CONTACT IS NOT ENOUGH The impact of a directed interprofessional clinical education placement (DICEP) compared to a standard clinical education placement (SCEP) on therapy students’ understanding of professional roles, teamwork, and interprofessional pr

Abstract Interprofessional education (IPE) is being conducted in health science programs in Australia as a strategy to produce more effective team-ready health professionals. Yet, research into students’ and clinical educators’ experiences of practice based IPE are limited in the interprofessional literature. As the practice of IPE evolves, particularly within the domain of clinical education, this study positively contributes to a discussion about factors which facilitate the acquisition of interprofessional competencies including knowledge of professional roles and an understanding of team processes and interprofessional practice (IPP). The purpose of this study was to compare the experience of allied health students undertaking directed interprofessional clinical education placements (DICEP) in community rehabilitation teams with the experience of allied health students undertaking standard discipline specific clinical education placements (SCEP) in similar contexts. The Modified Biggs’ 3P Framework (Freeth & Reeves, 2004) was used to structure the research questions, which investigated the experiences of students and clinical educators with each of these placement models. The experiences of students (N=54) and their clinical educators (N=19) were compared and contrasted to answer research questions pertaining to which presage factors, processes and products (outcomes) in both types of placement impact on the development of an understanding of teamwork and IPP and to inform discussion about what makes an effective interprofessional clinical education placement. A mixed methods approach using predominantly qualitative data collection was employed to understand and compare students’ and clinical educators’ experiences during both types of placement. Data were collected in individual and group semi-structured interviews with allied health students pre- and post-placement. Clinical educators from both types of placement were interviewed post-placement. A small cohort of students (n=16) were interviewed as new clinicians six months post-graduation to investigate their post graduation experiences of teamwork, IPP and workplace collaboration, as well as their teamwork and IPP experiences compared to their community-based student clinical education experiences. Students on the DICEP experienced more IPE opportunities than their SCEP counterparts and consequently developed a deeper understanding of their own roles in relation to the roles of other professionals. As their knowledge and respect for other team members’ roles developed they were better able to understand effective collaborative team processes and the advantages for clients and fellow team members. This knowledge and experience is necessary for the further development of interprofessional competencies. Acquisition of interprofessional competencies is a complex process. No one theory is sufficient to underpin interprofessional clinical education placements. This study demonstrated that to design, implement and evaluate such IPE endeavours requires a broad theoretical framework that encompasses a number of theories that address interpersonal interaction, learning and organisational impact, which can in turn inform practice regarding context, processes and outcomes. The key educational implications of this study are that contact alone is not enough for students to learn about IPP. IPE should not be taken for granted and does not necessarily occur incidentally as learning about teamwork does not happen “on the job” without planned IPE experiences during the student years. Explicit learning objectives and activities with explicit assessment tasks are required to facilitate IPE during clinical placements. Importantly, time for reflection and clinical educator support enhance students’ development of interprofessional competencies. Stakeholders in health professional education who embrace the collaborative agenda of health service redesign must recognise the need for and importance of explicit IPE activities during clinical education placements if students are to be adequately prepared for the future health workforce. This study was limited by geographical context in south east Queensland and to community rehabilitation settings but may be used as a basis to further examine the evidence for implementation of IPE within clinical education contexts for a wider group of students and in other health service contexts. This study demonstrated that clinical educators have an important role as facilitators of students’ development of interprofessional competencies. The knowledge, skills and attitudes necessary for collaborative practice require wider investigation in the Australian context. The competencies suggested by students and clinical educators in this study, such as willingness to collaborate, share knowledge and respect of others’ roles and effective communication skills, may inform further studies of IPE competencies in Australia. Finally, the follow-up data clearly demonstrated that collaboration in the workplace cannot be supported by individuals alone rather it must be supported by workplace policy, practices and leadership if new clinicians are to engage in interprofessional practice. Further research into the alignment of undergraduate and postgraduate IPE activities through continuing professional development is warranted to operationalise policies which are being implemented to create a more collaborative workforce. This study contributes to the evidence base for IPE and supports proponents of IPE who argue that IPE is an integral component of health professional education. Policy makers, academics, health professionals and students will find that rather than a ‘fashionable accessory’ that is easily added to existing curricula, IPE is a complex phenomenon which requires careful attention to its development and direction if it is to positively impact on health professional students and the communities of practice in which they learn