Facilitating interprofessional education: Key findings from a synthesis of qualitative research

1. Facilitating interprofessional education: Key findings from a synthesis of qualitative research Professor Scott Reeves

2. Overview Introduction Background Methods Findings Discussion Questions & Comments

3. Poll Question 1 Who has had experience facilitating IPE? -Yes -No -Not sure

4. Poll Question 2 Those of you who have facilitated IPE did you find the experience: -Easier than expected -More difficult than expected -Not sure

5. Introduction

6. IPE definition Occasions when two or more professions learn with from and about to improve collaboration and patient care (CAIPE/WHO)

7. IPE aims Improving IP attitudes/perceptions Enhancing IP skills/behaviour Improving collaborative behaviour Enhancing care delivered to patients

8. IPE activities Classroom Simulation Workplace Online Blended

9. Underlying principles Collaborative learner-led Group/team-oriented Non-hierarchical Addresses real-life problems

10. IPE Drivers Quality & safety Patient-centred care Chronic care Rising costs Media coverage

11. Background

12. Central role of IPE facilitator: Setting learning climate Encouraging collaboration Motivating Supporting/guiding

13. Attributes for IPE facilitator: Experience of collaborative practice, Conflict resolution skills Flexibility Confidence Sense of humour

14. Growth of literature: Range of competences Interprofessional role models Uncertainty with role Need for faculty development

15. Methods

16. Aim To undertake a meta-ethnography to synthesise available qualitative research in the IPE field

17. Objectives Synthesise qualitative research on staff who facilitate IPE Investigate range of factors that affect IPE facilitation Identify gaps in the evidence/suggest areas for research

18. Note on terminology IPE Facilitators Teachers Mentors Preceptors Supervisors

19. Meta-ethnography approach (Noblit & Hare 1988) Analysis/synthesis of qualitative data Translation concepts/themes across studies Production of new (generalised) interpretation

20. Inclusion criteria for studies IPE (as previously defined) Qualitative methods Focus of study: IPE facilitation

21. Search strategy Electronic databases: ASSIA; BEI; CINAHL; EMBASE; ERIC; HMIC; MEDLINE; PsycINFO Reference lists of included studies Hand searches: Med Teach & J Interprof Care Limited to the past 10 years / English language

22. Study selection Abstract screening & full-text screening Two reviewers, independent screening Any discrepancies resolved by third reviewer

24. 12 included papers Cooper & Spencer-Dawe (2006); Lindqvist & Reeves (2007); Rees & Johnson (2007); Anderson & Thorpe (2010); Carlson et al (2011); Egan-Lee et al (2011); van Soeren et al (2011); Chipchase et al (2012); Clouder et al., (2012); Hanna et al (2013); Evans et al (2014); Jakobsen & Hansen (2014)

25. Data abstraction Study characteristics (aims, methods, results) Contextual information Study quality (CASP appraisal tool)

26. Synthesis Collation of 2nd order interpretations (original author interpretations of data) to identify key concepts Synthesis of key concepts (review team) Development of 3rd order interpretations (key IPE facilitation factors)

27. Findings

28. Study context Classroom IPE (4 studies) Practice-based IPE (2 studies) Classroom/practice settings (2 studies) Online methods (3 studies) Simulated IPE (1 study)

29. Facilitation Co-facilitators (6 studies) Single facilitators (5 studies) Clinical supervisor (1 study Nursing, physiotherapy, occupational therapy, social work, medicine

30. Study information Six case studies Three phenomenological studies One ethnographic study One action research study One study ‘qualitative approach’

31. Data collection Focus groups (9 studies) Individual interviews (8 studies) Telephone interviews (2 studies) Written reflections (3 studies)

33. Methodological quality Clear research question, data collection & analysis (12 studies) No sampling strategy (7 studies) Convenience sample (5 studies) Researcher reflexivity (3 studies) CASP Score: good quality

34. Synthesis 8 key concepts generated from 2nd order interpretations (original authors) 3 three main factors (3rd order interpretations) generated

35. Key concepts Logistical and organisational issues The influence of technology Preparation and support Collaborating and co-facilitating Professional development opportunity Employing differing facilitation approaches Using experiences to enrich the learning

36. 3rd order interpretations (themes) The effect of contextual characteristics on facilitation How facilitator experience influence their facilitation work Need to use a range of strategies for effective facilitation

38. Discussion

39. IPE facilitation influenced by: -Context in which the IPE is delivered -Nature of the facilitators’ experiences -Use of different facilitation strategies Need to pay attention to these factors in recruitment, preparation & support of facilitators

40. Specific focus on Initial professional development Use of co-facilitation Combine IPE facilitation methods Use of IPE e-learning Use of prior IP experiences

41. Some next steps Research on differing learning contexts In-depth studies on co-facilitation Further work on use of prior experiences Studies on faculty development Self-report data – need for observations

42. Study limitations Excluding grey literature including studies only published in English. Only studies published in the past 10 years Bias for publication of positive results

43. Poll Question 3 Based on the findings are there any findings which strike you as most important? -Contextual characteristics -Facilitator experience -Using a range of strategies -All equally important -Not sure

44. Further reading

45. Questions & comments

46. Thank you s.reeves@sgul.kingston.ac.uk