Interprofessional and multiprofessional approaches in quality improvement education

Abstract

The imperative for all healthcare professionals to partake in quality improvement (QI) has resulted in the development of QI education programs with participants from different professional backgrounds. However, there is limited empirical and theoretical examination as to why, when and how interprofessional and multiprofessional education occurs in QI and the outcomes of these approaches. This paper reports on a qualitative collective case study of interprofessional and multiprofessional education in three longitudinal QI education programs. We conducted 58 interviews with learners, QI project coaches, program directors and institutional leads and 135 h of observations of in-class education sessions, and collected relevant documents such as course syllabi and handouts. We used an interpretive thematic analysis using a conventional and directed content analysis approach. In the directed content approach, we used sociology of professions theory with particular attention to professional socialization, hierarchies and boundaries in QI, to understand the ways in which individuals' professional backgrounds informed the planning and experiences of the QI education programs. Findings demonstrated that both interprofessional and multiprofessional education approaches were being used to achieve different education objectives. While each approach demonstrated positive learning and practice outcomes, tensions related to the different ways in which professional groups are engaging in QI, power dynamics between professional groups, and disconnects between curricula and practice existed. Further conceptual clarity is essential for a more informed discussion about interprofessional and multiprofessional education approaches in QI and explicit attention is needed to professional processes and tensions, to optimize the impact of education on practice.

Theory in quality improvement and patient safety education: A scoping review

“…Articles that used theory as a lens to interpret QIPS education drew upon different types of theories including sociocultural learning theories, activity theory with origins in psychology, the cognitively oriented learning theory of intrinsic motivation and sociology of professions theory [ 22 , 29 , 37 , 49 , 51 ]. These articles examined different types of learning and social processes (e.g., formal and informal acquisition of knowledge, zones for learning, professional socialization) occurring across different types of educational activities and settings (e.g., workplace based learning, QI projects, undergraduate or continuing professional development curriculum), and highlighted the complexity of delivering QIPS education and the interplay of the various factors that influence learning processes and outcomes.…”

“…Social science theories refer to a wide range of disciplines (e.g., anthropology, economics, psychology) concerned with human behaviours and their social and cultural aspects. The ten articles that drew upon social science theories were from the fields of psychology (n = 7), which included theories of planned behaviour, behavioural psychology, self-determination, self-efficacy, as well as activity theory that has origins in psychology [31,38,[45][46][47][48][49]; sociology (n = 2), which involved Bourdieu's concepts of field, habitus and capital and the sociological theory of professions [50,51]; and philosophy (n = 2), with both articles using realist evaluation [38,52].…”

“…Based on the theory that intention is the immediate antecedent of behavioural change, they requested participants to formulate an action to improve patient safety following the course, and then conducted follow-up interviews three months later to examine actions and understand gaps between intentions and behaviours. In six articles, theory provided an analytical approach for interpreting QIPS learning processes [22,29,37,43,49,51]. For example, de Feijter et al used activity theory as an analytic framework to highlight potential difficulties of learning about patient safety in the complex system of workplace learning [49].…”

An Interprofessional Yearlong Geriatrics Fellowship Program for Advanced Practice Nursing and Social Work Students

“…Fellows were assigned to complete a QI project either individually or in groups and in collaboration with a clinical setting with outcomes presented the last scheduled seminar. Teaching professionals QI skills has resulted in increased self-efficacy and positive system changes 21,22. Initially, fellows expressed confusion about the QI project as QI education can bring about tensions in the way different professions engage in this process 22.…”

Implementation of Multi-Professional Education: A Short Review of the Research Methodology and Biostatistics Course

“…Goldman et al through a sociological approach, mentioned that IPE and MPE represent different educational processes. 6 Barr et al defined "a multiprofessional course when members (or students) of two or more professions learn alongside one another: in other words, parallel rather than interactive learning". They stated that the difference between the two lies in the parallel educational process.…”