Learning collaboration between primary and secondary care trainees: how to benefit optimally from primary care trainee hospital placements? A design based research project.

Summary video

View the 2-minute summary video highlighting the key findings 'Empowerment of residents for intraprofessional collaboration; the role of context, culture and power dynamics' on YouTube:

A 2-minute summary video highlighting the key findings of empowerment of residents for intraprofessional collaboration

Background

The growing number of patients with multimorbidity and chronic illness has a direct impact on the growing number of health professionals involved with a single patient. The tendency is to provide care in a primary care setting as much as possible. This involves many transitions of both patients and knowledge between hospital and primary care. These transitions bring an increased risk of mistakes. Collaboration between doctors at the primary-secondary interface is essential to guarantee continuity of care. Therefore, to collaborate well, General Practitioners(GPs), Elderly care Physicians(EPs) and medical specialists should not only be proficient in their own professional work but also have knowledge of each other's expertise and roles. There is growing evidence that interprofessional education(IPE) between different professionals improves interprofessional collaboration and patient care. The commonly held opinion is, that the same applies to intraprofessional education(intraPE) between doctors from various disciplines. There are many calls to pay attention to primary-secondary care collaborative competencies during medical specialty training. However, it is difficult to organize intraPE between primary and secondary trainees who have divergent training schemes. It is known that the co-location of trainees contributes positively to learning outcomes with respect to collaborative competencies. GP and EP trainees have a six month hospital placement(HP) in their second year(GP/EP-HP). This forms a natural workplace setting where trainees from different specialties are working at the same department and have the opportunity to collaborate. However, learning intraprofessional collaboration(intraPC) is not yet formalized during HPs. It is therefore unknown whether and how learning of intraPC takes place in an informal way during these placements. When primary care trainees work in a secondary care setting, they engage in a form of ‘boundary crossing’. In educational science ‘boundary crossing’ is used to describe the situation where a trainee works in a setting that is outside of the boundary of his own work setting and culture. Boundary crossing brings with it a host of learning opportunities and activities. These learning activities can hinge on the use of boundary objects: tools used by two social communities in different ways. For example a discharge letter which has a different function for primary care specialists than it has in secondary care. Educational activities around boundary objects can stimulate intraPC.

Aim

The aim of this research project is: (1)to study how learning of intraPC takes place during GP/EP-HPs (2)to develop a toolbox and (3)an educational intervention for learning intraPC by both primary and secondary care trainees during these placements (4)to develop design principles to assist in organizing GP/EP-HPs with a focus on learning intraPC, in addition to the acquisition of medical competencies.  

Method

This research is a design based research(DBR) project. Characteristic for DBR is the systematic study of designing, developing and evaluating educational interventions as solutions for complex problems in educational practice, which also advances knowledge about the characteristics of these interventions and the processes of developing them. Trainees, supervisors, teachers and educationalists have an active role in the design, implementation and redesign, in order to formulate robust design principles that can be applied in other environments. A. Preliminary phase leading to ingredients for a blueprint for the intervention: A1. Scoping review of the literature on learning outcomes of GP/EP-HPs. A2. An ethnographic non-participatory observational study in the hospital during GP/EP-HPs to study whether and how intraprofessional learning takes place. A3. In depth interviews with supervisors and trainees focusing on what primary and secondary care trainees learn during their placements, and on what and how they would like to learn. B. Prototyping stage B1. Expert groups will develop a toolbox of interventions for the learning of intraPC based on A, and will discuss which intervention seems most promising and why B2. Based on B1 the research group chooses one promising intervention and redesigns it. B3. This intervention will be implemented and qualitatively and quantitatively evaluated with all relevant stakeholders. B4. Based on B3 the intervention will be redesigned, implemented and again qualitatively and quantitatively evaluated in a new group of stakeholders C. Assessment phase C1. Relating the results of B (including process and effect evaluations) with educational theory- in particular boundary crossing. Determining design principles of the intervention. C2. Describing final deliverables: (I)toolbox of interventions for learning intraPC (II)qualitatively and quantitatively evaluated intervention (III)theory driven and practice based design principles for the learning of intraPC.  

Dissertation

Dissertation 'Empowerment of residents for intraprofessional collaboration: the…

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Products

Title: IPE & IPC: docenten maken het verschil!
Author: A. Moser, H. Smeets, W. Kuijer, M. Barry, M. Breteler, M. Schokking, N. Looman
Title: Relevance and practical implementation of interprofessional collaboration & education in GP specialty training and practice.
Author: N. Looman & N. Scherpbier
Title: Aios die stage lopen bij een ander specialisme, in hoeverre is het nuttig? (literatuuronderzoek)
Author: N. Looman, N. Scherpbier, L. Vastenburg, E. de Groot, J. de Graaf, L. Fluit
Title: How to use the research results for/ into your interprofessional education
Author: N. Looman
Title: Chances for learning intraprofessional collaboration between residents in hospitals
Author: N. Looman
Title: Why, What, How IPE: how to provide intraprofessional education for GP trainees
Author: N. Looman & N. Scherpbier
Title: Kwalitatief onderzoek naar intraprofessioneel opleiden van aios eerste lijn en aios tweede lijn tijdens hun ziekenhuisstage
Author: N. Looman, N. Scherpbier, M. van Wijngaarden, E. de Groot, L. Fluit
Title: The hospital: a potential learning environment for learning intraprofessional collaboration?
Author: N. Looman & n. Scherpbier
Title: Learning collaboration between primary and secondary care trainees: How?
Author: N. Looman, N. Scherpbier, M. van Wijngaarden, E. de Groot, L. Fluit
Title: Kansen voor het leren van intraprofessioneel samenwerken tussen eerste en tweedelijns aios tijdens ziekenhuisstages
Author: N. Looman
Title: De juiste opleiding op de juiste plek: een plaatje zegt meer dan 1001 voorbeelden
Author: Natasja Looman & Dieneke van Asselt
Title: Hoe kunnen opleiders geriatrie hun aios leren interprofessioneel samen te werken.
Author: N. Looman & D. van Asselt
Title: werkwinkel Interprofessioneel Opleiden voor Belgische huisartsen-opleiders
Author: N. Looman & N. Scherpbier
Title: Learning collaboration between primary and secondary care trainees: how to benefit more from primary care trainee hospital placements?
Author: N. Looman, N. Scherpbier, M. van Wijngaarden, E. de groot, L. Fluit
Title: Hackathon for GP (supervisors): Let’s hack complex health problems in an interprofessional team together with patients. How to implement this in our daily professional practice.
Author: N. Looman, N. Scherpbier, S. Pullen
Title: Grens overstijgend leren; hoe kunnen we boundaries benutten voor interprofessioneel leren samenwerken?
Author: N. Looman, M. Breteler, N. Scherpbier, L. Fluit, M. Janssen, M. Barry
Title: Learning collaboration between primary and secondary care trainees: how to benefit more from primary care trainee hospital placements? A design based project.
Author: Natasja Looman
Title: Learning collaboration between primary and secondary care trainees: how to benefit more from primary care trainee hospital placements?
Author: N. Looman
Title: interprofessionele samenwerking tussen eerste en tweede lijn, hoe kunnen aios dit leren?
Author: N. Looman, N. Scherpbier, M. van Wijngaarden, E. de Groot, L. Fluit
Title: Let’s hack complex health problems in an intra/interprofessional team together with patients. Intra-/interprofessional education method for medical specialty trainees: learning how to collaborate between doctors.
Author: N. Looman & N. Scherpbier
Title: The hospital: a potential learning environment for learning intraprofessional collaboration?
Author: N. Looman & N. Scherpbier
Title: Interprofessioneel leren en werken
Author: N. Looman & M. Breteler
Title: •Discipline Overstijgend Onderwijs: transmuraal leren samenwerken in de praktijk (voor eerste en tweedelijns aios regio OOR-ON).
Author: N. Looman, S. van Egmond, E. Kupers, C. Hazeldonk, N. Scherpbier, J. de Graaf
Title: webinar "hoe interprfessioneel ben jij?"
Author: K. keijsers, JJ. Reinders, E. Janssen, N. Looman
Title: In de schoenen van je transmurale collega: learning intraprofessional collaboration in practice (for primary and secondary care trainees regio OOR-ON)
Author: N. Looman, N. Scherpbier, J. de graaf, S. van Egmond, E. Kupers, m. Janssen
Title: In de schoenen van je transmurale collega: learning intraprofessional collaboration in practice (for primary and secondary care trainees regio OOR-ON
Author: N. Looman, N. Scherpbier, J. de graaf, S. van Egmond, E. Kupers, m. Janssen
Title: How to provide intraprofessional education for GP trainees
Author: N. Looman, N. Scherpbier, R. van Schie, E. Kupers
Title: Trailer movie 'Chances for learning intraprofessional collaboration between residents in hospitals'
Author: N. Looman
Link: https://youtu.be/HgexRHObkqc
Title: Audioversion of our paper Chances for learning intraprofessional collaboration between residents in hospitals
Author: N. Looman, L. Fluit, N. Scherpbier
Title: Aios leren samenwerken
Author: Natasja Looman & Dieneke van Asselt
Title: Chances for learning intraprofessional collaboration between residents in hospitals
Author: Looman N, Fluit C, van Wijngaarden M, de Groot E, Dielissen P, van Asselt D, de Graaf J, Scherpbier-de Haan N.
Magazine: Medical Education
Link: https://doi.org/10.1111/medu.14279
Title: Leer transmuraal samenwerken, ook in de opleiding!
Author: Looman N, Scheele F, Scherpbier-de Haan N.
Magazine: Huisarts & Wetenschap
Title: Handreiking voor transmuraal opleiden in de OOR ON
Author: M. Janssen, J. de Graaf, N. Scherpbier, N. Looman, A. Exterkate, E. Kupers (i.o. aios, opleiders en onderwijskundigen uit de OOR ON)

Subjects

Training, learning and professionalisation
General practitioner care
Specialist medical care
Multidisciplinary collaboration
Elderly

Features

Project number:
839130010
Duration: 95%
2018
2025
Related funding round:
Onderwijs 2017
Project lead and secretary:
drs. N. Looman
Responsible organisation:
Radboud Universitair Medisch Centrum

Elderly Medicine Research

To meet the changing care demand in the future, we need to improve the quality of elderly medicine. We therefore support academicization by funding PhD research projects for elderly medicine physicians training to become clinical researchers, and leave them with an abiding interest in research. Learn more about our ‘General Practice and Elderly Medicine Research’ Programme.