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      Implementing interprofessional learning curriculum: how problems might also be answers

      research-article
      ,
      BMC Medical Education
      BioMed Central
      Interprofessional learning, Health, Curriculum, Activity theory

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          Abstract

          Background

          Despite interprofessional learning (IPL) being widely recognised as important for health care professions, embedding IPL within core curriculum remains a significant challenge. The aim of this study was to identify tensions associated with implementing IPL curriculum for educators and clinical supervisors, and to examine these findings from the perspective of activity theory and the expansive learning cycle (ELC).

          Methods

          We interviewed 12 faculty staff and ten health practitioners regarding IPL. Interviews were semi-structured. Following initial thematic analysis, further analysis was undertaken to characterise existing activity systems and the contradictions associated with implementing IPL. These findings were then mapped to the ELC.

          Results

          Five clusters of contradictions were identified: the lack of a workable definition; when and what is best for students; the leadership hot potato; big expectations of IPL; and, resisting cultural change. When mapped to the ELC, it was apparent that although experienced as challenges, these contradictions had not yet generated sufficient tension to trigger ‘break through’ novel thinking, or contemplation and modelling of new solutions.

          Conclusions

          The application of activity theory and the ELC offered an approach in which the most troublesome challenges might be reframed as opportunities for change. Seemingly intractable problems could be worked on to identify and address underlying fears and assumptions. If sufficient tension can be generated, an ELC could then be triggered. In reframing challenges as opportunities, the power of tensions and contradictions as potential levers for effective change might be more successfully accessed.

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          Most cited references32

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          Expansive Learning at Work: Toward an activity theoretical reconceptualization

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            Studies of expansive learning: Foundations, findings and future challenges

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              Interprofessionality as the field of interprofessional practice and interprofessional education: an emerging concept.

              This paper proposes a new concept and a frame of reference that should permit the development of a better understanding of a phenomenon that is the development of a cohesive and integrated health care practice among professionals in response to clients' needs. The concept is named "interprofessionality" and aims to draw a clear distinction with another concept, that of interdisciplinarity. The utilization of the concept of interdisciplinarity, which originally concerns the development of integrated knowledge in response to fragmented disciplinary knowledge, has caused some confusion. We need a concept that will specifically concern the development of a cohesive practice among different professionals from the same organization or from different organizations and the factors influencing it. There is no concept that focuses clearly on this field. Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives as well as determinants and processes inherent to interprofessional collaboration. Interprofessionality also involves analysis of the linkages between these two spheres of activity. An attempt to bridge the gap between interprofessional education and interprofessional practice is long overdue; the two fields of inquiry need a common basis for analysis. To this end, we propose a frame of reference, an interprofessional education for collaborative patient-centred practice framework. The framework establishes linkages between the determinants and processes of collaboration at several levels, including links among learners, teachers and professionals (micro level), links at the organizational level between teaching and health organizations (meso level) and links among systems such as political, socio-economic and cultural systems (macro level). Research must play a key role in the development of interprofessionality in order to document these linkages and the results of initiatives as they are proposed and implemented. We also believe that interprofessionality will not be pursued without the requisite political will.
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                Author and article information

                Contributors
                maree.okeefe@adelaide.edu.au
                helena.ward@adelaide.edu.au
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                8 June 2018
                8 June 2018
                2018
                : 18
                : 132
                Affiliations
                ISNI 0000 0004 1936 7304, GRID grid.1010.0, Faculty of Health and Medical Sciences, , The University of Adelaide, ; Adelaide, Australia
                Author information
                http://orcid.org/0000-0002-0371-5322
                Article
                1231
                10.1186/s12909-018-1231-1
                5994112
                29884159
                a9f6aa09-bc58-4b1d-8280-2683108f2a02
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 November 2017
                : 21 May 2018
                Funding
                Funded by: Australian Learning and Teaching Council
                Award ID: O'Keefe NTF 2013
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                interprofessional learning,health,curriculum,activity theory
                Education
                interprofessional learning, health, curriculum, activity theory

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