Exploring teams of learners becoming “WE” in the Intensive Care Unit – a focused ethnographic study

Abstract

BackgroundResearch about collaboration within teams of learners in intensive care is sparse, as is research on how the learners in a group develop into a team. The aim of this study was to explore the collaboration in teams of learners during a rotation in an interprofessional education unit in intensive care from a sociocultural learning perspective.MethodsFocused Ethnographic methods were used to collect data following eight teams of learners in 2009 and 2010. Each team consisted of one resident, one specialist nurse student and their supervisors (n = 28). The material consisted of 100 hours of observations, interviews, and four hours of sound recordings. A qualitative analysis explored changing patterns of interplay through a constant comparative approach.ResultsThe learners’ collaboration progressed along a pattern of participation common to all eight groups with a chronological starting point and an end point. The progress consisted of three main steps where the learners’ groups developed into teams during a week’s training. The supervisors’ guided the progress by gradually stepping back to provide latitude for critical reflection and action.ConclusionOur main conclusion in training teams of learners how to collaborate in the intensive care is the crucial understanding of how to guide them to act like a team, feel like a team and having the authority to act as a team.

Student learning in interprofessional practice-based environments: what does theory say?

“…Furthermore, resonating with Conte et al [ 19 ] we also suggest that socio-cultural frameworks can provide useful insights not just into the situated and relational nature of learning, within real-world interprofessional settings, but also into how students may construct and negotiate their professional identity. Understanding how students traverse professional boundaries and identities has emerged from preliminary work exploring health professional education in longitudinal integrated clinical placements where up to 30 students from different professions were placed at any one time in a rural community [ 24 ].…”

“…These include the recently published study by Conte et al . [ 19 ], which used socio-cultural learning theory as a lens to explore team collaboration during an interprofessional education rotation in intensive care. This study showed the importance of situated learning and guided participation within the clinical setting, and in particular the links between learner ownership and legitimate peripheral participation.…”

Challenging encounters as experienced by registered nurses new to the emergency medical service: explored by using the theory of communities of practice

“…Reflectivity, both on an individual level and within the team has been discussed as prerequisites for successful team collaboration (Conte et al 2015a ). Team collaboration is an important part of professionals’ engagement in practice and improves health outcomes (Conte et al 2015a , b ; World Health Organization 2010 ). The benefits of formal peer-support, for example mentorship, have been acknowledged in prior studies to support a new professional’s development and strengthen the sense of team unity (Chen and Lou 2014 ; Kalen et al 2012 ; Rush et al 2014 ).…”

“…Another challenging aspect involved in the transition into a new professional identity is finding one’s own part to play in the new professional practice and becoming a legitimate member of the team (Bridges 2009 ; Conte et al 2015b ). Becoming a legitimate member of a team is essential for successful team work, patient safety and retention (Numminen et al 2015 ).…”

Twelve tips for structuring student placements to achieve interprofessional learning outcomes

“…Junior year students usually require more support and guidance than senior students so extent of interprofessional involvement needs to be carefully matched with student capability to minimize risk to patients and/ or themselves. Supervisors have an important role to play in guiding students as they move from peripheral 'observers' to more engaged and legitimate contributors to collaborative patient care (Conte et al 2015). Identifying a specific work setting or activity where students can meet requisite interprofessional learning outcomes is important and university staff should check with the leaders and educators at placement sites that experiences that assist students reach their goals will be available during the placement (Henderson et al 2007).…”