Health care systems are constantly under pressure to deliver more efficient and effective health care and improve patient outcomes. Interprofessional education (IPE) is seen as a vehicle through which to educate current and future health professionals to meet changing healthcare demands and improve health care delivery. The transformation in health pedagogy from a historical single discipline ‘silo’ approach to an interprofessional approach is complex and requires collaboration and commitment within and between various stakeholders including higher education institutions and health professional groups. The complexity associated with health system change creates unique challenges. This study explores the challenges to successfully implementing IPE within higher education health professional education in the Australian Capital Territory (ACT) through an in-depth investigation of staff attitudes towards and the barriers and enablers to IPE adoption. A mixed methods approach was undertaken throughout three empirical research stages: focus groups (Stage 1,Chapter 4); a case study analysis (Stage 2, Chapter 5); and, a survey (Stage 3, Chapter 6) of health education professionals in the ACT. Thematic analysis and statistical tests including basic frequency, ANOVA, MANOVA and Bonferroni were used to analyse the quantitative and qualitative data sets, respectively. Participants involved in the study were from three health professional groups: allied health, nursing and midwifery and medicine; and four higher education institutions: Australian National University, Australian Catholic University, Canberra Institute of Technology and the University of Canberra within the ACT. The mixed method approach allowed the triangulation of data collection and data analysis tools. Staff attitudes towards IPE have a significant influence on the successful implementation of IPE within health professional curricula. Overall, the study found that ACT staff attitudes to IPE were favourable. There were, however, differences in attitudes not only between each health professional group, but also between the higher education institutions, and between single health professional groups within each higher education institution. The identification of barriers and enablers to IPE play a significant role in the successful pedagogical change in health professional curricula. Attributing barrier and enablers to areas of responsibility enables a deeper understanding of the complexities of IPE. This research found that barriers and enablers are specific to stakeholder levels: Government and Organisation; Institution; and, Individual. Interactions within and between these three levels create complex tensions and synergies that hinder or enhance the embedding of IPE. These interactions, however, are dynamic and were shown to change across the three research stages, health professional group and higher education institution in areas such as: funding availability; restrictions imposed by professional associations; structure of health professional curricula; scheduling of clinical placements; and, staff and student involvement in IPE activities. Some of these factors have a dual role and can be both a barrier and an enabler. The varying degrees of interaction and dynamic nature of factors are captured within an IPE Higher Education Interactional Model developed from the findings of this study. In addition to developing a new model, this study compiled a unique list of enabling factors to IPE. In summary, the mixed methods approach, the developed survey, the Tertiary (health) Sector Acceptance of Interprofessional Learning Survey (TAILS),and the IPE Higher Education Interactional Model in this thesis provides a comprehensive means by which to explore the factors influencing IPE implementation and sustainability in the higher educational health sector. The methodology and tools derived can be adopted and adapted for use in other health care settings, different geographical locations and for capturing the changing relationships over time between stakeholders.
|Date of Award||2012|
|Supervisor||Judith Anson (Supervisor) & David Greenfield (Supervisor)|