Intraprofessional workplace learning in postgraduate medical education: a scoping review

Abstract

Background Residents need to be trained across the boundaries of their own specialty to prepare them for collaborative practice. Intraprofessional learning (i.e. between individuals of different disciplines within the same profession) has received little attention in the postgraduate medical education literature, in contrast to the extensive literature on interprofessional learning between individuals of different professions. To address this gap, we performed a scoping review to investigate what and how residents learn from workplace-related intraprofessional activities, and what factors influence learning. Methods The PRISMA guidelines were used to conduct a scoping review of empirical studies on intraprofessional workplace learning in postgraduate medical education published between 1 January 2000 to 16 April 2020 in Pubmed, Embase, PsycINFO, ERIC and Web of Science. This study applied ‘best fit’ framework-based synthesis to map the existing evidence, using the presage-process-product (3P) model developed by Tynjälä (2013). Results Four thousand three hundred thirty records were screened, and 37 articles were included. This review identified influencing (presage) factors that derived from the sociocultural environment, learner and learning context. Studies described that complexity of care can both facilitate and hinder learning. Furthermore, intraprofessional learning is threatened by professional stereotyping and negative perceptions, and awareness of learning opportunities and explicit reflection are critical in intraprofessional workplace learning. Studies described a range of informal and formal intraprofessional activities (process) under the headings of collaboration in clinical practice, rotations or placements, formal educational sessions and simulated workplace training. In general, learners responded well and their attitudes and perceptions improved, learners reported increased knowledge and skills and positive behavioural changes (product). Learning outcomes were reported in the domains of patient-centred care, collaborative attitudes and respect, mutual knowledge and understanding, collaborative decision making, communication, leadership, teamwork and reflexivity. Conclusions This review gives insight into the high learning potential of intraprofessional activities. Many of the included studies relied on self-reported perceptions of change, therefore, future research should focus on generating more robust evidence including objectively examined outcome measures. This review offers a comprehensive overview of the factors that influence intraprofessional workplace learning in postgraduate medical education. Finally, we provide recommendations for enhancing intraprofessional learning in clinical practice.

Dental students’ attitudes and perceptions about intraprofessional collaboration/education

“…Undergraduate/postgraduate training programs, however, do not provide formal training in IPC/IPL; therefore, studies on this subject are scarce. 4 , 14 In one of the few studies published on this topic, trainees reported that IPC led to a better understanding of one another's professional roles, responsibilities, and behaviours. They observed that most extraprofessional learning occurs informally in the context of patient care.…”

Investigating the Effects of Intraprofessional Learning in Nursing Education: Protocol for a Longitudinal Study

“…In nursing education, the intent of IPL is for nurses to learn how to work with multiple health workers from different professional backgrounds to deliver the highest quality of care to patients, carers, families and communities [ 2 ]. Intraprofessional learning (IaPL) is the learning that occurs when individuals of two or more disciplines within the same profession collaborate [ 3 , 4 ]. Interprofessional learning and its positive effects are widely described in the literature [ 3 ].…”

“…Intraprofessional learning (IaPL) is the learning that occurs when individuals of two or more disciplines within the same profession collaborate [ 3 , 4 ]. Interprofessional learning and its positive effects are widely described in the literature [ 3 ]. Whilst IaPL is less well documented in health professional education, it has been reported in some studies, for example, dentistry students and dental hygienists learning collaboratively to deliver team-based care [ 5 , 6 , 7 , 8 , 9 , 10 ], occupational therapy and occupational therapist assistant students learning together [ 11 ], physical therapists and physical therapy assistants collaborating within the classroom [ 12 ] and intraprofessional workplace learning in postgraduate medical education [ 3 ].…”

Learning collaboration at the primary-secondary care interface: a dual-method study to define design principles for interventions in postgraduate training programmes

“…Primary and secondary care trainees acknowledge the importance of learning about PSCC but mention that explicit education in such collaboration is not provided. They mostly learn informally through interaction in the patient-care context [ 12 , 13 ]. To make such interaction more meaningful and create valuable learning opportunities, postgraduate training programmes should pay more explicit attention to learning about PSCC [ 14 ].…”