Interprofessional learning in the trenches: Fostering collective capability

Abstract

The greatest resource for improving interprofessional learning and practice is the knowledge, wisdom, and energy of professionals who adapt to challenging situations in their everyday work. We call collective capability the ability of a group of professionals to balance two interdependent levels of organization of practice: what professionals know and what they do collectively over time. Organizing what professionals know links the relational value--caring for patients--to the knowledge value of practice. Organizing what professionals do includes human and organizational factors that facilitate collective work and learning: technical skills for care delivery, institutional support, and a complex mix of emotional, ethical and moral factors involved in social decision-making. Performance gaps can result from a lack of an integrated knowledge framework or from a disembodied knowledge that is not anchored in practice. Opportunities for continuous learning can be seized by documenting the source of the performance gap, and providing the relevant resources to establish the balance between the organization of knowledge and the organization of work.

Effects of Facilitated Team Meetings and Learning Collaboratives on Colorectal Cancer Screening Rates in Primary Care Practices: A Cluster Randomized Trial

“…These approaches move beyond fi lling a knowledge defi cit on the part of patients or clinicians to enhancing the organization's capacity and resources for change. [13][14][15][16][17] Research on stakeholders-those individuals and groups who have an interest in and are infl uenced by the organization 18 -suggests that when stakeholders identify problems and generate their own solutions, they are more likely to engage in and sustain change processes. 19 Without the engagement, motivation, and commitment of key stakeholders within an organization, even meritorious innovations may be abandoned before they have had the chance to be effective.…”

Learning and Caring in Communities of Practice: Using Relationships and Collective Learning to Improve Primary Care for Patients with Multimorbidity

“…42,43 Although what the participants learn and do cannot be predicted, the context of their practice can be designed with strategies that support diverse participants and enhance collective learning. 40,55 Two of these strategies have a basis in human ecology: designing for community, and designing for emergent learning and practice.…”

“…Clinicians in these communities would improve patient care by building relationships, refl ecting on practice, selecting alternative care strategies, and accomplishing tasks by iterative exploration. 29,40,43 Testing the added value of communities of practice in primary care remains an empirical issue worth exploring in future research.To read or post commentaries in response to this article, see it online at http://www.annfammed.org/cgi/content/full/8/2/170. …”

“…When shared among different users, these narratives can stimulate further validation and learning. 42,43 In this sense, the community becomes a self-organizing and self-renewing knowledge management system through which clinicians can improve practice outcomes. …”

“…These collaborative processes facilitate the transition from uniprofessional care plans into interprofessional care plans and foster an iterative learning process that combines structure with renewed improvisations in the face of uncertainty, uniqueness, and confl icting values. 30,40,43,49,55,58,63,[75][76][77] Given the potential for group case-based learning, refl ective practice sessions could be fi lmed for further review and improvements, as well as a basis for student learning. …”