and Maas, 1998) support
this observation, suggesting that more importance be given to this
Describes where the scope of ones own profession ends and another
begins
Interprofessional collaborative practice in the healthcare system allows for optimal contributions by all team members in providing holistic client care. An attitude of acceptance helps build IP
competence and team capacity (Baxter and Markle-Reid, 2009). In
order to collaborate in an effective manner, specic role expectations and professional contributions of each team member must
be clearly delineated (Pellat, 2005; Suter et al., 2009). To be effective, team members must accept the responsibility to act in accordance with the standards of practice and within the role
obligations dened by their professional scope of practice, and
communicate this scope of practice to others (Harrison, 2005; Suter et al., 2009). Students, therefore, should be prepared for their
roles and responsibilities by placing an emphasis in undergraduate
curricula on standards of practice and on professional competencies for their profession.
The willingness of a professional to learn about other professional roles leads to a broadening and an enrichment of the knowledge required to collaborate with other team members in
providing effective healthcare (Rodehorst et al., 2005). Interprofessional teamwork allows healthcare professionals to identify unique
differences in, and to understand, the roles and contributions of
other team members (Insalaco et al., 2006). Consequently, each
team member is able to participate in a shared team experience.
However, this outcome is not always the case. As Pellat (2005, p.
144) suggested, There is evidence that professionals may be unclear not only about roles and functions of other professionals,
but also about their own roles. Therefore, the preparation of
undergraduate nursing students should provide the kind of interprofessional education that enables them to gain insight into the
roles, professional cultures, and practices of collaborating team
members, as well as their own. Documents that clearly enunciate
the roles and responsibilities of other professions such as the one
circulated by the Dieticians of Canada (Royall and Brauer, 2009)
provides an excellent basis for this learning.
241
well as the knowledge and skills that other team members possess
(Caldwell and Atwal, 2003). When a team member perceives other
team members as having similar or overlapping roles, team members must clearly designate the professional who will assume
responsibility for that aspect of care on behalf of the team (Pellat,
2005). At times, efciency of care may dictate that a single professional provide several aspects of care, based on the common skills
of several professional groups.
Traditional barriers very often limit healthcare professionals
ability to reach their full potential by constricting the range of their
professional activities. In undergraduate curricula, nursing educators must attempt to eradicate those barriers. Such curricula must
help students to differentiate the skills that are specic to each
profession, as well as concentrating on sharing skills across professions (Caldwell and Atwal, 2003). Each team member would bring
unique skills and knowledge to the team in order to provide effective and comprehensive client care. The goal is for nursing students
to develop strategies that encourage interprofessional team work
with an emphasis on acknowledging the skills of each professional
team member, and using these skills appropriately to improve client care. There will be some overlap, intersection, or commonality
of skills (Suter et al., 2009). Rather than duplicating efforts, each
professional needs to acknowledge the common skills and use
them effectively to enhance patient care and limit duplication.
One team member could perform common functions on behalf of
the healthcare team rather than duplicating efforts of other team
members. Potentially, this could save time and effort for the team
members and avoid frustration for the client as long as ndings are
communicated effectively among all team members.
Values the enhanced benets of the collaborative efforts of the team
Efcient interprofessional practice is dependent on knowledge
of the professional role of each team member and on the ability
to value the collaborative contributions of each professional as
enhancing positive client outcomes. In turn, effective team functioning and collaborative practice will lead to cost-effective, high
quality client care.
To enhance the ability of nursing students to value the professional skills and the collaborative efforts of the team, nursing curricula must include a strong focus on courses that enhance their
own professional identity as well as expose students to the practice
of other healthcare professionals. This approach will ensure that
nursing students become aware of their own competencies, the
competencies of other healthcare professionals, and the resulting
condence in their value as a team member. Such curricula must
also include an emphasis on developing leadership skills within
interprofessional classroom and clinical environments (Ross et
al., 2005).
Describes the different perspectives and knowledge of other
professionals
Describing the different perspectives and knowledge of other
professionals is a challenge that each team member must accept
and achieve if the team is to function effectively. Team members
must know and be condent of not only their own skills and competencies, but the competencies and skills of other team members,
as well as the contributions that all can make to the team effort
(Pellat, 2005).
To develop the ability to identify and describe the various perspectives and knowledge of other team members in interprofessional practice, nursing students must be given the opportunity
to discuss team relationships openly in a supportive environment.
An emphasis on interprofessional group discussions could aid in
the development of an enhanced understanding of each others
242
competencies and roles, and thus the ability to describe the knowledge and perspectives of other team members. Problem-based
learning experiences within an interprofessional healthcare team
setting in the classroom, and emphasizing and encouraging interprofessional team experiences in clinical areas, are strategies that
should be utilized to achieve success in describing the different
perspectives and knowledge of other professionals.
and, nally, the development of strategies that encourage interprofessional teamwork. The underlying element that is crucial to such
an approach is the faculty members knowledge and utilization of
the key competencies of interprofessional practice. This approach
will no doubt improve the quality of care that clients receive in a
collaborative healthcare environment.
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