Preparing students for interprofessional collaboration

By Monica Bianchi | 07/13/2017

When tutors mentor students, the learning process deepens.

Preparing students for interprofessional collaborationIn conducting research for my PhD, I explored mentorship and the role of tutors. My objective was to understand the process of preparing nursing students through interprofessional education (IPE) to work effectively in healthcare careers that involve interprofessional collaboration.

I chose constructivist grounded theory as the methodology for my research because it enabled me to observe the research setting from the inside. As a result, I was able to collect data on students attending various undergraduate health profession programs and participating in IPE experiences, as well as data on the clinical tutors who supervise them during their clinical placements.

Between classroom and clinical practice
Monica BianchiI focused my research protocol on students in the sixth semester of their bachelor sequence—the last stage—because doing so gave me the opportunity to observe what happens between students and tutors during periods of clinical training when they are preparing for future collaboration as part of an interprofessional team. Although academic guidelines are provided for this transitional period between classroom and clinical practice, the recommendations are often not followed. Instead, they are modified to fit the student and the context. As students transition into clinical practice with its rules, rituals, and values, they develop their identities, integrating what they have learned up until that point in their academic environments with what they experience, discuss, share, and negotiate as they interact with professionals in the clinical environments where they have been placed.

Reflecting on data collected from interviews with students and tutors and based on observations of research participants, I concluded that, as students and tutors work together to create models of care during this final stage of training, tutors can be very helpful in preparing students to become professionals in their own right.

Even if they have retained the principles and theories learned in the classroom, students who enter this phase of clinical practice are still novices. They need to acquire judgment skills and capabilities that can only be obtained from working in a particular context and being exposed to repeated real-life situations that result in experience. According to Patricia Benner (2003), “experience” occurs when preformed notions and theories meet real situations that complement and enrich theory.

Not a time for solitude
While conducting my research, I observed that the student doesn’t take these important steps in solitude; there is always a mentor at his or her side who shares the situation. Although some steps in the process take place at the cognitive level, they are enhanced by the joint reflections of students and tutors—a process that deepens the learning experience.

My analysis of the data revealed that, as students transition from the academic phase of their education and prepare to become professionals, they appreciate having someone at their side with whom they can talk, express emotions, explore ways to address reality, and from whom they can receive feedback and support. Although the literature often reports that students are alone and on their own during the clinical practice phase, my research indicates that students prefer being “accompanied” and “supported” by a tutor. Important to consider, therefore, is the role of the tutor as described in this research: the tutor as traveling companion—one who accompanies and supports the student and encourages him or her to share thoughts and feelings. 

The tutors I interviewed and observed were involved with their students. To help students achieve established goals, they expressed interest and empathy, as well as willingness and commitment to identify ways to reach those goals. Their positive motivation to help students was evidenced by their attitudes, willingness to teach and share their knowledge, feedback, and taking time to reflect with them. Defining a one-size-fits-all approach to mentorship is impossible, but once the journey has begun, a more precise path can be determined, evaluated, and modified as needed, taking into account a student’s individuality, timing considerations, and program objectives.

Communication and interaction vital
My interviews and observations revealed the importance of communication and interaction, both verbal and nonverbal—factors common to all tutor and student pairs. I was very impressed with the way each observed couple developed its own way of communicating. For example, I noticed how students dealt with new or complicated situations by physically positioning themselves to allow constant visual contact with their tutors. By seeking nods of approval from their tutors before proceeding in new situations or participating in debates, the students gained confidence.

When students recounted their internship experiences to me, they often started by describing the emotions they felt when they first managed to enter into a relationship with a patient. They then described situations where they felt the need to involve other healthcare professionals in a patient’s treatment. Eventually, they explained how they came to view the path they have shared with their tutors and the choices they made together in developing models of care.

When I asked about changes in perception—how their initial definition of interprofessional collaboration had changed after experiencing clinical practice and sharing their experiences with a tutor—everyone said their definition of IPC had changed. Their experiences had changed their initial perceptions. With support from tutors, the students had learned proper ways to collaborate, communicate as members of healthcare teams, and create models of interprofessional care that were linked to their situations, as well as those of patients and families.

Summing up
The students reported that the theoretical definition given before their internships began was as important as the integration of acquired experiences in the period that followed. Those who were part of an interprofessional team and had the experience of providing integrated patient care emphasized how important it was and how much it reinforced their decision to adopt a similar approach in future care situations.

Tutors, on the other hand, recounted seeing students’ perceptions change as they transitioned from an individualized approach to care to a shared-experience approach. Through mentoring, the tutors had helped the students overcome difficulties, relate to the healthcare team, and develop positive attitudes toward interprofessional collaboration.

After analyzing the data I collected as part of my research, I clearly see the tutor’s role as facilitator, analogous to an “enzyme” that allows the student to “digest” the not-always-easy experiences encountered in clinical practice. By facilitating students’ learning, tutors assist them in constructing their identities and recognizing their roles as members of healthcare teams while helping them become effective participants in interprofessional collaboration.

Monica Bianchi, PhD, EMBA, MSc, RN, is lecturer and researcher at the University of Applied Sciences and Arts of Southern Switzerland, Department of Business Economics, Health and Social Care.

Reference:
Benner, P. (2003). Excellence in nursing clinical practice: Learning based on experience. Milan, Italy: McGraw-Hill.

Editor’s note: Monica Bianchi, Annamaria Bagnasco, Giuseppe Aleo, and Loredana Sasso will be presenting a session titled “Preparing Students for Interprofessional Collaboration: A Grounded Theory Study,” on Friday, 28 July 2017, at the 28th International Nursing Research Congress in Dublin, Ireland. See the Virginia Henderson Global Nursing e-Repository for additional information. 

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