A postgraduate curriculum for integrated care: a qualitative exploration of trainee paediatricians and general practitioners’ experiences

Abstract

BackgroundIntegrated care unites funding, administrative, organisational, service delivery and clinical levels to create connectivity, alignment and collaboration within and between care delivery and prevention sectors. It aims to improve efficiency by avoiding unnecessary duplication of resources. Consequently, implementing integrated care is increasingly important; however, there are many barriers and how we teach healthcare practitioners to work across systems is under-researched. This paper explores an innovative educational curriculum, the Programme for Integrated Child Health (PICH).MethodsThe PICH involved an experiential learning approach supported by taught sessions on specific issues relevant to integrated care. A qualitative study was conducted by interviewing 23 participants using semi-structured one-to-one interviews. Participants included trainees (general practice, paediatrics) and programme mentors. Data was thematically analysed.ResultsResults are coded under three main themes: integrated care curriculum components, perceptions of a curriculum addressing integrated care and organisational change, and personal and professional learning. The data highlights the importance of real-world projects, utilising healthcare data, and considering patient perspectives to understand and develop integrated practices. Trainees received guidance from mentors but, more crucially learnt from, with, and about one another. They learnt about the context in which GPs and paediatricians work and developed a deeper understanding through which integrated services could be meaningfully developed.ConclusionsThis study explored participants’ experiences and can be taken forward by educationalists to design curricula to better prepare healthcare practitioners to work collaboratively. The emergence of integrated care brings about challenges for traditional pedagogical approaches as learners have to re-align their discipline-specific approaches with evolving healthcare structures. PICH demonstrated that trainees acquired knowledge through real-word projects and experiential learning; and that this facilitated integration, empowering doctors to become leaders of organisational change. However, there are also many challenges of implementing integrated curricula which need to be addressed, including breaking down professional silos and integrating resourceful healthcare. This study begins to demonstrate the ability of an integrated curriculum to support trainees to work collaboratively, but further work is needed to develop the wider efficacy of the programme incorporating other professional groups, and to assess its longer term impact.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1420-y) contains supplementary material, which is available to authorized users.

Midwifery Continuity of Care in Indonesia: Initiation of Mobile Health Development Integrating Midwives’ Competency and Service Needs

“…Therefore, it helps the recommended need to provide a standard of care following the practice of midwives [ 88 , 89 ]. The programs significantly affect midwives’ leadership [ 90 ] and their performance. Thus, competence greatly influences performance appraisal in midwifery services [ 91 ].…”

Competencies for collaboration between general practitioners and medical specialists: a qualitative study of the patient perspective

“…Using patients' experiences with the collaborative process can be used as a strong motivator. 24 Patients are willing to play a role in collaboration, but to be able to do so they need to have a grasp of the process of collaboration and the people involved. At all moments of the patient's journey through primary and secondary care, therefore, collaboration between doctors could be made more visible.…”

Education for collaboration: the influence of the third space on professional boundaries

“…Participant demographics are detailed in Table 1. Education for collaboration: the influence of the third space on professional boundaries 5 A coding scheme was developed, and interviews were independently coded by four team members (AG, CC, AA and AM) using QSR NVivo 11 (see also Griffin et al, 2017Griffin et al, , 2019. Three researchers (AG, LK and PC) conducted a secondary analysis of the data and, with the input of an additional researcher (CO), interpreted the findings in relation to Whitchurch's (2008) concept of the third space.…”